A hospital CEO I know made rounds of his facility recently and stopped by the emergency department. A patient was raising Cain because he had been waiting four hours.
“Why are you here?” the CEO said. “A toothache,” the man said angrily. “Why don’t you go to the dentist?” wondered the CEO. “I don’t have one, so I came to the ER,” the patient replied.
This isn’t unusual — someone in the wrong place, waiting too long, angry and blaming the hospital. Ask CEOs, and they’ll tell you it’s a growing problem: Care and services are changing dramatically, making it harder for patients and family members to understand what it means for them. Are patients missing out on opportunities and benefits? Are hospitals, networks and other providers missing out as well? Could they benefit from better educating their constituents?
The answer to these questions is, of course, yes. There is much to be gained if both parties understand each other and know how the health care dynamic has changed for each. The first rule of thumb for engagement and education appears to be creating a two-way street between the provider and the community, which includes schools, nonprofit groups, businesses, developers, faith-based organizations and government. “Listening” groups, events and initiatives have become an essential part of health systems’ ability to educate themselves to better educate citizens.
The American Hospital Association has taken the lead in helping providers reorient and expand their patient and community education efforts — encouraging organizations to be more “activist” and “upstream” in their outreach, for example. Smaller regional and community-level initiatives are cropping up as well. The Centers for Disease Control and Prevention’s Community Health Improvement Navigator provides a wealth of information on engagement and education.
A new mindset in community health outreach
Better educating constituents on changing philosophies and service models requires a shift in thinking within a hospital's leadership team and the organization. Allow me to share some of the best practices I see emerging:
- Revisit your mission. I’ve been privy to board meetings several times in the past year in which it dawned on trustees that they have to change their mission if they are to fulfill strategies aimed at population health and wellness. An organization’s mission should go beyond caring for the sick and needy or providing quality health care; it should include community engagement, involvement and collaboration with diverse stakeholders. Mission statements and values should be short and sweet yet as encompassing as necessary. Trustees need to leave room for the two-way street.
- Set the stage internally. Aggressively communicate the importance of community education. Get everyone on the same page. “A redefined hospital and health care system can be achieved only through mutual trust and transparent, two-way collaboration among C-suite leaders, boards of trustees, multidisciplinary teams and a diverse group of community stakeholders,” write Thomas W. Burke, M.D., chair of the 2014 AHA Committee on Performance Improvement, and Jonathan B. Perlin, M.D., immediate past chairman of the AHA board and chair of the 2014 AHA Committee on Research. (See “Collaborating with Communities to Redefine the Hospital.”) Organizations can educate their entire staff, at all levels, on the benefits of community and on the uniqueness of the communities they serve. Striving to become a culturally competent organization can go a long way toward connecting with the community and demographics served.
- Engage with the community at the grass roots. “Move outside your hospital’s comfort zone to listen to voices and perspectives that often go unheard in general hospital meetings and planning sessions,” recommended the Committee on Performance Improvement following “community conversations” it held throughout the country. Other recommendations that came out of those conversations include holding community forums, enhancing the quality of community health needs assessments and prioritizing public-private partnerships.
- Embrace the consumer aspect of reform. Once providers view patients and constituents as health consumers, they can set about innovating, improving the experience and better providing for individuals and groups with diverse health and wellness needs. Expert marketers know that consumers expect familiarity and trust before they will buy a new product; this philosophy can be extended to a health care organization and the new products and services it is offering.
- Get creative about social media. Providers have had real success interacting with consumers on Facebook, Twitter and other forms of social media. They are pushing communication directly to individuals and are receiving direct feedback from consumers, enabling a real-time dialogue between patients and caregivers that has not previously existed in health care.
- Build community outreach into executive responsibilities and contracts. The organization and its board can review and modify executive job descriptions. There should be a written expectation that executives be integrally involved with patients, charities and other community partners through social events, town hall meetings, committee activities and more. It’s important to spell out clearly what is expected of each executive — from the chief executive officer on down — in regard to interacting with and serving the community. This is particularly true for positions tied to care delivery such as chief operating officer and chief medical officer, but also for the heads of finance, human resources, information and other departments. Many networks are creating new executive roles — chief experience officer and chief population health officer come to mind — with strong patient and community obligations. This is a positive trend but does not relieve other leaders from their responsibilities to reach out. As organizational performance metrics become more closely tied to community health and wellness, incentives related to delivering on population health and community engagement initiatives can be added to executive pay and bonuses.
- Study and learn from peer organizations and market leaders. Hospitals and health networks nationwide have developed creative community engagement, assessment and outreach programs. Information about these programs is readily available on the internet as community health needs assessments and implementation strategies — required of tax-exempt organizations under the Affordable Care Act — are posted on organizations’ websites. Advocate Health Care, Cleveland Clinic and Kaiser Permanente all run good programs. Leading health systems are also more than willing to highlight corporate social responsibility and community-based initiatives. Few systems have the resources of Advocate or Kaiser, but there are many examples of inventive community initiatives for smaller organizations to emulate.
- Provide the community with clear resources and contacts. Cleveland Clinic, for instance, has developed working collaborations with more than 200 community groups over the years. It boasts a full regional coordination team within its office of government and community relations and has explicit information on its website about how community groups can work with its staff and different facilities. It also does an excellent job of producing comprehensive economic impact reports describing the benefits of its operations to the communities it serves. It is essential that community stakeholders appreciate the breadth and depth of economic value that hospitals and health systems provide.
These are just a few of the ways that health care leaders are positioning their organizations to improve the education of patients and communities by looking inward as well as outward. The current communication gap between providers and consumers is confusing, frustrating and complicated — it warrants immediate attention before the “toothache” turns into a bigger problem.
Andrew Chastain is the managing partner and chair of the health care practice at Witt/Kieffer, an executive search firm in Oak Brook, Ill.