There is widespread agreement that the health of Americans is poorer than that of other wealthy nations, that there are inequalities in health status and life expectancy affecting minority and socioeconomically disadvantaged populations, and that factors creating both health underachievement and disparate outcomes lie outside of the reach of the medical health care delivery system. Meaningful gains in population health require better public understanding and expanded institutional actions, which support changes in the social and physical environment. In accordance with New York State's 2013-2017 Prevention Agenda and consonant with requirements for not-for-profit hospitals contained in the Affordable Care Act, the Maimonides Medical Center in Brooklyn, New York has undertaken a comprehensive community health needs assessment (CHNA) that is intended to support implementation of actions that improve the health of the diverse catchment area it serves while striving to reduce racial, ethnic, and socioeconomic health disparities.
M aim onides has worked with The New York Academy of Medicine (NYAM) in conducting the CHNA and now wishes to prioritize a set of evidence-based programs directed at improving population health for implementation within the community it serves.
M aim onides is interested in using a deliberative methodology whereby members of the public will offer informed and value-based advice to the institution with respect to programs they view as having the highest utility to improve the health of the community. In response to this, NYAM proposes to implement three citizen panels comprised of 24-28 participants that will reflect the diversity of the population served by Maimonides. The results will be summarized in a report to Maimonides leadership that will provide informed public guidance for programmatic priorities and will be evaluated for process and outcomes at the individual and institutional level.
The specific aims of the study are to (1) implement multiple public deliberative sessions that are responsive to the decision-making responsibilities of an urban medical center serving a diverse, largely minority community; (2) Assess the impact of the deliberative process on participant knowledge and attitudes about evidence, comparing pre and post participation; (3) Assess the quality and effectiveness of the deliberative sessions; and (4) Examine the institutional response to recommendations made by citizen panels, including acceptability of recommendations and barriers and facilitators to implementation Strengths of this proposal are a highly experienced team, as well as the full interest and engagement of Maimonides Medical Center, an institution needing to make key programmatic decisions to comply with new state and federal requirements, and to meet the needs of its community. We anticipate that our findings will inform Maimonides decision making and will offer lessons that will be widely disseminated and can be used by non-profit hospitals across the country with new mandates to effectively engage their communities in health care decision making and to promote and protect population health.
There is widespread agreement that the health of Americans is poorer than that of other wealthy nations, that there are inequalities in health status and life expectancy affecting minority and socioeconomically disadvantaged populations, and that factors creating both health underachievement and disparate outcomes lie outside of the reach of the medical health care delivery system. Meaningful gains in population health require better public understanding and expanded institutional actions, which support changes in the social and physical environment. In this study, we will use a citizen panel deliberative process to inform and engage community members in the prioritization of population health programming for a New York City hospital, consistent with the community health planning requirements of the Affordable Care Act and NYS's Prevention Agenda.
