ELISSA BASSLER, ILLINOIS PUBLIC HEALTH INSTITUTEBONNIE CONDON, ADVOCATE HEALTH CARE

Stakeholder Health—Chicago September 25, 2015

It started with relationships and possibility

Then there were more….

Transformational Collaboration

In order to transform our communities, we must transform ourselves.www.stakeholderhealth.org

The Meeting

February 15, 2015

Shared Goals, Bold Leaders

Individual egos were “left at the door” Invitation to be part of a movement Individuals and entities desired to “make a

difference” and move the needle on health issues All non profit hospitals must do CHNA All public health departments must do IPLAN All wanted to meet their regulatory requirements Initial group developed suggested model/timeline All participants own the group

Setting The Context

Vision/Rationale

Efficiency Effectiveness Collective Impact National Pilot Beyond health fairs,

disease management, health promotion

Vision/Rationale

The State of Community Health

City planners are increasingly aware of health benefits of clean, living landscapes

New Models of Care

Triple Aim Reduce costs, better patient experiences and

improved population health outcomes Crossing the Moat

Population health moves us beyond the walls of the hospital and upstream in our communities

Data-driven The more we know, the better we are at serving

“Effective partnerships take an integrative, innovative approach to solving problems in communities…These partnerships can help improve health while also providing benefits for the economy, housing, transportation, education and other sectors.” –Trust for America’s Health

Social cohesion and shared value of health

• Advocacy, public service education and media campaigns • Improved public planning (e.g., infrastructure to encourage walking, environmental hazard reduction) • Civic leadership development and youth empowerment • Communitywide events or challenges (weight loss, sponsored runs) • Community volunteer efforts to address socioeconomic drivers, physical environment or health (volunteer tax preparation, tutoring, volunteer neighborhood improvements)

Improved quality, efficiency and equity of health and health care systems

• Expanded access to health care services • Expanded insurance coverage • Navigation and advocacy assistance (insurance enrollment, connections to health and social resources, financial assistance, community health workers) • Discounted services (prescriptions, health and ancillary services, equipment)• Wellness programs and community outreach (e.g., screenings, primary care, wellness education, support groups, prevention, educational resources) • Chronic disease management and improved care coordination • Culturally appropriate approaches to outreach and care

Opportunities for Hospitals to Partner for a Culture of Health

Health Research & Educational Trust, AHA, RWJF. (2014, October). Hospital-based Strategies for Creating a Culture of Health.http://www.rwjf.org/content/dam/farm/reports/reports/2014/rwjf416021

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Multisectoral collaboration to build health partnerships

• Convening & collaborating with community stakeholders (e.g., fire/police departments, public health departments, churches/faith communities, senior centers, schools, community members, etc.) • Networks of collaborating providers to offer care for vulnerable pops• Pooled resources and initiatives to achieve collective impact • Seamless services (physical health, behavioral health, social, emergency, housing, transportation, crisis and other services) • Collaborative data systems for tracking, analysis and evaluation

Improved and equitable opportunity for healthy choices and environments

• Investments in community development to reduce socioeconomic insecurity − Local economy stimulation − Availability of affordable housing − Community infrastructure/asset building • Addressing food deserts • Healthy food and beverage procurement• Services to provide social and basic needs (reading/literacy, crisis intervention, life/job-skill building, clothing and basic supplies) • Workforce capacity development and local hiring • Reduction of environmental hazards and improved env sustainability

Opportunities for Hospitals to Partner for a Culture of Health

Health Research & Educational Trust, AHA, RWJF. (2014, October). Hospital-based Strategies for Creating a Culture of Health.http://www.rwjf.org/content/dam/farm/reports/reports/2014/rwjf416021

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New Models for CHNAs

Collaboration is desired Regulations encourage joint planning,

both with CHNAs and implementation plans

Clarification that allows hospitals to focus more clearly on social determinants

Increasing community engagement and strengthening partnerships by broadening the stakeholder pool

Developing strategies and methods to evaluate broader impact

OpportunityCommon Problems, Common Priorities

2012 review of LHD IPLANS for NIPHC

NIPHCChicago

CookDuPageGrundyKane

KendallSkokie

McHenryWill

Winnebago

OpportunityCommon Problems, Common Priorities

Review of Chicago and Suburban hospital CHNAs (n=31)

Top priorities

Priority Number PctObesity/Heart Health/CVD Risk Factors 25 81%

Access to Care 22 71%

Mental Health and Dementia 16 52%Diabetes/Chronic Kidney Disease 13 42%

Violence/Injury 9 29%

The Model

CHNA Principles (Sarah Rosenbaum, GWU)

Multisector collaborations; shared ownership Community engagement to improve results Community definition: population wide

interventions + targeting health disparities Transparency Evidence-based interventions & innovative

practices Evaluation /continuous improvement Quality data from diverse sources

Collective Impact Conditions of Success

Common Agenda Shared Measurement Systems Mutually Reinforcing Activities Continuous Communication Backbone Support Organizations

John Kania and Mark Kramer; Stanford Social Innovation Review; Winter 2011

IRS & Collaborative CHNA

Separate CHNA reports While a hospital facility may conduct its CHNA

in collaboration with other organizations and facilities … every hospital facility must document the information … in a separate CHNA report …If a hospital facility is collaborating with other facilities and organizations in conducting its CHNA .... portions of the hospital facility's CHNA report may be substantively identical to portions of a CHNA report of a collaborating hospital facility

