Achieving Success through Community Leadership

Health Progress, Jan/Feb 2003 by Salzmann, Carol

Achieving Success through Community Leadership

Peter A. Well, Richard J. Bogue, and Reed L. Morton

Health Administration Press, Chicago, 2001, 104 pp., $35

MISSION-THE REASON THAT AN ORGANIzation exists-is fundamental to its existence. Board members know this. CEOs know this. Senior leadership knows this. But do these leaders truly believe and practice their hospitals' stated missions? Authors Weil, Bogue, and Morton emphasize from the start the importance of community health as a "driver" for a hospital's mission statement. Achieving Success through Community Leadership is about helping hospitals learn through "best practices" how to relate to their communities and ultimately how to improve community health.

I was delighted to recognize a name amongst the acknowledgments on page xi: Jane Oehm of Golden, CO. I appreciated the authors' inclusion of community members on their panel. Jane is a former member of my organization's board, and it was a pleasure working with her.

Achieving Success through Community Leadership is designed to reset priorities for financially focused health care leaders and reintroduce them to the importance of community leadership. The book's introduction describes the volatile history of health care over the past two decades and puts into perspective hospitals' current focus on the bottom line. The authors include seven strategies for linking performance expectations to community health improvement. They dedicate a chapter to each strategy, from visioning to process. Twenty-five "leading practices" are aligned with these strategies.

The book's conceptual framework and content are pertinent to health care's current environment. In their introduction, the authors describe the multifaceted approach they used to identify "leading sites," hospitals that responded to their call for data. They then define and describe what they call "leading practices," and do so in a manner that makes them easily adaptable by other hospitals and health care systems. The authors also describe lessons learned from six "demonstration site" hospitals. The leading practices, they say, are intended to have an impact on the management and governance of hospitals or health systems; they are not meant to be community health initiatives.

The authors of Achieving Success through Community Leadership follow a consistent format as they proceed, chapter by chapter, to highlight each strategy. In discussing a particular strategy, they sometimes give exampies from both the leading sites and the demonstration sites involved. Scattered through the book are concrete examples of curricula, surveys, and self-assessment tools that have been developed and implemented by the "leading sites." Chapter 1, "Visioning a Healthy Community," sets the stage for learning. Here, the authors elaborate on the ways that hospitals are "discovering new synergies and making better strategic decisions by embedding population and community health goals in the performance management system" (p. 1).

In Chapters 2, 3, and 4 the authors encourage leaders to invest in community health, invest in education, and make personnel decisions that foster community health. In their remaining chapters, they focus on marketing activities, structural changes, and developing processes that promote community health. Their goal is to change hospital leaders' behaviors so that they can develop a culture in which "community health is as important as financial performance" (p. 90).

I was intrigued by the diversity of hospital and public health relationships highlighted in the book's appendix, entitled "The Role of Public Health" (p. 97). Both hospitals and local health departments will continue to face challenges. Collaboration seems imperative; I was happy to see that the authors noted some "leading practices" involving strong hospital and public health partnerships.

Weil, Bogue, and Morton have collaborated to publish a book with real application to hospitals and health care systems. They suggest that health care leaders should decide on a strategy (or group of strategies) that seems most appropriate for their organizations and then act on it. The authors conclude, and I concur, that it is possible for creative, mission-driven leaders to improve community health and regain the trust of the public and dedicated staff and physicians.

Carol Salzmann, RN, Director, Community Development Exempla Lutheran Medical Center Wheat Ridge, CO