In 2012 the Internal Revenue Service mandate that all non-profit hospitals undertake a community health needs appraisal (CHNA) that year and every three years thereafter. Further, these hospitals need to file a report every year thereafter detail the progress that the community is making towards meeting the indicated needs. This type of appraisal is a prime example of primary prevention strategy in population health management. Primary prevention strategy focus on prevent the occurrence of diseases or brace the resistance to diseases by focusing on ecological factors generally.
I believe that it is very lucky that non-profit hospitals are carrying out this activity in their communities. By assessing the needs of the community and working with society groups to improve the health’s of the community great strides can made in improving public health’s, a key determinant of one’s overall health. As stated on the Institute for Healthcare improvement Blue Shirt Blog (CHNAs and Beyond: Hospitals and Community Health Improvement), “There is growing credit that the social determinants of health – where we live, work, and play, the food we eat, the opportunities we have to work and exercise and live in safety – drive health outcome. Of course, there is a large role for health’s care to play in delivering health care services, but it is beyond doubt that the foundation of a healthy life lies within the community. To manage true population health – that is, the health of a society – hospitals and health systems must partner with a broad range of stakeholders who share ownership for civilizing health in our communities.” I believe that these types of community participation will become increasingly important as repayment driven by value.
Historically, healthcare providers have managed the health of persons and local health departments have managed the community setting to promote healthy lives. Now, with the IRS condition, the work of the two is start to overlap. Added to the recent connection of the two are local coalitions and community organization, such as sacred organization.
The community in which I live provide an excellent example of the new interconnections of various organization to collectively improve the health of the society. In 2014 nine non-profits, with three hospitals, in Kent County, Michigan conducted a CHNA of the county to assess the strength and weakness of health’s in the county and to assess the community’s perception of the pressing health needs. The assessment finished that the key areas of focus for civilizing the health of the community are:
- Mental health issues
- Poor nutrition and obesity
- Substance abuse
- Violence and safety
At this time the Kent County Health Department has begin rising a strategic plan for the community to address these issues. A wide variety of society groups have begun assembly monthly to form this planned plan. There are four work groups, one for each of the key areas of heart. I am involved in the Substance Abuse workgroup as a envoy of one of my clients, Kent Intermediate School District. Other members include a substance abuse prevention coalition, a federally qualified health center, a substance abuse action center and the local YMCA, among others. The local hospitals are involved in other workgroups. One of the treatment group council is a co-chair of our group. The health department wants to sure that the planned plan community driven.
At the first meeting the health department control stated that the planned plan must be community driven. This is so in order that the various agencies in the community will buy into the planned plan and will work kindly to provide the most effective prevention and conduct services without overlap. The dollars spent on services will be more successful if the various agency work to enhance each others’ work, to the extent possible.
At this time the Substance Abuse work group is probing relevant data from the 2014 CHNA survey and from other local resources. The epidemiologist at the health’s section reviewing relevant data with the group so that any decisions about the goals of the planned plan will data driven. Using data to make decisions is one of the keystone of the group’s operating principles. All objectives in the planned plan will be specific, measurable, attainable, realistic and time-bound (SMART).
Once the planned plan finished, the groups will continue with implementation of the plan, evaluating the outcomes of the completion and adjusting the plan as wanted in light of evaluation. As one can see, the workgroups of the CHNA are following the classic Plan-Do-Check-Act process. This process has been shown time and again in many settings-healthcare, business, developed, et al-to produce excellent outcome when properly followed.
As noted above I recommend that healthcare providers become involved with the public groups to apply population level health running strategy to improve the overall health’s of the community. One good area of involvement the society Health’s Needs Assessment project being implemented from side to side the local health section and non-profit hospitals.