10 Lessons One Community Healthcare Provider Learned from Its Stakeholders
An important goal in healthcare experience design is to improve trust between users and healthcare providers. Because every cultural community has a different dynamic in relation to the healthcare system and its care providers, a deep knowledge of diverse community needs is especially essential for future urban community development projects.
When leaders of Saint Anthony Hospital in Southwest Chicago, Illinois, began exploring the potential to build a replacement hospital on a new site, they wanted assurance that the project would serve community needs and successfully engage with its key target markets in a financially viable way for the long term. They sought to gain a thorough understanding of stakeholder expectations for U.S. healthcare provision and education in lower socio-economic communities.
Gleaned from the full research document, the following 10 lessons show that listening to community members can greatly influence decision making:
1. Do the homework: Assumptions aren’t facts.
Rather than simply assuming that a new facility will attract and positively impact the 400,000 residents in nearby neighbourhoods, SAH leadership wanted the project to be deeply connected with community groups and needs from its inception. So they sought to better understand stakeholders’ perceptions, cultures, and needs as related to healthcare and perceived community health overall.
To accomplish that goal, researchers from HDR joined forces with the University of Nebraska Medical Center College of Public Health, the University of Nebraska-Lincoln College of Architecture, and Saint Anthony Hospital to investigate differences between neighbourhood ethnic groups’ healthcare choices and service needs. Focusing on four neighbourhoods surrounding the hospital, the team collected quantitative and qualitative resident data on healthcare use and choice, and the likelihood of engaging in new health-promoting services.
2. Residents need a place to engage in community well-being.
Residents desire a solution that’s more than just a place for accessing healthcare services and treating illness; they need someplace they can go to be engaged on many levels in improving and sustaining the overall well-being of a community.
Implication: Success rests in improving and enhancing the social fabric of the community. For someone to have a shot at a healthy life, they have to be able to buy healthy food, feed their mind with education, nurture their creativity through the arts, have a place to send their kids to keep them off the streets, and have a job to support their family.
3. Health and well-being are integrated values.
Study participants view health broadly as “balance,” “self-sufficiency,” “vitality,” “opportunity,” etc. They view health and well-being as being integrated values and so they define it as “much more than healthcare.”
Implication: Understanding the importance of living a healthy lifestyle is a necessary first step towards improved health and well-being. To help achieve this, interactive health education programs and community partnerships that promote immunizations and preventative healthcare are needed.
4. Community members are aware of chronic health challenges.
Interview participants were very aware of chronic health challenges in the community, e.g., diabetes, adult and childhood obesity, heart problems, etc. Some spoke in terms (e.g., “food desert”) that indicate a high level of knowledge about the problems, due to existing and past intervention efforts.
Implication: Residents need help navigating through their healthcare journey, learning about health risks and healthy living along the way. And they need access to fresh foods that support healthy diets and eating habits.
5. Community interest in amenities is high.
A great deal of interest was shown for the addition of a fitness centre, an arts facility with a program for children, a learning centre for health information, child care and elder care, community garden, and shopping and eating establishments.
Implication: The importance of the extended family elevates the need for family-centric space to accommodate large family gatherings. Restaurants and churches were often mentioned by interview and focus group participants as favourite neighbourhood places, in large part because they foster connections among people.
6. People are hopeful about improving their community.
Despite problems with drugs and violence in area neighbourhoods, many people are hopeful about improving education trends in elementary schools. In fact, the importance of educating children is a unifying factor across all ethnic groups.
Implication: A commitment to children is a commitment to the future of the community. Decades of studies and ongoing research show that children from a high-quality learning environment not only have better academic performance in school but also gain critical social and emotional tools for a successful life as adults. They are also more likely to be employed as adults, earning higher wages, and less likely to commit crimes. A need exists for a comprehensive continuum of cradle-to-career programs and services, from early childhood education to elementary and charter schools and trade and college prep programs.
7. Green space is critical.
Parks, or green space, are seen as critical, so that kids have outdoor places to play. Some in the community are already working to increase the number and quality of area parks.
Implication: Ending youth and gang-related violence are top priorities, which elevates the need for sports fields and gymnasiums that offer opportunities to engage youth in extra curricular activities.
8. New built environments bring hope.
The physical environment is important and meaningful. Boarded up buildings and vacant lots signify lack of hope.
Implication: A new building can be a “psychic boost,” although its impact depends upon what is done with it over the longer term.
9. Respond to community diversity.
While immigration significantly impacted access to health services in the Hispanic community, a low percentage of respondents identified it as a major obstacle to healthcare.
Implication: Respondents represent a diverse melting pot of languages and cultures; environments are needed to cater to them all, with communications (online, print, signage, etc.) in multiple languages, and when possible, which follow a universal language approach that uses recognizable symbols and graphics.
10. Transportation is a crucial community component.
Significant differences exist between car ownership and primary mode of transportation between the neighbourhood groups.
Implication: Transit hubs and services can help reduce the inequities associated with unreliable access to transportation. Additionally, mobile clinics that travel into the community could elevate widespread access to healthcare even further.
Ultimately, this research helped transform what began as an idea to build a replacement hospital into a full-scale, mixed use community campus, with the hospital serving as an anchor to the development. It also triggered the idea for a new financial model for the campus (now called Focal Point), where the rental income from revenue-generating tenants — such as retail stores and schools, hospitality and day care, a parking garage, and Saint Anthony Hospital and its outpatient clinic — will be reinvested into programs and services such as continuing education and wellness classes, a centre for creativity and a park and recreation centre. Beyond being designed to provide the balance necessary to keep the model financially sound, each aspect of the campus has been custom-selected based on the initial research study.
The Focal Point Community Campus will not only provide valuable programs and services to local residents, it will be watched as a national model for forward-thinking and neighbourhood-driven community development. As the Focal Point model is refined and brought to life in the coming years, we are learning more about how a community can be strengthened when every voice matters.