8 STEPS TO COMMUNITY ENGAGEMENT FOR RURAL HOSPITALS

COMMUNITY ENGAGEMENT DEFINED

Community Engagement is a series of purposeful activities intended to build or increase communication and collaboration between community stakeholders that will lead to a desired change. It is a long term commitment with short term wins along the way. Community Engagement is “doing, not just talking” and is stronger than just “participation”.

Goal: have an institutional strategy for community engagement as a core element of your management approach.

ENLIGHTENED SELF-INTEREST

What do community stakeholders get out of working with you? Go into the community and speak with stakeholders to gain an understanding of their needs. What do they want to get for contributing their time, energy and resources? The key to getting groups and individuals to work together is to understand their enlightened self-interest. For example, elected officials want votes while organizations want to fulfill their mission. Identify or develop a strategy that incorporates all the goals of your contributors then you have their combined resources available to you to solve a problem.

PARTNERSHIP APPROACH: THE PROCESS

Your immediately concern may not be the communities concern. For example, you may think that diabetes is a top concern for the population but the mayor’s wife has breast cancer and the community feels they need to be doing something to help with early detection of breast cancer because it has impacted their lives.

STEP 1: HOW TO START

  • Talk to locals (cab driver, hotel clerk, chamber of commerce president, hospital staff, etc.) to seek out the informal consensus of a specific community health issue.
  • When the issues becomes prominent, often an individual or a group will emerge to “champion” a solution to this issue.
  • The Community champion will become the “convener” of the process that will engage a broad sector of the community in solving local health priorities. This person needs to be able to convene a group and start a process. They must be credible and have the community’s trust. This individual should have a large network and be capable of disseminating information and communicating clearly.
  • You must provide a lot of support, making it easy for the champion to say YES to the effort.
  • Look for individuals and organizations from all facets of the community to form your team. Be sure to include those with influence and buy-in. (Suggestions: local mortician, county judge (in rural areas this person may be well known), local pharmacist, well respected business leaders.) The Washington State Hospital Association has an excellent checklist to help identify potential community partners. See page 20 of this toolkit: https://www.wsha.org/wp-content/uploads/CommEngagementToolkit_1_1.pdf

STEP 2: ENGAGING THE COMMUNITY – A PARTNERSHIP IS ESTABLISHED

  • Engage the community from beginning-to-end to ensure ownership.
  • This step is led by the community champion.
  • The partnership approach utilizes community assessment as an organizing tool.
  • Community is involved in determining what they need to know, who to ask, and how the assessment is deployed to gather as much community input as possible.
  • Assessment process is often lead by an initial, often informal partnership team representing various community sectors that can encourage assessment participation.

Who are the participants in “community engagement”?

EVERY sector of a community has a vested interest in success of local healthcare: local governments, schools, hospitals, clinics, private business- big and small, charitable organizations, faith-based community, civic organizations, social service organizations, agencies, law enforcement, investors, local media, ALL demographic sectors.

STEP 3: CONDUCTING A COMMUNITY ASSESSMENT

Assessments will:

  • Provide wonderful data (everyone benefits from having better data).
  • Serve as an organizing tool for bringing people together.
  • Provide a snapshot of the community.
  • Confirm and document community priorities.
  • Identify community issues and priorities-all of which may not seem directly related to health.
  • Identify community resources- these could be tangible (money, facilities) or intangible (access to networks with resources).
  • Provide a historical community context-how has this community worked together previously? What was successful and why? What past efforts were not successful and why?
  • Provide advice- such has “who should be involved in addressing community needs? What is the best way to communicate with community members?” Tip: Newspaper, Facebook, word of mouth!

Assessment Components and Mechanisms for Conducting Assessment:

  • Assessment components
    • Surveys (door to door, mail).
    • Existing data (census bureau –demographic data from Chronic Disease Data).
    • Community discussion groups (10-20 people per group).
    • Key stakeholder interviews –with community leaders.
  • Mechanisms and Support for Assessment
    • Via local hospital that is required to conduct a community health needs assessment.
    • Local health departments conducting assessments for new or continued accreditation.
    • Local collaboration or organizations, sponsors.

