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Fellows Present Ideas on Enhancing Collaboration and Building Healthy Communities

Salzburg Global session, Building Healthy Communities: The Role of Hospitals, reaches a conclusion

Fellows of the Salzburg Global session, Building Healthy Communities: The Role of Hospitals, pose for a group photo

Participants of the Salzburg Global session, Building Healthy Communities: The Role of Hospitals, have been encouraged to keep the conversation flowing following the end of the five-day program.

This message came after participants presented their ideas on the final day of the program to enhance effective collaboration and information-sharing between hospitals, social services, and community organizations.

Their presentations explored several areas, building on the discussions and exercises that had taken place over the previous days.

The first group to present did so under the title of “Yearning for Change.” They advocated a framework for system change convening and assisting like-minded leaders in a community social movement to share experiences and test ideas while committing to a sustainable health system.

This would lead to a “Salzburg Community of Practice” – a group of peers from different countries who share a passion for sustainable system change who learn how to do it better through regular interaction on a voluntary basis. Everyone has access to information and each other. All peers share a view of what’s significant.

The group said they’d know if they were successful when an online library was established and actively used. Other markers include active participation by a minimum of five countries, and the sense participants find it useful.

The next presentation focused on creating a resource which would help result in healthy people, healthy communities, and a healthy planet – taking innovation to scale. This group produced a set of values they felt were paramount for successful innovation scale, which they referred to as the Four-Is Framework. Innovation, issue, and influence are the essential domains of interaction that are necessary. Impact, the fourth “I,” is only achieved when the other fields have had time to interface and intersect.

Underpinning this framework are guiding principles of equal partnership and representation, a focus on trusting, respectful relationships among all stakeholders, stakeholder/community engagement and co-creation, continuous involvement of end-users, investment of resources in enabling capacity for stakeholder engagement, and incremental progress.

The third working group showcased an action-oriented research agenda, designed to improve individual, community and planetary health simultaneously. The rationale behind it was that a more conscious research and action agenda on social determinants of health could maximize health system impacts and investments to achieve benefits at all three levels.

The group highlighted several domains where interventions could be identified. These areas included food insecurity, poor and unhealthy housing, energy poverty, transportation, waste management/recycling, air quality, education, violence prevention, and social isolation. An example of a research question could be: What are the most effective partnership models to achieve maximum results?

If health care professionals are to reach out to the community, they’ll need to understand the community first. This message came through during the next presentation. The working group behind the presentation focused on services to help clinicians to improve communication. Members advocated using local community resources and smart and existing technology to integrate, share and disseminate knowledge to improve community health.

The methods of achieving this include identifying community needs and health guardians in the community, using smart technology to develop connectivity and health education, and having a regular review of the whole process. The presentation concluded with the message: “Change will happen. It just needs passion, commitment, and desire.”

Throughout the session, participants considered the capacities of hospitals and the position they were in to support healthy communities. One working group decided to focus on ways to improve their capacities through a global toolkit. The final product would be a dynamic digital repository, which brings together individuals, frameworks, methodologies, tools, and cases to facilitate, strengthen and guide hospital collaboration, co-operation and co-design efforts with communities to improve the health of its citizens.

The group stated hospitals could and should work together with communities and evolve to improve the health and well-being of all citizens by addressing social determinants. While doing so, hospitals should continue delivering on their core mission, which is providing high-value care to its patients and families with “healthy staff.” Resources which could be made available in a global toolkit include partnership agreements, education and training materials, communication strategies, and co-design methodologies.

Members of the sixth working group began their talk by describing the existing system as unsustainable. The speaker said the system “doesn’t know what it doesn’t know.” The group proposed co-producing a learning front end to enable a health-creating system that is accountable to the community.

Members of this group suggested describing a theory of change based on people’s preferences and an understanding of needs and wants. The next steps would be to present a way to invite co-producers and then form or find communities of interest to refine and spread. One participant said what they were talking about was “transformational change” – starting with an individual and then extending to the system.

Taking the work forward

A seventh working group worked on an outline proposal for six peer-reviewed articles to be published by the British Medical Journal (BMJ), based on the themes that emerged during the session. The initial plan is to release these articles in 2018.

The articles would be presented on a BMJ Collection page alongside any BMJ Opinion pieces written by Salzburg Global Fellows. Participants heard a working group would meet regularly to ensure the project moves forward. Suggested article themes already include the role of hospitals, lowering the walls and breaking down barriers, and how data can act as a bridge.

Salzburg Global Program Director John Lotherington said Salzburg Global would do everything it can to support Fellows’ ideas, but he encouraged prime movers in each group to keep the conversation moving forward.

Several participants said they would support the idea of producing a Salzburg Statement. Lotherington indicated this was something which could be pursued but would have to stem from a smaller working group first before it could branch out to all participants.

Anne Weiss, managing director at the Robert Wood Johnson Foundation, said the program had provided her the opportunity to discuss a challenge experienced in more than one country and that the conversation had moved from hospitals to health eco-systems.

Susan Mende, a senior program officer at the Robert Wood Johnson Foundation, said participants had disproved the notion that something that happens in one part of the world can’t be applied to another. To conclude, Mende said participants had seen the "winds of change” at Salzburg Global, and a gale was beginning to build.

The session, Building Healthy Communities: The Role of Hospitals is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with the Robert Wood Johnson Foundation. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.


Salzburg Global Seminar