The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, NH, Lebanon, USA.
Department of Family and Community Medicine, University of California, CA, San Francisco, USA.
J Gen Intern Med. 2023 Nov;38(15):3348-3354. doi: 10.1007/s11606-023-08308-y. Epub 2023 Jul 18.
Health care organizations' partnerships with community-based organizations (CBOs) are increasingly viewed as key to improving patients' social needs (e.g., food, housing, and economic insecurity). Despite this reliance on CBOs, little research explores the relationships that health care organizations develop with CBOs.
Understand how health care organizations interact with CBOs to implement social care.
Thirty-three semi-structured telephone interviews collected April-July 2019.
Administrators at 29 diverse health care organizations with active programming related to improving patients' social needs. Organizations ranged from multi-state systems to single-site practices and differed in structure, size, ownership, and geography.
Structure and goals of health care organizations' relationship with CBOs.
Most health care organizations (26 out of 29) relied on CBOs to improve their patients' social needs. Health care organization's goals for social care activities drove their relationships with CBOs. First, one-way referrals to CBOs did not require formal relationships or frequent interactions with CBOs. Second, when health care organizations contracted with CBOs to deliver discrete services, leadership-level relationships were required to launch programs while staff-to-staff interactions were used to maintain programs. Third, some health care organizations engaged in community-level activities with multiple CBOs which required more expansive, ongoing leadership-level partnerships. Administrators highlighted 4 recommendations for collaborating with CBOs: (1) engage early; (2) establish shared purpose for the collaboration; (3) determine who is best suited to lead activities; and (4) avoid making assumptions about partner organizations.
Health care organizations tailored the intensity of their relationships with CBOs based on their goals. Administrators viewed informal relationships with limited interactions between organizations sufficient for many activities. Our study offers key insights into how and when health care organizations may want to develop partnerships with CBOs.
医疗机构与社区组织（CBO）的合作关系日益被视为改善患者社会需求（如食物、住房和经济不安全）的关键。尽管依赖于 CBO，但很少有研究探讨医疗机构与 CBO 之间建立的关系。
了解医疗机构如何与 CBO 互动以实施社会关怀。
2019 年 4 月至 7 月期间进行了 33 次半结构式电话访谈。
29 家具有改善患者社会需求相关活跃项目的多样化医疗机构的管理人员。组织范围从多州系统到单一地点的实践，在结构、规模、所有权和地理位置上有所不同。
医疗机构与 CBO 关系的结构和目标。
大多数医疗机构（29 家中有 26 家）依赖 CBO 来改善患者的社会需求。医疗机构社会关怀活动的目标推动了他们与 CBO 的关系。首先，单向转介给 CBO 不需要正式关系或与 CBO 频繁互动。其次，当医疗机构与 CBO 签订合同提供离散服务时，需要领导层关系来启动项目，而员工之间的互动则用于维持项目。第三，一些医疗机构与多个 CBO 开展社区层面的活动，这需要更广泛、持续的领导层伙伴关系。管理人员强调了与 CBO 合作的 4 项建议：（1）尽早参与；（2）为合作建立共同目标；（3）确定谁最适合领导活动；（4）避免对合作伙伴组织做出假设。
医疗机构根据其目标调整与 CBO 的关系强度。管理人员认为，组织之间互动有限的非正式关系足以满足许多活动的需求。我们的研究提供了医疗机构何时可能希望与 CBO 建立伙伴关系的关键见解。
