← Advancing Health
Loading summary
Transcript15 lines
- [00:01]
A
Welcome to Advancing Health. An increasing number of hospitals today are part of a larger health system. How can the big system support the mission of their local member hospitals while avoiding a one size fits all approach that may not work for everyone? As we recognize Community Health Improvement Week, we learn more about Michigan based corewell Health's approach, from technical support to collaborative community partnerships that helps each hospital or health system be the best it can be. My name is Andrew jagger. At the AHA today, it's my pleasure to be joined by two colleagues from Coralwell Health in Michigan. With me, we have Dr. Corey Smith and Vanessa Briggs. Today, as part of Community Health Improvement Week, we're going to talk a little bit about the role of a health system in supporting hospitals to maintain a really robust process in identifying and understanding the health needs of the local communities that they serve. Now I'd like to turn to our guests to hear a little bit about how you see the role of health systems like corewell Health in supporting local hospital efforts to identify, understand, and to address community health needs. Starting with Vanessa, how do you see the role of coralwell in this?
- [01:10]
B
That's a really great question. And some of the lessons I think that we've Learned here at CoralWell Health, it really does take a collaborative process, and that really requires diverse voices and perspectives and lived experiences because that engagement process is really critical because we think about when we do CHNA as an ecosystem and an ecosystem model that can be replicated across all three regions, given the span and reach that Coral Health has within Michigan. And so our CHNA ecosystem is made up of public health partners, health and human service organizations, community based organizations, as well as community advocates. And we also include our core health local community board representatives, and health professionals that have local but yet regional specific insight into the needs that are happening and needed within community. And so when we work alongside all of those individuals, when we call our ecosystem, it really allows us to deliver programs and work alongside our community to engage throughout the entire process for the chna.
- [02:29]
A
I love that Vanessa really taking that ecosystem approach and then intentionally bringing in those local community voices to create that strong effort. Corey, what would you add to Vanessa's response?
- [02:40]
C
Well, the one thing I would add is for a health system like Corwell Health, it can be sometimes easy to think, given our size, that we are kind of the main actor in a space. Right. And I think it's important, especially at the regional level and at the local level, to remember the kind of the legacy and positionality that some of these local hospitals have in their communities and that they are a part of the fabric. Right. And so I think in some of our regions, and one of the things that we're trying to lift up as best practice is to be conducting the needs assessment process as part of a collective. Right. A collective group in collaboration with public health departments, with local organizations, with school districts and other stakeholders that have some interest and where it's relevant for them to be aware of and participating in the process of defining community health needs. Right.
- [03:31]
A
Yeah. I love that sort of intentionality of recognizing the true complexity of across the communities, the legacy, different perspectives, and the intentionality of bringing all those together in a process is great. So moving on to that process, I guess I'd ask Vanessa, from the system level, what would you say are some of the most important resources or tools that you can use to support that local priority identification?
- [03:56]
B
Yeah. At coralwell, we firmly believe that technical support to help prioritize and help our local hospitals and stakeholders, it really has to align on focus areas effectively. And so having that technical support that Corey's team actually provides for my team in healthier communities is critical to the success. And that's a huge resource that's beneficial to us. And I'm sure Corey has some other examples that he would like to share in terms of some resources as well.
- [04:29]
A
Yeah, I'd love to hear Corey's thoughts, especially around what do you think about when you try to balance standardization across the hospitals in your health system and data collection, reporting, et cetera, with the flexibility that local teams really need to get at those needs and address them in a local way.
- [04:45]
C
Yeah. It's one of the main tensions that we wrestle with. Right. And it can be enticing to want to go with standardizing across systems. Right. It's simpler. You know, you can feel like you're focusing, but when you bring it to local stakeholders, it can feel misaligned with what they actually need and what they experience. So, you know, I think stepping back from the actual process of identifying the needs, rather than bringing forth a standard set of here are the needs that we're going to identify at each hospital across our system. We try to frame it as, here is our broad theory of change for how we think we can address health needs across the Coral health service area. Right. We think we need to have a balanced approach to investing in initiatives that are going to create change at lots of different levels. And so rather than saying this is exactly, you know, the condition or the need that you need to work towards trying to offer a way to work rather than a how to work, I think is a critical part of what we try to bring into both the chna, the community health needs assessment process, but also the development of the strategies and response to that process. So I think that's part of the way we balance that tension. And then we've thought a lot about, you know, what does a system sort of backbone look like for local teams doing this work and what kind of technical support can we bring to the table, whether it's, you know, in the, in the form of how to create better surveys, whether it's in the form of bringing forth access to publicly available data sets that look more at community need, mining census data, mining other forms of information that, you know, that communities themselves, they may have the capacity but not the time necessarily to do that work. And even more recently, what tools are available from a technology standpoint side now that even boost the efficiency of accessing that kind of information even more? Right. There are tools now that, you know, make that an even simpler process. And then how do we make that data more publicly available to people to use as part of the CHNA process or in their own work? Right.
