The Internal Revenue Service required all non-profit hospitals to conduct a community health need assessment (CHNA), in 2012 and every three years thereafter. These hospitals must file reports each year detailing how the community is meeting these needs. This assessment is an example of a primary prevention strategy in population management. Primary prevention strategies are designed to prevent the occurrence or increase resistance to diseases. They also focus on environmental factors.
This activity is carried out in communities by non-profit hospitals, which I consider very lucky. It is possible to make great strides in improving the public health, which is a major determinant of one’s overall health. According to the Blue Shirt blog of the Institute for Healthcare Improvement ( CHNAs and Beyond : Hospitals and Community Health Improvement), “There is increasing recognition that the social determinants o f health – where you live, work, eat, and have the opportunity to exercise, and work safely – are key determinants of your health. This will impact your health outcomes.” While there are many roles for health care in providing health care services, it is clear that the core of a healthy lifestyle is found within the community. Hospitals and health systems need to partner with diverse stakeholders in order to manage true population health, which is the overall health of a community. These types of community involvement will be more important as reimbursement becomes driven by value.
Healthcare providers have historically managed the health of people, while local health departments have managed communities to promote healthy living. The IRS has made it mandatory that both the IRS and local health departments work together. The two have been connected by local coalitions, community organizations, and religious organizations.
My community is a great example of how different organizations can work together to improve the health of the entire community. A CHNA was conducted in Kent County, Michigan by nine non-profits in 2014. The purpose of this assessment was to determine the strengths and weaknesses in health and the perceptions of the community regarding the most pressing health issues. According to the assessment, the following are the areas that need to be improved in order for the community’s health to thrive:
* Mental health issues
* Obesity and poor nutrition
* Substance abuse
* Safety and violence
The Kent County Health Department began developing a strategy plan to address these problems. This strategic plan has been developed by a variety of community groups that meet monthly. There are four workgroups, one for each key area of focus. As a representative for Kent Intermediate School District, I am part of the Substance Abuse Workgroup. The Substance abuse prevention coalition, a Federally Qualified Health Center, a substance treatment center, and the local YMCA are some of the other members. Other workgroups are also supported by local hospitals. Our group has a co-chair, one of the representatives from treatment groups. The health department wants to ensure that the strategic plan is community-driven.
The health department leadership stressed that the strategy plan should be community-driven at the initial meeting. The strategic plan must be community driven so that all agencies within the community can buy in to it and work together to provide the best prevention and treatment services. Spending more money on services will be more efficient if all agencies collaborate to improve each other’s work.
The Substance Abuse Work Group is currently reviewing relevant data from both the 2014 CHNA Survey and other local resources. So that the strategic plan’s goals can be determined, the epidemiologist from the health department will be reviewing the relevant data with the group. One of the core principles of the group’s operation is the use of data to make decisions. The strategic plan should contain specific, measurable and achievable goals that are realistic, time-bound, and achievable.
After the strategic plan has been completed, the workgroups will continue to implement the plan. They will evaluate the results and adjust the plan as necessary in light of that evaluation. The CHNA workgroups are following the Plan-Do-Check-Act method. This process is proven to produce great results in many settings, including business, healthcare, manufacturing, and other industries.
As I mentioned above, I recommend healthcare providers get involved in community groups to implement population-level health management strategies to improve overall health. The Community Health Needs Assessment Project, which is being carried out by the local health department as well as non-profit hospitals, is a good example of how you can get involved.