Frontiers of Health Services Management最新文献

When governing boards of healthcare organizations resolve to support their executive teams' commitments of time and money to create strategic action plans that meet their communities' environmental and social criteria-and when those healthcare organizations work with others that share their passion to measurably improve health-their communities can realize remarkable benefits. For example, this case study describes Chesapeake Regional Healthcare's collaborative approach to a community health need that began with data from the hospital's emergency department. The approach included the development of intentional relationships with local health departments and nonprofits. The possibilities of such evidence-based collaborations are endless, but the support of a solid organizational structure is required as data collection identifies additional needs.

At Advocate Aurora Health, the board of directors established parameters for effectively executing the governance (G) function related to ESG activities while adopting a comprehensive approach to ESG that includes the corporate commitment to health equity. Establishing a board diversity, equity, and inclusion (DEI) committee with external experts served to integrate these efforts with the ESG strategy. This approach will continue to guide the board of directors of Advocate Health, formed in December 2022, by the combination of Advocate Aurora Health and Atrium Health. Our experience has demonstrated that empowering individual board committee members of not-for-profit healthcare organizations to embrace their unique responsibility for driving ESG requires collective efforts in the boardroom as well as a commitment to board refreshment and diversity.

Hospitals, health systems, pharmaceutical companies, device makers, and payers have a responsibility to provide high-quality, innovative, cost-effective care and services to their patients and communities. The governing boards of these institutions provide the vision, strategy, and resources and choose the best leaders to achieve those outcomes. Healthcare boards can play a vital role in ensuring that resources are distributed where they are most needed. The need is great in communities of racial and ethnic diversity, which are almost always underserved-a preexisting condition that came into stark relief during the COVID-19 pandemic. Widespread inequities in access to care, housing, nutrition, and other components of good health were documented, and boards promised to pursue change, including becoming more diverse themselves. More than two years later, healthcare boards and senior executives remain mostly white and male. This continuing reality is especially unfortunate because diversity in governance and the C-suite has positive implications for financial, operational, and clinical success, including solving persistent inequities and disparities experienced in disadvantaged communities.

Like many communities across the United States, St. Louis, Missouri, faces stark inequities in health outcomes, including wellness, quality of life, and life expectancy. These inequities are the result of social systems and policies that have robbed generations of St. Louisans of opportunity. BJC HealthCare's (BJC's) commitment to becoming a catalyst for community health by helping to eliminate health disparities led to the launch of its community health improvement strategy. This article details the community-driven and evidence-informed process that BJC used to create a multiyear, proactive approach to addressing the social and economic factors that are the root causes of health inequities. It examines areas of opportunity through which the strategy will drive change and explores lessons learned and promising practices for other healthcare institutions to consider as they advance health equity.

Identifying and addressing the social determinants of health is an integral part of the mission at ProMedica as a health and well-being organization and an anchor institution in the communities we serve. For more than a decade, ProMedica has been on a progressive journey to integrate identification, screening, and interventions with important drivers of adverse outcomes to create a new model for healthcare, a model designed to bend the cost curve and enhance the health of our patients, clients, and communities. We are living our commitment to a healthier, thriving community by coupling high-quality care with community outreach and strategically implemented social care. Initiatives include job training, affordable housing initiatives, and financial coaching.

Many police departments have ride-along programs in which community residents accompany police officers in the field. Community organizers in one Cleveland, Ohio, neighborhood took that concept and flipped it to create a "reverse ride-along" program. During a reverse ride-along, police officers take part in community tours and dialogues to learn more about the area they serve and explore issues involving trust and trauma. In 2019, the reverse ride-along program added medical care providers from St. Vincent Charity Medical Center. The program was designed to connect residents and medical professionals for conversations in which learned knowledge and lived knowledge are valued equally. Participants identify barriers that deter positive health outcomes and prohibit effective engagement with the medical system. They do that by defining the social constructs unique to the community, then developing opportunities to address the barriers.

In November 2021, after more than a year of investigating the racial health disparities across its organization, Boston Medical Center launched the Health Equity Accelerator, a system-wide approach to holistically address the root causes of health inequities among people of different races and ethnicities and speed improvements in health outcomes. This article discusses lessons learned during the institution's process of discovery, shares examples of the work to dismantle a structural narrative that impedes health justice, and outlines interventions that can be applied to other healthcare systems across the United States.

Social determinants of health (SDOHs) are the "conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks" (Healthy People 2030 2021). These conditions include economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Ultimately, social determinants affect health status and outcomes to a greater degree than direct clinical care. Although these factors are experienced at a personal level, their impact can be seen on a community level. Also, while SDOHs vary, they tend to be more negatively impactful in rural communities-which then experience more harmful effects on health outcomes than their urban or suburban counterparts (National Advisory Committee on Rural Health and Human Services 2017). The unique experiences and challenges of rural communities require unique solutions. Guadalupe County Hospital in Santa Rosa, New Mexico, collaborates with community partners to address SDOHs. These efforts have a positive impact on their communities and can be replicated in other rural settings.