- [06:50]
A
Those are such good examples of kind of how you think about balancing that tension, as you mentioned, between kind of having a standard set of measures and having things resonate with the local communities that you serve. You've talked about. I think, Vanessa, there are three regions across Michigan that you serve. So I wonder from a practical level, what does this work look like? Could you share how it plays out maybe in one of the initiatives from one or two of those regions?
- [07:15]
B
So the way that we like to approach our work is we sort of like to say we use a system wide approach and we're developing what we're calling program portfolios that allows us to encapsulate programs that healthier communities can deliver at a regional level. This approach gives us a system wide strategy, but. But it gives us local context within the regions across east, west and south by addressing the needs that we have identified within our 21 hospitals. And so examples of those programs, it ranges from doing school based clinics on the east side of the state, where we're actually providing primary care in the school for our students as well as for residents in community. In the west side of the state, we have a school nursing program that allows us to have a different model, but yet still in the schools, providing training for the school administrative staff, providing basic care for our students in the schools and helping them manage their chronic diseases, whether it's asthma or diabetes. So that's why we're able to sort of customize our approaches, but yet still, still have, if you will, a collection of programs in a portfolio that addresses the needs of children, adolescents in a school environment. And so that's a good way and a good example to show how you can have a system wide strategy, but yet still keep it very, very local based off of the needs that are in community, the partnerships that we have in community. Because we know, as I mentioned, it takes an ecosystem to do this work. And so Coral has deep relationships with other nonprofits within organizations to help us execute programs, whether it's prevention programs, chronic disease management programs, and even coalition building and doing what we like to call collective impact work. And so it's a variety of programs and interventions that are derived from our implementation plans and as you know, come from the priorities that are identified in our community health needs assessments.
- [09:34]
A
Such a powerful example, I think, of the ways that you're thinking about understanding what are the local assets of your communities and then partnering to address those needs in a way that is really having an impact across the state. So thank you for that work, Corey. One of the questions I frequently get, and I imagine maybe you hear something like this too, is how do we show the impact of the work that we're having, both through metrics as well as through sharing the stories of the work across our communities? So how do you share your work in a way that gets people excited about the work you're doing, brings in partners, and also that can help to develop a system wide culture of learning, adaptation and continuous improvement?
- [10:13]
C
Definitely a question that I get. You know, my background is in evaluation, and so this is something I've been thinking a lot about at corewell Health for the time I've been here. And I think the question that's been sitting in my head for five years has fundamentally been how do we evaluate at scale? You have three regions with, you know, over 100 individual initiatives. How do you think about evaluating at scale? Right. You want to have evaluation where it makes sense, but you also have limited resources. And so what we've been doing is working to establish a systematic way of making choices with our regional leadership about where to invest evaluation resources based on local priorities. Right. So really trying to define first, where do we need to do this evaluative work? Where do we feel it's most important for us to either generate learning or evidence of impact, and then through that, designing evaluation and monitoring processes that are really going to help us hone in on the indicators that are going to be useful for tracking our progress over time, but also the critical outcomes that our stakeholders have helped us develop, that our regional leadership has decided are most important. And then it's just a technical task, right? Then it's designing methodologies, whether they're quantitative or qualitative, whether they're optimally mixed. You know, the application of both is most often the best way to answer the evaluative questions that you may be trying to answer. The last thing I'll say about that is, you know, we really have been working to try and establish a set of regional sort of priority indicators that can serve as a guidepost where they're not going to be right the first time and they're going to have to get better over time in terms of their relevance to local need. But really trying to establish what are some of our, you know, our North Stars, our guideposts that we can organize around as we try to make decisions about what to do and where to invest some of our resources.
- [12:16]
A
Really well said. Vanessa. Any last words? I mean, a lot of the listeners are health system leaders, so what do you think they need to know about supporting a process that's locally led and owned with the system level resources?
- [12:30]
B
The way that I sort of think about it is it really is important to have a system wide strategy. As I mentioned, whether or not it's in the interventions, in creating portfolios to allow you to house like programs, or whether it's having Corey's team do evaluation, provide technical assistance across the entire system in doing our community health needs assessment. But what's most important and critical is that that system wide strategy still needs to have and allow for adaptability and customization based off of local context. While we can move to centralize and provide benefits from economies of scale within a system wide approach, we can't lose sight that the relevance and the effectiveness of addressing unique needs at a local level or regional level is still critically important because that's when you're able to address the needs that have been identified within community. And I think that that's what's most important. We can have system wide strategies, but that local context is what really matters because then we know we're moving the needle to address health disparities, access to care, partnering with organizations, addressing transportation, food access.
- [14:02]
A
Thank you so much for encapsulating really the important work that hospitals do across the country every day to support their communities and to help people be as healthy as they can be. Well, thank you to each person listening for the work that you do to support health and resilience of your communities. Community Health Improvement Week is really about recognizing the important work that you do every day on behalf of America's hospitals and health systems, and more importantly, the communities that we all serve. Special thanks to Vanessa and Corey for sharing your thoughts and expertise for the great work that you're doing at corewell for Michigan Communities. Be well and until next time, this is Andrew Jagger from the aha. Wishing you all a very happy Community Health Improvement Week. Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts.