CHICAGO — Health systems often are in a powerful position to act as a driving force for community improvement, but effecting change is often easier said than done.
Three prominent health system CEOs gathered Tuesday to discuss the role of the hospital as a community anchor during a panel discussion at the National Center for Healthcare Leadership 2016 Human Capital Investment Conference.
Each leader agreed hospitals must embrace their role in the community to achieve health equity, but they questioned whether that means the hospital should be leading the charge to improve health or whether it can work through an established community organization.
Following are some of the discussion's highlights:
Henry Ford Health System, Detroit
The city of Detroit has had well-documented struggles, but Nancy Schlichting, Henry Ford Health System CEO, says the system has fully embraced its role as an anchor institution by partnering with Michigan's education system.
Henry Ford partners with a local community college and the public school system to create an "early college." At-risk kids in the city are enrolled in a five-year program from ninth grade through one year after high school. Currently, 250 students are enrolled and on track to become allied health professionals, and the school's success has been remarkable, Schlichting said. It has become the third-highest-ranked high school in the state and is among nationally ranked high schools.
“It sometimes appears more difficult than it really is,” Schlichting said of partnering with community organizations. “If you put your focus around things that everyone cares about, that are universal aids for the health care institutions and aids for the community, it really allows us to come together.”
And it’s not always about engaging the community through a sector as large as education.
When Schlichting came to Henry Ford 18 years ago, the hospital had an incinerator on its campus. After talking with people in the neighborhood, it became clear to her that this was a problem. The incinerator was removed, and the health system worked with the community to design an environmentally sustainable model for its waste.
“That earned trust in a huge way. And when you engage at that level, it makes a huge difference in your role as an anchor institution,” Schlichting said.
Rush University Medical Center, Chicago
Rush University Medical Center has challenges similar to those in Detroit, especially on the city's West Side, where Rush is based. You can travel on a Chicago L train through neighborhoods where lifespans drop dramatically as you move further from the city’s center.
Larry Goodman, M.D., CEO of Rush, says the hospital has had more success partnering with local programs than when running initiatives to address social determinants because “in some communities it leaves a lot of suspicion when an academic medical center rolls in and says we’re going to solve the world’s problems.”
The city created a program for the City Colleges of Chicago — College to Careers — that focuses its curriculum on four sectors, one of which is health care. Graduates receive a degree or certificate preparing them for the next step in the field. Rush partnered with Malcolm X College to help with curriculum changes and added programs and degrees of its own, including a ladder program in which students attend Malcolm X for two years and Rush the subsequent two and receive a bachelor of science degree.
As an anchor institution, a hospital is a real driver of the community and relationships, says Goodman. He said that once a system becomes involved with an organization, “it is really important to make sure that impact is as sustainable as possible.”
“Once you do get started with a group or entity ... it does have to be constant communication, and it can’t be withdrawn just because we’re not having such a great year.” That's because many hospitals are working in areas that have faced challenges for years, he said.
Carilion Clinic Health System, Roanoke, Va.
For Nancy Howell Agee, president and CEO of Carilion Clinic, engaging physicians and those who work within the hospital has been a great way to better meet the needs of the Roanoke community.
One of Carilion’s pediatric clinics has a heavy population of Spanish-speaking patients. So a physician and several nurses, most of whom speak Spanish, suggested dedicating one day a week to speaking only Spanish in that clinic. “It created more efficiency ... the staff was happier and more engaged in the community they treat, and it’s [been] a very efficient way to give care,” she said.
The Virginia Tech Carilion School of Medicine and Research Institute, a public-private partnership with Virginia Tech University, invites members of the community to interview perspective students. Applicants go through multiple eight-minute scenarios and ethical dilemmas and are then ranked on their responses.
Agee says the community is highly engaged with the medical school, and students love the sense of community. Neighbors go as far as to create welcome-week signs and bake cookies for the students.
But like the other panelists, Agee believes change doesn’t always have to be led by Carilion.
“It doesn’t have to be my brand. The point is, how do we improve health and how do we fulfill our mission?” she said.