The 6 Challenges of Hospital-Public Health Partnerships: Insights and Lessons from Successful Partnerships

It is vitally important that the various efforts going into improving population health and the resulting partnerships that are needed to make it successful be studied so as to learn from best practices.

This allows for data and evidence-based management to set the course, and thus more reproducible at scale.

Work conducted by Prybil et al, on a study with support from the Commonwealth Center for Governance Studies highlights the insights and lessons learned from successful hospital and public health partnerships.

The purpose of the study was to identify and examine successful partnerships involving hospitals and public health agencies committed to improving the health of the populations they serve.

Methodology:

1. Identifying core characteristics of successful partnership

2. Identifying partnerships and inviting them to participate in the study (157 partnerships)

3. Identifying highly successful partnerships (17 partnerships with evidence of success)

4. Planning and conducting site visits to a selected set of highly successful partnerships focused on improving population health

5. Processing, tabulating, and analyzing data

When multiple stakeholders are involved, we will also observe an increasing difficulty as to how the complexities will be addressed.

The study identifies the six challenges that are observed in collaborative partnerships of broad magnitude:

Challenges Identified:

First Challenge:

• The inherent difficulty in creating, organizing, and leading "partnership models"
• This is especially true for those collaborations including a large number of partners that have varying levels of engagement.
• Varying engagement makes decision-making more diffuse and highly complex
• The key here is the formalization of decision making and resource allocation to guide collaborations through this initial challenge

Second Challenge:

• Creating and sustaining the collaborative partner's interest and engagement, which is often difficult without meaningful financial investments or contractual obligations
• Until recently, "improving community health", has not been a core mission of large health institutions, businesses, government and civil organizations. The model of improving overall health as seen in organizations like Kaiser Foundation is still gradually taking hold.
• The key here is to cultivate and sustain engagement and the support of stakeholders as a vital part of the process as it present a constant and ongoing challenge for all partners

Third Challenge:

• How to bring about tangible and measurable improvement in the health of the population being served.
• It is very difficult to tell if the curve is being bent from your efforts or something else
• Partnerships are advised to select factors that are rooted in evidence and have been shown to be intricately linked and drive the overall measure of interest
• The key is to place focus on high priority health measures

Fourth Challenge:

• Identifying and attaining sustainable funding
• The reliance on predominantly external funding has been shown to limit the ability of collaborative partnerships to take a long-term view in development and ultimately necessary support
• Work to ensure sustainable funding

Fifth Challenge:

• Limited staff hours and reliance on volunteers to perform on many initiatives
• This is tied in with funding as lack of dedicated staff hours and reliance on voluntary effort however engaged tends to result in higher than desired turnover
• The partners need to be committed in engagement and effort

Sixth challenge:

• Another challenge for collaborative partnerships is working to build "community recognition, credibility, and respect"
• There is also a level of trust that is very important and needs to be built, which can be a challenge as well
• The successful partnerships studies expressed, that although progress had been made there was still "a lot more work to be done"
• Work to build trust throughout the process

These are the challenges that will be faced by all agencies and collaborative leadership will be a necessary component to achieving success.

Sources:Prybil, L. and Scutchfield et al. Improving community health through Hospital - Public Health Collaboration. Nov. 2014American Hospital AssociationCenter for Governance StudiesRobert Wood Johnson Foundation

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