Shared Governance

IPHI – Process Facilitators Steering Committee

Central Leadership Team (CLT)

Central Stakeholder

Advisory Team (SAT)

Broad Stakeholder

s and Community

Groups

North Leadership Team (NLT)

North Stakeholder

Advisory Team (SAT)

South Leadership Team (SLT)

South Stakeholder

Advisory Team (SAT)

Data Committee

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Steering Committee

Strategic Thinking, Vision and Leadership Process Design and Planning Recruitment and Engagement of

Hospitals and other Stakeholders Seeking Resources Including External

Funding Initiating the Robert Wood Johnson

Foundation (RWJF) Evaluation Project

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Regional Leadership Team (RLT)

Representative from each hospital with CHNA responsibility + local health department/s staff as applicable

RLT works with IPHI to design and implement process and data collection; liaise with other hospital staff; liaise with community (provide hospital data as determined by group; assist with

survey distribution and collection; assist with organizing focus groups

Identify Stakeholders Participates in monthly planning conference calls with IPHI Lead who liaises with IPHI, handles region

communications, scheduling and logistics for the process

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Stakeholder Advisory Team (30-50)

1) Participate in a series of 8-10 meetings between May 2015 & August 2016

2) Contribute to developing the Collaborative’s vision and values.

3) Provide input on design of the assessments, including data indicators, surveys, focus groups, and asset mapping.

4) Share data that is relevant and/or facilitate the participation of community members to provide input through surveys and focus groups.

5) Review assessment data and assist with developing findings and identifying priority strategic issues.

6) Participate in action planning to develop goals, objectives and strategies for improving community health and quality of life.

Also have the opportunity to join and shape implementation efforts that will follow this process.

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Stakeholder Advisory Team (SAT)

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Data Advisory CommitteePurpose:• Review/recommend additional indicators• Define/discuss data issues/needs• Provide input on data collection for Community

Themes and Strengths Assessment• Foster “data” communication with N/C/S

regions

Structure:• Collaborative-wide (north, central and south)• Steering committee representative• CCDPH/CDPH/IPHI representatives• 2 representatives from each region• May also include ad-hoc members as the

committee grows28

Three Regions• North• Central• South

The Assessment Process

MAPP Process

Mobilizing for Action through Planning and Partnership

Strategic Thinking

Requires broad-scale information gathering

Encourages exploration of alternatives Places emphasis on future implications of

present decisions Facilitates communication and

participation Accommodates divergent interests and

values

CHSA

CTSA

LPHSA

FOCA

Indicator Categorie

s

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Community Health Status Assessment

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BRFSS/YRBSHIV

CDC ENVACS/Census

Social Vulnerability Index

Vital RecordsState/Local Police

Hardship IndexChild Opportunity

IndexIL Cancer Registry

OtherUSDA

COMP dataFinalize tables &

presentation

July =================================> Oct

Timeline Overview

Mar April May June July Aug Sept Oct Nov Dec Jan Feb Mar April May JuneJuly Aug Sept Oct Nov Dec. Jan Feb MarchApril May June

Partnership Development

Plan Assessments (CLT & SAT)

Community Health Status assessment

LPHSA&FOCA review

Community Themes and Strengths Assessment

CHSA Review and findings

CTSA Review & Findings

Strategic Issues

Complete Collaborative CHNA report

Hospitals develop individual chapters

Hospital Approvals

CHNA Filing/Posting

Convene Priority-area Action Teams/train on goals & objectives

Technical assistance to 5 action teams per cluster

Compile/write Implementation planHospitals develop individual local implementation goals if any

Hospital approvals

Post Implementation plans

IPHI Support for collabortive activity

Individual Hospital efforts

IRS Fil ings (depending on hospital fiscal year)

IMPLEMENTATION PLAN DEVELOPMENT

CHNA DEVELOPMENT20172015 2016

Mission, Vision, Values

Mission, Vision and Values – It’s Official!

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Mission:The Health Impact Collaborative of Cook County will work collaboratively with communities to assess community health needs and assets and implement a shared plan to maximize health equity and wellness. 

Vision:Improved health equity, wellness, and quality of life across Cook County

Values

① We believe the highest level of health for all people can only be achieved through the pursuit of social justice and elimination of health disparities and inequities.

② We value having a shared vision and goals with alignment of strategies to achieve greater collective impact while addressing the unique needs of our individual communities.

③ Honoring the diversity of our communities, we value and will strive to include all voices through meaningful community engagement and participatory action.

④ We are committed to emphasizing assets and strengths and ensuring a process that identifies and builds on existing community capacity and resources.

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Values

⑤ We are committed to data-driven decision making through implementation of evidence-based practices, measurement and evaluation, and using findings to inform resource allocation and quality improvement.

⑥ We are committed to building trust and transparency through fostering an atmosphere of open dialogue, compromise, and decision making.

⑦ We are committed to high quality work to achieve the greatest impact possible.

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What’s Next?

Results from Collaborative CHNA

Layout-ready/template Collaborative CHNA report with IRS requirements

Layout-ready/template Collaborative Implementation Plan

Formal Evaluation Action-ready community and cross-

hospital partnership to support collective impact Vision for the future……

It started with relationships and possibility…

It continues with hard work and vision…

The future looms with hope and dreams….

Thank You!