An Overview of a Recent Study of Successful Multi-Sector Partnerships Focused on Improving Community Health ________________________________________ A New Road Forward: How Hospital, Public Health, and Stakeholder Collaboration has Changed the Community Health Landscape Lawrence D. Prybil, PhD, LFACHE Norton Professor in Healthcare Leadership University of Kentucky October 15, 2015

I. Overview ____________________________________________________ Basic purpose of this study Phases of the study Core Characteristics of successful partnerships Study population Review selected recommendations (6 of 11) Concluding remarks 2

II. Purpose of this Study ______________________________________________________________________ Purpose: The overall purpose of the study was to identify and examine successful partnerships involving hospitals, public health departments, and other stakeholders who share commitment to improving the health of communities they serve and ascertain key lessons learned from their collective experience. The intent is to accelerate change, encourage collaboration, and contribute toward creating a “culture of health” in American communities. 3

III. Phases in the Study’s Methodology _______________________________________ 1.Identify the core characteristics of successful partnerships 2.Invite partnerships that demonstrate “core characteristics of successful partnerships” to participate in the study 3.Select what appear to be highly successful partnerships from the pool of 157 nominees located in 44 states through a four- step process involving members of our National Advisory Committee 4.Conduct site visits to a selected set of twelve partnerships which had demonstrated exceptional durability and success 4

III. Phases in the Study’s Methodology Continued _______________________________________ 5.Verify, tabulate, and analyze data obtained through the nomination process, official documents, confidential, structured interviews with partnership leaders, and small- group discussions during site visits. 6.Determine key findings, patterns and conclusions, and formulate recommendations for local leaders and public policy makers. 5

IV. Core Characteristics of Successful Partnerships Focused on Community Health Improvement ______________________________________________ Vision, Mission, and Values – The partnership’s vision, mission, and values are clearly stated, reflect a strong, direct focus on improving community health, and are firmly supported by the partners. Culture – The partners demonstrate a culture of collaboration with other parties, understand the challenges in forming and operating partnerships, and enjoy mutual respect and trust. Goals and objectives – The goals and objectives of the partnership are clearly stated, widely communicated, and strongly supported by the partners and the partnership staff 6

IV. Core Characteristics of Successful Partnerships Focused on Community Health Improvement Continued ______________________________________________ Organizational structure – A durable structure is in place to carry out the mission and goals of the collaborative arrangement. This can take the form of a corporate entity, an affiliation agreement, or other less formal arrangements such as community coalitions. Leadership – The partners jointly have designated well-qualified and dedicated persons to manage the partnership and its programs Partnership Operations – The partnership’s programs and functions operate effectively and efficiently. Performance Evaluation and Improvement – The partnership monitors and measures its performance regularly against agreed upon goals, objectives, and metrics Program Success and Sustainability – The collaborative partnership has demonstrated operational success, durability, and positive impact on the health of the population served 7

V. Study Population: 12 Partnerships Located in 11 States ___________________________________________ National Community Health Initiative Kaiser Foundation Hospitals and Health Plan Oakland, California California Healthier Living Coalition Sacramento, California St. Johns County Health Leadership Council St. Augustine, Florida Quad City Health Initiative Quad Cities, Iowa-Illinois Fit NOLA Partnership New Orleans, Louisiana HOMEtowns Partnership Portland, Maine Healthy Montgomery Rockville, Maryland Detroit Regional Infant Mortality Reduction Task Force, Detroit, Michigan Hearts Beat Back: The Heart of New Ulm Project New Ulm, Minnesota Healthy Monadnock 2020 Keene, New Hampshire Healthy Cabarrus Kannapolis, North Carolina Transforming Health in King County, Washington Seattle, Washington 8

VI. Review Selected Recommendations _____________________________________________ 9 Recommendation #2: “ Whenever possible, partnerships should be built on a foundation of pre-existing, trust- based relationships among some, if not all, of the principal founding partners. Others partners can and should be added as the organization becomes operational, but building and maintaining trust among all members is essential.”

VI. Review Selected Recommendations Continued _____________________________________________ 10 Recommendation #4: “For long-term success, partnerships need to have one or more ‘anchor institutions’ with dedication to the partnership’s mission and strong commitment to provide on-going financial support for it”

VI. Review Selected Recommendations Continued _____________________________________________ 11 Recommendation #5: “Partnerships focused on improving community health should have a designated body with a clearly-defined charter that is empowered by the principal partners to set policy and provide strategic leadership for the partnership.”

VI. Review Selected Recommendations _____________________________________________ 12 Recommendation #6: “ Partnership leaders should strive to build a clear, mutual understanding of ‘population health’ concepts, definitions, and principles among the partners, participants, and, in so far as possible, within the community at large.”

VI. Review Selected Recommendations _____________________________________________ 13 Recommendation #7: “To enable objective, evidence- based evaluation of a partnership’s progress in achieving its goals and fulfill its accountability to key stakeholders, the partnership’s leadership must specify the community health measures they want to address, the particular targets they intend to achieve, and the metrics and tools they will use to track and monitor progress.”

VI. Review Selected Recommendations _____________________________________________ 14 Recommendation #8: “All partnerships focused on improving community health should place priority on developing and disseminating ‘impact statements’ that present an evidence-based picture of the effects the partnership’s efforts are having in relation to the direct and indirect costs the partnership is incurring.”

VII. Concluding Remarks _______________________________________ Our team believes a paradigm shift is occurring in America: there is growing realization that controlling the increase in health expenditures and improving the health of our nation’s population will require major changes in traditional policies, practices, and organizational models. We view these partnerships as pioneers and, we hope, as harbingers of a new era of innovation and multi-sector collaboration focused on building a robust culture of health in communities throughout America. The PDF version of our full report can be accessed and downloaded without cost at: 15