Promoting health and well-being in a geographic region is essential, and it requires numerous strategies to be successful.
When it comes to community engagement in medicine, there’s no shortage of metrics to quantify organizational success. But how well do those measures capture the unique nature and dynamic identities of the communities and the individuals within? And how can physician leaders ensure that communities are being engaged in a meaningful way?
We believe that it's important that the leadership of hospitals and health systems represent their patient population and the communities they serve.
Cynthia Washington, Institute for Diversity and Health Equity
Community engagement is central to any initiative to promote health and well-being, and to reduce health inequalities in a specific geographic region. It involves a range of strategies, from simple consultation to community control.
Here are four tips for physician leaders who are looking to elevate community engagement within their organizations.
Look at the data closely to understand circumstances. As physician leaders prioritize community engagement in their organizations, they are taking a closer look at the data — down to the individual level.
“When you look at data, the data tells a story,” says Cynthia Washington, the interim president and CEO of the Institute for Diversity and Health Equity, an affiliate of the American Hospital Association.
By investigating the specific patterns in the treatment of individuals, a unique picture emerges that provides clues to why individuals are having health-related issues in the first place. Washington says this is particularly relevant for patterns related to the social determinants of health, such as access to transportation, food insecurities, social isolation and other characteristics of a person’s lifestyle that can influence their health.
When the details of this type of investigation emerge, the results sometimes include treatment that extends beyond the walls of the hospital. “They [analysts] are able to see something that someone in the hospital wouldn't be able to or wouldn't even know,” Washington says.
For example, Washington says with such detailed, individual information in mind, physicians can write prescriptions for things like air conditioners.
“It's in the best interests for both parties to make sure that the patient gets quality care upon each visit and that these visits aren't readmissions because we missed something,” Washington says.
Appoint leaders who represent the communities they serve. In her work with AHA, Washington has built alliances with the National Urban League, a historic civil rights organization, and UnidosUS, the country’s largest nonprofit Latino advocacy organization.
“We believe that it's important that the leadership of hospitals and health systems represent their patient population and the communities they serve,” Washington says.
Washington’s organization worked with the groups to identify potential candidates to serve on hospital boards in their own communities. Then, those candidates were trained on basics of governance and the roles they would play in it.
The program began last year, but plans are underway to expand its scope.
“It’s truly about engaging community,” Washington says.
Check your own privilege. For Robert Like, MD, MS, the director of the Center for Healthy Families and Cultural Diversity at the Rutgers Robert Wood Johnson Medical School, physician leaders are wise to consider the cultural backgrounds of the communities they serve as well as their own cultural histories.
“I think leaders need to develop what some call cultural humility, which includes the ability to look at one's own beliefs, prejudices and biases, as well as being open and receptive to learning from the individuals, populations and communities served,” he says.
Like says physician leaders bring their own histories to their interactions with patients and colleagues in their organizations. Coming from a position of privilege can change how leaders experience a situation, especially when compared to others who fought their way up through challenges such as workplace discrimination.
“Leaders come with their own personal experiences and their own assets and strengths,” Like says, acknowledging it’s impossible to understand everything about your own culture, let alone someone else’s.
Consider the strengths communities bring — and the challenges. Like says it is essential for physician leaders to shift their mindsets when looking at how to best serve communities.
“Too often, we focus from the needs-assessment standpoint,” he says. “Sort of like, ‘What's going wrong? What are the problems? What are the pathologies?’ We also, I think, have to look at the strengths and the assets that all communities bring.”
He says it’s important to also shift your understanding of a community as it evolves, allowing room for the cultural changes that occur. “Remember that communities are not static,” he says. “They're often constantly changing due to demographic shifts, generational diversity, migration and other socioeconomic forces.”
Similarly, the process of engaging and collaborating with communities also evolves over the years. Building a relationship with communities takes time, and the process can be influenced by changes within the organization doing the outreach.
Washington says she has noticed increases in the number of hospital CEOs who make increased community collaboration and partnerships a priority. She says she has seen many leaders broaden their understanding of health care to conditions outside a health care organization as well as those within it.
“The bright spots, from my perspective, is that this work is really trending,” she says, “and I think it will continue to do so for years to come.”
Hannah O. Brown is a freelance journalist based in Florida.