STEP 4: SOLIDIFYING A HEALTH PARTNERSHIP – ASSESSMENT FINDINGS INFLUENCE FURTHER DEVELOPMENT, REFINEMENT OF PARTNERSHIP.

Link up with other organizations that have to conduct assessments, e.g. local Health Departments (if seeking accreditation), FQHCs, and United Way organizations.  You can spit costs across multiple organizations and gain a lot of creditability when it’s the community’s assessment, not just the hospital’s assessment.

When you identify poverty, public transportation or lack of jobs or some other issue as the primary driver of poor health status in your population and you have a community partnership they co-own that outcome. You then have organizations that could step up and put fourth their resources to meet a need.

For example: If transportation is identified as a need and the local church who partnered with you on the assessment has church vans that are not being used 5 days a week you may be able to use the vans to help meet the transportation need. A local service organization such as Lions Club or a Rotary Club may be able to provide volunteer drivers or donations for fuel expenses.

Assessment findings presented to a community:

  • Present at a public forum focused on assessment presentation.
  • Present at an established public meeting, e.g. the annual Chamber of Commerce banquet, commissioner’s court, Rotary club breakfast or annual hospital event.
  • Community—identified priorities will lead to determination of who needs to be represented in the partnership, in terms of both leadership and workers.
  • Partnership structure is finalized, guiding principles are established, and operational processes are agreed upon and documented.

STEP 5: MAKING A PLAN – THE PARTNERSHIP RESPONDS TO COMMUNITY PRIORITIES THROUGH A PLANNING PHASE.

  • Assessment has identified 2 to 3 priorities to be addressed.
    • Include goals that are ‘low-hanging fruit’ and those that can be completed within 2 years or less.
  • Planning process needs to have a skilled facilitator, a recorder, and a single point of contact to disseminate and received information throughout the process.
    • May require external technical assistance and resources.
  • Needs to establish and adhere to a publically announced timeline.
    • Sticking with a timeline and providing a quality product builds credibility, trust, and community support.
  • Final plans should be transparent and available to public and include:
    • Intended outcomes, activities, timeline, support required, responsible parties and measures of success.

STEP 6: GET BUSY – IMPLEMENT THE PLAN

  • Well defined leadership and roles for all implementers will need to be in place prior to first action steps.
  • An accountability plan must be in place and a strong manager must be provided the authority and time to keep things on track.
  • Status updates for the community are a must throughout the implementation phase.
  • Celebrate and promote the achievements!

STEP 7: EVALUATE THE IMPACT OF SOLUTIONS

  • Established partnership leads the evaluation of the implemented initiatives.
    • Evaluation is based on measures established in planning process.
    • Relevant data and information should have been collected to support conclusion of outcomes.
    • Outcomes should be documented.
  • Impact is shared with the public.
    • Disseminated widely via open forum, print, social media, etc.
    • ALL outcomes should be presented-both successes and shortcomings.
    • Plans for ongoing improvements should be included as well as next steps.

STEP 8: ASSESSMENT BEGINS A NEW CYCLE

  • Utilize the partnership to continue to tackle other health and community priorities.
  • Establishing a partnership is a lot of work, but once the infrastructure and processes are in place, issues can be addressed and facilitated more efficiently and broadly.
  • Regular assessments help the community anticipate concerns, become prepared for opportunities, and continue to engage new partners. Assessments:
    • Should be part of an ongoing, proactive approach to address community health issues.
    • Provide documented needs, resources, and partners to serve as the basis for securing grant funding and/or in-kind resources to continue to improve health.
    • Strengthen community collaboration across sectors.

You’ve now developed the infrastructure and created efficiencies to be able to complete the steps of this process!

TIPS:

  • Be mindful of language used-medical terminology, “academic-ese” and local colloquialisms. You are hopefully drawing people from all of life so make sure to relate to all individuals at the table. Avoid acronyms.
  • Your champions and partners will likely consist of a few people who wear many hats-you are competing with the priorities of everyone at the table. Stick to the agenda and move on.
  • Trust is earned-do what you say you’re going to do.
  • Be persistent-keep inventing, keep them informed (updates), be transparent and show the impact.
  • Self-interests change and so do funding streams.
  • Build in sustainability. Start early.