For win-win community partnerships, start with good evaluation criteria
To best use tight funds, set achievable goals and analyze project effectiveness
Until recently, staff at OhioHealth Cancer Services in Columbus never said "no." When someone from the state department of health, a church group, or any other organization asked them to participate in a health fair, they would automatically agree to set up a display of literature and promotional items. They entered into other partnerships for community outreach, such as health screenings, blindly as well.
"That’s not a bad thing to do if you have the resources, the time, and a department that can support that kind of work," says Mary Szczepanik, MS, BSN, RN, manager of cancer education, support, and outreach. Most not-for-profit health care facilities, however, don’t have the staff or funds to operate in such a manner, and that includes OhioHealth, she says.
To make better use of tight funds, a five-year strategic cancer plan was developed by gathering data and analyzing statistics. "We looked at the incidences of different cancers across the state and what health care is available in certain geographical locations," says Szczepanik. A target population was selected based on the demographics, the incidence of cancer, and the health services available in those areas.
Staff must check with Szczepanik if they get a call requesting support for an outreach project from any place other than the target areas or about any disease other than the six selected cancers (breast cancer, prostate cancer, colon cancer, lung cancer, brain cancer, and GYN cancer). "It helps us use our resources in the areas we have defined as being our target population for prevention, early detection, diagnosis of cancer, treatment of cancer, and follow-up," she explains.
OhioHealth Cancer Services’ goal is to look at all six of the cancer diagnoses, determine where the gaps are across the continuum of care, and provide services staff determine that the target population needs in the areas of prevention, early detection, diagnosis, treatment, or follow-up.
When people call to request that OhioHealth Cancer Services partner with them in a community outreach effort, a program request form is completed by asking the caller certain questions over the telephone. In this way, Szczepanik will know if it meets the criteria.
There was a process in place for analyzing requests in the past, and a form was completed but the answers to the questions really weren’t useful because there was no strategic focus that determined how decisions for participation would be made, says Szczepanik.
Partnerships with community organizations are a great resource, says Mary Paeth, MBA, RD, patient & community health education coordinator at Southwest Washington Medical Center in Vancouver. However, to form appropriate partnerships, good criteria for selection are a must.
The following are the criteria used to select partners at the medical center:
- Does their mission correspond with our strategic initiatives?
- Do their ethics meet our expectation with regard to reputation, treatment of their customers, interaction with the community, the way they conduct business, meet regulatory codes, support habits and choices that promote and enhance a healthy and fit lifestyle?
- Do they serve the geographical location that fits our market?
- Do we already have a contractual agreement with them for some other purpose?
Reaping many benefits
When carefully selected, community partnerships can be beneficial financially and in many other ways. OhioHealth Cancer Services had a goal to screen a certain number of women for cervical cancer by the end of the year. Because they had not done cervical cancer screenings as a community outreach for a long time, Szczepanik asked her staff to find out if a community agency, church group, health advocacy group, or other organization was doing them so that they might form a partnership. In this way, they did not have to spend time in the planning phase.
Their partner, Columbus Cancer Clinic, which is within their health care system, has been doing cervical cancer screenings for a long time, so the costs involved are clearly known. This made it possible for Szczepanik to find out how much money OhioHealth Cancer Services would need to donate to make the screenings free for women. In that way they could reach an underserved population, which fits their strategic plan. This population would be women who have poor access to health, are uninsured, or have not had a Pap smear in five years.
To make sure that they are meeting the goals of their strategic plan, scripts are developed for taking reservations for free screenings to ensure that the target audience is being reached. For example, for prostate screening, men cannot have a regular physician because the screenings are for underserved populations.
Not having to reinvent the wheel is a good reason for partnerships, says Paeth. Currently, Southwest Washington Medical Center is partnering with the Oregon Arthritis Foundation to offer the Arthritis Self-Help Course, a six-part class series. The foundation provides trained instructors and curriculum while the medical center provides the class space and any other resources needed. The series is sponsored by the rehabilitation department at the medical center.
"It is a perfect partnership and the type that I look for as the community education coordinator. It promotes our services and provides local interest groups with connections that have a solid expertise," says Paeth.
