CHNAs—Take Them off the Shelf

Jun 1, 2017 11:30:00 AM |

Barry Plunkett

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CHNAs-309062-edited.jpgCommunity Health Needs Assessments (CHNA), unfortunately for many, are conducted simply to fulfill the Section 501(r) of the Internal Revenue Code which requires a tax-exempt hospital to conduct a CHNA. Also, community health assessment is a prerequisite of public health accreditation under PHAB standards. As we have discussed in a previous blog, a hospital’s CHNA can achieve so much more than fulfilling a regulatory obligation.

At the least, the CHNA should serve as a baseline to monitor improvements associated with one or more indices of health. At best, it can form the core of a plan to identify collaborative partners and engage the community in efforts to improve the health and quality of life of its citizens, plus renew or increase the support for the local community hospital. 

Integrating the CHNA and the institution’s strategic plan will not only advance efforts to improve the health of your community, but it can also create positive business development opportunities and potential to increase market share.

Facilitating Community Engagement

In our work with communities, we regularly hear both from official and non-official leadership that in-depth and ongoing community member engagement is an essential part of a sustainable health improvement process.

Hospital leadership should emphasize the importance of engaging community stakeholders, not simply as sources of input for CHNAs, but as equal partners with shared accountability and investment in addressing health concerns.

When HORNE is engaged to facilitate a hospital’s CHNA, we often facilitate either a Community Focus Group or a Community Forum. The Community Focus Group is a meeting of invited community leaders who are informed and invested in the health of the community. These leaders could include elected officials, representatives from various governmental agencies, health care providers, educators, or consumers. 

The Community Forum is an open meeting to the general public where certain key individuals are requested to be a part of the meeting. This type of community engagement brings the full force of combined experiences, expertise, and knowledge to bear on the relevant questions of creating a healthier community.  Because the composition of the audience is not predetermined, the facilitator must be adept at managing an open forum.  Hospital leadership also must be prepared to positively address concerns that are expressed at the meeting. 

At both the Focus Group and the Forum, it is likely that the hospital will find torchbearers for particular causes and strong supporters of the hospital’s mission.  Enlist these people to be part of the task groups that will develop the creative solutions.

The dialogue that occurs at both types of meetings is encouraging and energizing for all in attendance. It will become obvious that many people seek the same positive outcomes for their community but, they have been working in silos. During public meetings, participants might cite challenges such as lack of infrastructure and expertise for ongoing engagement, and commitment to the coordination of efforts across institutions and agencies.

Here is where the hospital can become the hero by taking the lead and becoming the catalyst for health improvement in the community. The initiatives that come out of these forums typically do not require a large financial investment on the part of the hospital, but they do take human resources. It is important that the hospital provides leadership of these efforts while engaging talent and funding opportunities from community resources with common goals of health education and improvement.

How to Get Started

Making significant improvement in the health status of the community requires reaching outside the traditional healthcare delivery model. It is not too late to turn your CHNA into a tool for community collaboration.  Pull your CHNA team together and look at your report with fresh eyes considering the following questions:

  • Have you identified your primary strategic health actions for the next three years?
  • Who are your possible collaborative partners?
  • Who can pull these people together to create a community wide plan of action? From a business development perspective, how do you align these health initiatives with your strategic business decisions for the near future?
  • Do you have programs or service lines that can address the needs created by lifestyle diseases and chronic illnesses?

The CHNA can be a tremendous resource; but it will not be effective if it remains on the shelf. If done properly it should provide you with data that can not only help you address health issues and disparities in your community, but it will also assist you in identifying the appropriate partners in facing these challenges. 


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Barry Plunkett provides operations and management consulting to HORNE LLP clients. He works with companies to facilitate strategic and long range planning and create initiatives that ensure excellence in health care operations and in other arenas. Barry is a frequent speaker at local, regional and national meetings, focusing on current trends in health care product development and marketing, and how today’s hospitals and health care delivery systems can partner with physicians and their communities.