Partnerships in the Panhandle: Using the Rankings to Achieve Collective Impact

Tucked into the upper left corner of the Florida Panhandle, Escambia and Santa Rosa Counties’ Partnership for a Healthy Community is using the County Health Rankings & Roadmaps as the foundation for achieving collective impact. Collaborative leaders Becky Bray Washler and Chandra Smiley recently spoke to FIHI about how they have used the Rankings’ model of population health to facilitate collaborative action.

Founded in 1994 by two private hospitals responding to public health gaps, the Partnership for a Healthy Community leveraged their reputation and skills in community health needs assessment to initiate and support cross-sector collaborative action. In 2013, they issued a call to action, convened a community health summit and facilitated the design of a county health improvement agenda. Healthy weight, tobacco cessation and access to health care emerged as prioritized community issues. This was their common agenda.

“We had to break out of the old habit of attending meetings for networking only,” said Becky Bray Washler, MPA, AICP, Senior Planner at Sacred Heart Health System, Inc. “We needed to move from reporting on the same old things to doing something.”

To better assess population health, they worked with county health departments, forging an alliance between health care and public health. Next they engaged the University of West Florida. “We knew we couldn’t manage every aspect of achieving a healthy weight or cutting tobacco in the workplace,” shared Becky “so together we decided to pick one or two things and monitor that.”

In order to begin the community conversation, Becky, Chandra and leaders of the Partnership used the County Health Rankings & Roadmaps model of population health to discuss the social, economic, physical, behavioral and clinical factors that contribute to a community’s well-being. Using the Rankings as a backdrop, they assembled the business community to provide them with resources needed for the adoption of smoke-free workplace policy and employee wellness programs. As a result, the region’s leading employers went smoke free, affecting 11% of the workforce (40,000 people).

To increase healthy eating and physical activity in elementary schools, the Partnership identified and engaged school district representatives to champion their cause. Again, they provided these partners with the resources needed to implement change.

To improve access to health and human services, as a neutral and collaborative stakeholder, the Partnership intentionally bridged the gaps between health care, public health and the community. Leveraging this success, incrementally, Sacred Heart and Baptist hospitals began aligning their community health priorities and needs assessment indicators with Escambia Community Clinics and the health departments in Escambia and Santa Rosa counties. By 2012, everyone was using similar success indicators and scales. They had developed a shared measurement system. Leading up to 2016, the Partnership formed a cross-sector Community Assessment & Planning Committee (CAP) to oversee the completion of the assessment process. CAP Committee members included representatives from the Florida Departments of Health in Escambia and Santa Rosa Counties, Baptist Health Care, Sacred Heart Health System, Escambia Community Clinics (a federally qualified health center), and the University of West Florida. They used the County Health Rankings & Roadmaps to align indicators in order to begin tracking the Rankings’ social determinants of health.

The result of intentional alignment, by 2016, the health systems and county health department collaboratively produced one Community Health Needs Assessment using the Rankings model of population health as the structural backdrop. Released on the same day as the County Health Rankings, the Partnership’s 2016 Community Health Needs Assessment analyzes the 35 health indicators used by the County Health Rankings plus 125 additional measures to describe the overall health within Escambia and Santa Rosa counties.

“People had to be willing to set aside competition and come together,” stated Chandra Smiley, CEO of the Escambia Community Clinics. “We were committed to making sure there was no duplication of efforts.” Their intentionality yielded, in Chandra’s words, “collective synergy and impact.” In other words, partners swapped competition for collaboration and began to mutually reinforce each other’s activities.

As a neutral convener, coordinator and facilitator, the Partnership for a Healthy Community assumed the role of the Collective Impact backbone organization. They drove the collaborative process. “The umbrella of the Partnership created a ‘safe zone’,” Becky Washler shared. Basically, the Partnership was ideally poised to encourage and support a results-oriented collaborative process.

As a next step, the Partnership and its collaborative partners are now using this community health needs assessment to develop and implement health improvement plans and to evaluate individual and shared progress. Three work groups, one for each health priority area (tobacco cessation, healthy eating/physical activity and health care access), are currently using best practice strategies to address these prioritized health issues.

Not only did the County Health Rankings & Roadmaps framework support a common agenda and provide shared measurement among partners, it equipped stakeholders from multiple sectors with a communications platform, a way to discuss the social, economic and environmental factors that are contributing to overall health and well-being in Escambia and Santa Rosa counties.

“We needed a framework to help tell the story to the general public,” Becky stated. She believes that the model provided a straightforward message about the myriad of factors in addition to clinical care that contribute to our health. As a matter of fact, the Partnership and its stakeholders told the story so well that the Partnership has been asked to complete the assessments together with county health departments in Franklin, Golf, Bay and Walton counties.

Both Becky and Chandra credit their use of the County Health Rankings & Roadmaps model of population health as the backdrop for creating their common agenda, establishing shared measurement and facilitating continuous communication with different sectors over a 10-year period, accomplishing in a decade a solid foundation for achieving collective impact.

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