The following recommendations are based on a study of 12 successful population health collaborations nationwide.
With a broken bus system in inner-city Detroit, some pregnant women had no access to proper prenatal care. The city's infant mortality rate was climbing — it was comparable to the rate in some underdeveloped nations. The crisis spurred collaboration between four local health systems and public health agencies, called the Detroit Regional Infant Mortality Reduction Task Force.
The collaboration, successfully implemented in three Detroit neighborhoods, used trained "navigators" to go out into public places to build trust with young women and provide access to health resources and prenatal care services. Due to the successful collaboration, three more Detroit neighborhoods are expected to benefit from the task force.
As the U.S. aims to better align health expenditures with health outcomes in our communities, population health collaborations like this in Detroit are becoming more common. They are forming among hospitals and public health agencies to address individual communities' most pressing public health needs.
Twelve successful and diverse hospital-public health collaborations, including the infant mortality collaboration in Detroit, were examined in a recent study directed by Lawrence Prybil, PhD, of the University of Kentucky College of Public Health. The study examined partnerships across the country to determine patterns in their origins, organization, mission, goals, challenges and strategies for success. The following 11 recommendations to achieve success in population health initiatives were suggested based on data from the study:
- Establish hospitals and public health agencies as core partners in the collaboration. These core partners should work to establish a sense of collective action among private and public organizations and promote a "culture of health" within their communities. School systems, health plans, universities, local governments and the business community can help create a broad-based understanding of community-wide health.
- Build trust-based relationships. All partners involved must operate on trust-based relationships for the collaborations to be as successful as possible. This means partners must openly communicate with each other and help each other track progress.
- Adopt a clear mission and goals. Most communities will have more than one specific need, but the collaboration should prioritize and identify a community's most pressing health needs. Focusing on high-priority issues will enable the organization to set clear, obtainable goals and foster interest, support and engagement within the community.
- The collaboration must establish "anchor institutions" dedicated to supporting the mission financially. Often small organizations band together to advocate for a cause, but for a collaboration to have significant impact and long-term success, at least one anchor institution must be identified to form the foundation of economic support. Expanding financial support should be a priority.
- Designate a governing body and establish a charter. Often public health collaborations begin informally, however, the most successful have a clearly defined group to make decisions and set policies for the collaboration. This charter should be defined, reviewed and updated regularly.
- Build an understanding of population health concepts and principles within the organization and the community. Deliberate and define these principles and continuously revisit them as healthcare evolves.
- Specify quality measures, objectives, metrics and tools to track success. It may be necessary to enlist experts from universities and professional associations to assist in creating an objective, scientific process to measure and assess change.
- Produce "impact statements" comparing the effects of the organization with the costs. Based on outcomes, produce and share impact statements to determine the effectiveness of the collaboration. If collaboration is not working, the impact statements can help determine how much more support is needed to create a significant impact within a community.
- Devise strategy to broaden and diversify sources of funding. Use the impact statements to secure more interest and apply for grant funding.
- Establish oversight committees. This should be done by the governing boards of nonprofit hospitals and health systems and the boards of local health departments. These boards will be responsible for determining their respective organization's role, priorities, and performance in population health in their community, and in creating future collaborations to address these needs with other community organizations.
- Local, state and federal agencies should adopt policies to make population health collaborations and partnerships possible and promote their development. These policies can create public awareness, as well.
The following collaborations were included in the study: California Healthier Living Coalition, based in Sacramento, Calif., Detroit Regional Infant Mortality Reduction Task Force, Fit NOLA Partnership in New Orleans, Healthy Cabarrus based in Kannapolis, N.C., Healthy Monadnock 2020 based in Keene, N.H., Healthy Montgomery based in Rockville, Md., Hearts Beat Back: The Heart of New Ulm Project based in New Ulm, Minn., HOMEtowns Partnership, MaineHealth, based in Portland, Maine, Kaiser Foundation Hospitals and Health Plan, based in Oakland, Calif., Quad City Health Initiative based in the Quad Cities, Iowa and Illinois, St. Johns County Health Leadership Council, based in St. Augustine, Fla., and Transforming the Health of South Seattle and South King County based in Seattle.
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