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A community strategy forms one part of the community’s strategic plan. It’s neither the first nor the last part. Strategic planning is a process of identifying the broad goal, of translating that goal into member behaviors (objectives) you need to achieve. You then create a strategy (or strategies) to achieve those objectives. Once you have
created the strategy, you identify the best way to fulfil that strategy (tactics). Next, you decide who, what, and when those tactics will be executed (action plan). Finally, you measure and improve. The key elements of a community strategic plan are below. You can take many approaches to achieve your goal, multiple strategies to fulfil your objectives and many tactics to implement your strategy. Let’s connect these together into a similar example. The broader
business goal might be to increase retention rates of a software platform. The customer success department might do that by building a community that shares useful tips on using that platform better and increasing the perceived value of the product. Notice above how everything fits together. Also, notice how the strategy works. By devoting the majority of our resources to create stars and amplify the sense of jealousy (or admiration), we are taking resources away from other areas and other members. This means you face the risk that this will fail and other areas
might be a better use for those resources. In the next few chapters, you’re going to learn more about the community goals, objectives and types of strategy you might choose.
PurposeDeveloping comprehensive, multifaceted strategies to address the community health needs prioritized in your assessment is crucial to improving community health. Regardless of whether you have been doing community health improvement work for many years or are new to this process, you can build or supplement services or programs to address the needs identified in your community health assessment (CHA). Key ComponentsEngage strategic partnerships both within the hospital and with external stakeholders Internal partnerships: Individuals and departments across the hospital may be able to assist with development and implementation of community health improvement strategies by helping to scale the strategies across the hospital or engaging clinicians who focus on the needs identified in your CHA. The support of hospital leadership can be crucial for securing funding and resources to implement desired strategies. Engage with C-suite executives and hospital trustees to share the CHA findings and discuss intervention approaches. External partnerships:Develop a plan with community stakeholders to garner support for implementation efforts. You may want to form an implementation committee including individuals who participated in previous stages as well as new stakeholders who can offer fresh insight and resources. It is particularly important to involve members of the population who will be affected by the implementation strategies to ensure plans are culturally appropriate. Many hospitals are also engaging their local and state health departments in developing their CHAs. Reinforcing and strengthening these relationships can be important as hospitals move from the assessment phase to developing and implementing strategies to address identified community health priorities. Align strategies with the hospital and other community stakeholder organizations Collaborative strategies increase potential for impact
Consider adopting some or all of these elements as you shape your approach for addressing community health needs. Determine your community assets Identify the drivers of community health improvement Select strategies to address priority
needs Type of strategy: There are multiple approaches you can take to address the identified need, but the overarching dichotomy is between a practice (a way of doing things) and an intervention (a program or initiative). Both are valuable and have the potential to make a significant impact on community health; however, instituting a practice may have longer-term sustainability as it becomes part of the daily workflow. Level of intervention:Think critically about the level at which you are intervening and how your efforts can make the most impact. Will your strategy be clinically based, or will it take place in the community? Will you address the specific needs of individuals or the community as a whole? The following models may help you conceptualize how you want to target your strategies. Which level of prevention will your strategy address?
What level of intervention are you targeting? To make an impact at the population level, be sure that the strategy gets at the root of the identified need. Frieden’s health impact pyramid (2010)2 suggests that interventions to address socioeconomic factors and changing the context of individuals’ decision-making may have a greater impact on population health than more traditional, clinically focused or educational actions. Health Impact Pyramid Source: Frieden, T. R. (2010). A framework for public health action: the health impact pyramid. American Journal of Public Health, 100(4), 590-595. What type of intervention are you proposing? CDC’s 6|18 Initiative conceptualizes types of prevention into three buckets3:
How many facets of the health need does your strategy address? To move the needle on community health, it is helpful to develop a comprehensive strategy that addresses multiple facets of each health need. This requires thinking of the big picture of health and the hospital and health care system’s role in improving it. A comprehensive approach includes:
Identify interventions with evidence of success
Some organizations have synthesized studies on various community health needs to provide you with the most promising, evidence-based practices. Those are available at:
Some interventions may be promising but do not yet have a body of data to qualify them as “evidence-based.” This does not mean that such interventions may not be beneficial. By implementing similar interventions in your community and measuring their success, you could contribute to building that evidence base. Assess
the impact the strategies would have on health in your community
Set goals and objectives for the implementation strategies Specific Measurable Achievable Realistic Time-bound Strive for quantifiable measures, but do not neglect critical issues whose importance may justify the development of non-standardized measures and/or new data sources. Do not shy away from challenges or setting audacious goals—this is your opportunity to tackle the most pressing health issues facing your community. If possible, work with community stakeholders to develop community-wide metrics to measure the collective impact of the strategies. Hospitals should also have separate metrics to measure the impact of their specific strategies. Tailor strategies to community culture Consider evaluation from the start
Evaluation can look at short- and long-term outcomes as well as process metrics. The short-term measures are most likely to be process measures (how many people used a service or attended a program), while long-term outcomes will monitor changes in health status—a process that takes more time. Intermediate goals and benchmark metrics in the evaluation process will help you know if you are going in the right direction and will be important when discussing progress with executives, leadership and other internal teams, as well as external stakeholders. More information about evaluation can be found in Step 9. Identify funding sources and opportunities
Because these strategies will take time to make a population level impact, secure funding sources that will allow the strategy to be sustainable. Document the implementation strategies
1. Hanleybrown, F., Kania, J., and Kramer, M. (2012). Channeling change: Making collective impact work. Retrieved from http://jcisd.org/cms/lib/MI01928326/Centricity/Domain/218/Making%20Collective%20Impact%20Work%20Stanford%202012.pdf 2. Frieden, T. R. (2010). A framework for public health action: the health impact pyramid. American Journal of Public Health, 100(4), 590-595. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836340/ 3. Hester, J., Auerbach, J., Seeff, L., Wheaton, J., Brusuelas, K., and Singleton, C. (2016). CDC’s 6|18 Initiative: Accelerating evidence into action. Retrieved from https://nam.edu/wp-content/uploads/2016/05/CDCs-618-Initiative-Accelerating-Evidence-into-Action.pdf 4. National Research Council (U.S.). Committee on Health Impact Assessment. (2011). Improving health in the United States: The role of health impact assessment. Washington, DC: The National Academies Press, p. 5. Retrieved from http://www.nap.edu/read/13229/chapter/1 5. Centers for Disease Control and Prevention. (2011). Develop SMART Objectives. Retrieved from http://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.html What are the factors to be considered for a successful implementation of community action plan?The following points should be taken into consideration in completing a community action plan:. Partnerships among people. ... . Budget. ... . Close alignment with the community's mission and vision. ... . A feasible plan does not have to be “perfect”.. What should be considered in making a community action plan?The plan describes what the community wants to achieve, what activities are required during a specified time period, what resources (money, people and materials) are needed to be successful. A community action plan becomes a framework for implementing the activities that are decided by the community itself.
How can an action plan be successfully implemented?Implementing action plans
To create an action plan, first clarify the outcomes you want to achieve. For each outcome, list the activities necessary to achieve it. Then put the activities in order. Next, assign responsibilities for completing each activity.
What are the factors that prompts community action?Environmental factors: social support, available resources and services, barriers (including financial, physical, and communication), social approval, policies, environmental hazards, living conditions, poverty.
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