Issue link: https://beckershealthcare.uberflip.com/i/1047089
67 PRACTICE MANAGEMENT THOUGHT LEADERSHIP tributes to good health. In some communities, grocery stores and choices of grocery stores with fresh fruit and vegetables and a fresh food selection is a non-issue. In other communities, you can't find them. If we were pri- oritizing resources, we wouldn't put energy into getting more food in communities where they already have choic- es. We would put our energy in communities where they don't have any. The second thing is we regularly complete a compre- hensive community assessment across all our markets. We work within our communities, so they never feel like we're the big healthcare organization telling them what they need. It's a very collaborative process in which we're working out of mutual respect, trust and alignment that we're all trying to do the right thing. Community voices are critically important to help guide how we prioritize our time, resources, energy and effort. Q: Can you walk me through the decision-making pro- cess for these kinds of investments at Kaiser Perma- nente? I.e. who champions the ideas, who is the final decision-maker, etc.? BJT: A lot of different people can come up with ideas. We have a fluid process where we encourage and engage ideas from throughout the organization, and an infrastruc- ture for ideas is headed by the chief community health officer [Bechara Choucair, MD], whom I recruited a couple of years ago. By design, I brought Dr. Choucair into the organization with the clear direction that his responsibility is to represent the voice of the 68 million people who live in the communities in which Kaiser Permanente exists. He works with the teams on the ground to tailor programs to the individual communities. At the very top, there's a com- munity health committee of the board. That's how serious- ly we take this. It's the board of directors who ultimately makes the decisions for capital and other investments brought to them by the management team. The board plays a critical role in both the strategy and the funding of major initiatives to make sure we are achieving the pur- poses and mission of the organization. Q: How does Kaiser Permanente measure and track progress? BJT: Sometimes we have tangible goals and expected outcomes, and we measure ourselves against them. In other cases, we identify the outcomes we want to impact, and we measure those over time to see if we are achieving the results intended. If we're not, then there's the question of why not, and that can present both opportunities and challenges. We continue to learn when we conduct the community health assessment. After the assessment, we identify the two or three top problems, and then we do another as- sessment three or four years later to determine whether we've made progress in the hearts, minds and realities of the people we care for. And in some cases, we track our- selves against public data. Did we lower crime in a partic- ular community over a time period? Even though we may not be able to contribute everything to our individual ef- fort as an organization, we track to see if the outcome was achieved. It's often not one solution or answer that solves a problem. Q: Leavitt Partners published a survey in May that found the majority of physicians believe social deter- minants of health matter — yet most physicians do not believe it is their responsibility to address them. With that in mind, how should health systems approach population health work? BJT: That certainly is not the mind, attitude and behavior of our Kaiser Permanente physicians in the Permanente Medical Groups. They lead a lot of this work. I was just reading about one of our areas that's teaching eight-week classes on our eight-step program for healthy eating, meditation and activities for patients with Type 2 diabetes, and this is physician-led. Q: How does Kaiser Permanente engage physicians around its community health goals? BJT: They are directly involved. Many of our efforts are inclusive of physician leadership and equivalent. They're in it. They bring their expertise into the communities, into the thinking. It enriches and enhances our messaging, ac- tions, behaviors and credibility. Because the community holds our physicians in the highest regard, it adds to the credibility of what we're trying to accomplish in our com- munities around the country. n "Community voices are critically important to help guide how we prioritize our time, resources, energy and effort. " — Bernard J. Tyson, Chairman and CEO, Kaiser Permanente