Published in South Florida Hospital and Healthcare Association Newsline –
I spent most of my career as an executive in hospitals and healthcare delivery systems, witnessing firsthand the incredible work of the physicians, nurses, technicians, and the healthcare support teams I was privileged to lead. More recently, I have become involved as a healthcare consultant in Florida’s public health system; in that role, I devote my efforts to encouraging and facilitating healthy environments, healthy behaviors, and healthy lifestyles for the members of our Florida communities. And I have become convinced that the public health teams of researchers, community health workers, environmental engineers, disaster response specialists, contract managers and policy advocates are just as passionate, just as committed, and just as concerned about “population health” as their colleagues in the field of healthcare delivery.
Now, more than ever, there is a confluence of issues related to both public health and healthcare delivery. Even before COVID-19, both fields shared the challenges of dealing with healthcare-related societal issues—gun control, natural and man-made disaster preparedness and response, anti-vaccination fears, tobacco-related smoking and vaping prevalence, elimination of race-related health disparities, and controlling the spread of communicable diseases like Hepatitis, Measles, and HIV/AIDS. Public Health has long been concerned about health equity (so much so that it is a basic goal of the State Health Improvement Plan) and has identified priority populations which require additional resources to achieve optimal population health. Likewise, healthcare delivery administrators and practitioners are now recognizing the outsized impact that social determinants of health—availability of adequate nutrition, access to reliable transportation, degree of family support, stable housing status, to name a few—have on community heath status and actual clinical outcomes.
And, of course, now we have COVID-19 to reinforce to us how important it is that professionals in public health and healthcare delivery come together to tackle the most important issue of our era. We have been rudely reminded that public health is still an evolving science as we grapple with the uncertainty around the novel coronavirus—mode(s) of transmission, adequacy and length of antibody protection, “shelf life” of the virus, which types of personal protective equipment are most effective, necessity and/or degree of social protective measures, and side effects of potential vaccine and treatment pharmaceuticals. What is inarguable, however, is that the brave healthcare workers on the front lines bear some of the greatest burdens in caring for the most vulnerable members of their communities. Their burdens include a risk of personal infection, a likely forced separation from family and loved ones to minimize viral spread, shortages of requisite supplies and equipment, and the untold emotional toll, and resultant burnout and PTSD, associated with long hours and the strain of working in an environment replete with death and disease.
So how best as a system of healthcare should we address the challenges both inside and outside our respective institutions? Can we as public health and healthcare delivery professionals develop a shared vision of population health which bolsters both institutional prosperity and community health? Of course we can; here are a few steps we can take.
- As a first order of business, Let’s do everything possible to protect, support, and reward the healthcare delivery workforce, that is, those who are charged with providing care and contributing selflessly to the health of the community. This goes beyond ensuring safe staffing ratios, providing adequate PPE, and storing reservoirs of supplies and equipment; it means truly addressing the emotional health of the workplace and the mental health conditions that often follow stress and fatigue, like depression, anxiety, insomnia and distress. Utilize the public health resources that are available, adopt institutional policies to support mindfulness and stress reduction, develop a back-up workforce of volunteers or retirees, and devote additional resources to providing healthcare workers with crisis intervention, hotlines, psychological support, and telepsychiatry.
- Empower your employees to become public health advocates and agents of change. Arm them with information and make them available personally or virtually to community organizations and policy makers. Let them share their personal stories of tragedy and triumph to illustrate the positive effect of public health initiatives or the need for further policy change.
- Collaborate with one another and with public health officials to address current challenges. One of the links below shows the example of collaboration among healthcare leaders in Florida to address the COVID-19 surge. As healthcare leaders, we can sponsor community forums (virtual, if necessary) to stimulate meaningful discussion among public health and healthcare professionals, business leaders, media representatives, and state and local legislators. Let your clinicians provide guidance to the community and share the message of personal and corporate responsibility to help address and eliminate disparities in care.
- Advocate for social justice and pragmatic change. The lay community is hungry for healthcare leadership and knowledge. Recognize that your responsibility for spearheading and facilitating that change extends far beyond the historical four walls of your institution into the fabric of the community.
Being a public health or healthcare delivery leader today comes with unprecedented challenges but incalculable rewards. By getting out of our respective comfort zones, reaching across the aisle, protecting and empowering our workforces, and calling upon the guidance and wisdom of professionals from both disciplines, we can come together to achieve our collective yet ever-elusive goal of optimal population health.