Another good partnership took place between the rehabilitation unit at Southwest Washington Medical Center, the local chapter of the Alzheimer’s Association, and the local Agency on Aging. The project was a caregiver conference in which the outside groups provided a mailing list of contacts as well as opportunities to participate in a support group following the conference. The medical center provided knowledgeable speakers and space.
The partnership allowed the professionals at the medical center to work with others in the continuum of care to provide a well-rounded program, Paeth explains.
"These connections help us to make contacts with those who will be working with our patients in the future. The continuum of care has a different set of needs at each stage and working with others outside our particular segment makes sure we are meeting the long-term needs of our patients," she explains.
Partnerships with local organizations provide patients with needed services and support that a medical facility does not have to duplicate. For example, the local branch of the Leukemia & Lymphoma Society and a faith-based patient centered peer volunteer program provide educational programs, material and unique and individualized patient support, reports Donna Armstrong, RN, OCN, oncology nurse coordinator at the Cancer Center of Southwest Washington Medical Center in Vancouver.
Patients often reap benefits from the close connections medical facilities maintain with organizations. The Cancer Center referred a genetic testing patient to the National Institute of Health’s clinical studies where the testing, counseling, and all costs are covered. "The patient met the testing criteria and had been denied testing coverage by the State Health Plan," says Armstrong.
Evaluate effectiveness
The benefits from partnerships are not always long-term; therefore, the relationships should be evaluated on a regular basis, says Szczepanik. For several years, OhioHealth Cancer Services worked with other health care facilities to host a cancer survivor celebration. However, as attendance trended downward, costs went up, and the number of actual cancer survivors attending declined. Szczepanik decided not to participate in the event because it no longer reached the target audience.
"We went through an organized approach this last year in trying to decide whether to do that event again and decided not to. It’s important that we determine if we are using limited resources to the best result either for the community or for individual groups of patients," says Szczepanik.
Whether OhioHealth Cancer Services continues to support a project or let it go depends on what it is trying to accomplish. To evaluate the effectiveness of the school cancer education program, Szczepanik relies on pre- and post-tests distributed to the students.
The goal of the program is to teach kids certain facts about cancer. For example, the curriculum covers the link between marijuana and lung cancer, also the relationship between a high-fat diet and colon cancer. Although it is hoped that the education influences the students’ lifestyle, resulting behavior choices are difficult to evaluate. Therefore, at this point, knowing that students learned certain facts about cancer is enough.
"We can say with confidence that it isn’t just that we taught 4,000 kids last year, but they learned certain information, and we will continue to offer the program," says Szczepanik.
Evolving objections
Some events, such as health fairs, rarely are entered into any longer because they simply do not fit the strategic objectives of OhioHealth Cancer Services. "What we have learned is that it isn’t a good way to educate anyone," says Szczepanik. People pick up information, but there is no way to follow up to determine if they read the materials or changed their health behaviors. For example, women may watch a video on self-breast exams, but that may not prompt them to start the practice. It is quite an outlay of resources without much of a return, she says.
When a partnership works, the event or program is included in the budget for OhioHealth Cancer Services the following year, says Szczepanik. Cancer services pools its resources with the community relations department that budgets for outreach efforts as well.
Whenever she is told by administration to cut money from her budget, she never eliminates one of the partnerships completely because of a funding shortfall. "If I have 10 programs planned with the community, I take some money out of each one," says Szczepanik.
Sources
For more information about the financial benefits of forming community partnerships, contact:
- Donna Armstrong, RN, OCN, Oncology Nurse Coordinator, Cancer Center of Southwest Washington Medical Center, Vancouver, WA. Telephone: (360) 514-2363. E-mail: [email protected].
- Mary Paeth, MBA, RD, Patient & Community Health Education Coordinator, Southwestern Washington Medical Center, P.O. Box 1600, Vancouver, WA 98668. Telephone: (360) 514-6788. E-mail: [email protected]. Web site: www.swmedctr.com.
- Mary Szczepanik, MS, BSN, RN, Manager, Cancer Education, Support and Outreach, OhioHealth Cancer Services, 3535 Olentangy River Road, Columbus, OH 43214. Telephone: (614) 566-3280. E-mail: [email protected].
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