Dennis Keefe, CEO of Cambridge (MA) Health Alliance (CHA), knows what it takes to build healthier communities, and what he’s learned can help others. For his efforts to expand access to care, Keefe last month received the “Lifetime Achievement Award” from the health care advocacy group Health Care for All. That honor came after Cambridge Health Alliance’s “Volunteer Health Advisor” program won the 2008 Booker T. Washington Award for Wellness in Minority Health, an award sponsored by the National Minority Quality Forum. Cambridge Health Alliance’s outreach to diverse communities also earned it a 2005 AHA NOVA Award, which honors local partnerships that improve community health. Keefe’s health care career spans more than 30 years, and he’s been Cambridge Health Alliance’s leader since 2002. We spoke to him about his organization’s strong community connections.
AHA News: Many hospitals struggle to maintain the esteem and trust of the people they serve. Do you see strengthening public trust and creating channels for community outreach as key to the future of the nation's hospitals?
Keefe: Overcoming barriers often associated with racial and ethnic disparities is engrained in what we do, and our patients – as well as stakeholders that include legislators and community leaders – recognize that we are committed to delivering the best possible care for all who need it. We are the state’s last remaining public health hospital. Forty-five percent of our patients speak a language other than English, and communication is key to caring effectively for our patients and community. It’s why we recruit many bi-lingual and multi-lingual providers and provide comprehensive multi-lingual interpreting through face-to-face, video and telephone communication.
Our “Volunteer Health Advisor” program is a strong example of our bridge to underserved communities. The advisors live in the community we are trying to reach. It’s by fostering the community’s trust that we can make initial contact with the hard-to-reach population and introduce them to our services, with the goal of keeping them well. Through outreach, we are able to communicate and learn from each other. The journey to wellness and improvement in health outcomes is a partnership.
AHA News: Do the range of services you provide outside the walls of the hospital help demonstrate accountability to the community? And is it also recognition that these types of initiatives are necessary to ensure the long-term viability of both the hospital and the community?
Keefe: One of our greatest strengths is our ability to respond to community needs. By working with individuals, community groups, non-profit agencies and public health departments, we link people to health care services and educate them about health issues. Integral to our success is our planned care initiatives, which focus on chronic disease management in diabetes, asthma and depression. It’s one of the ways that we keep our patients healthy and help to manage their diseases while preventing them from becoming hospitalized or visiting the emergency department.
These services improve the health of our communities, but they are not recognized by payers as reimbursable services. This will be an ongoing challenge for many health systems as the population nationwide continues to diversify and age during a time where there is a focus on efficiencies and containing health care costs. I’m sure it will be a critical part of policy discussions regarding health care reform.
Our academic affiliations with Harvard Medical School, Harvard Dental School of Medicine, Harvard School of Public Health, and also with Tufts University School of Medicine put us in a unique position as a premier training site for those interested in community-based medicine. Our academic programs offer exceptional educational and research programs while adding credibility and visibility to our mission. Many graduates stay on and become part of our workforce and members of our communities.
AHA News: Does the community recognize the breadth of services you provide and appreciate what your presence means to them?
Keefe: Our state has many nationally recognized and high-quality providers to choose from, and Massachusetts’ newly instituted health care reform gives resident more flexibility to access their provider of choice. We found that even with opportunities to seek new providers, our patients (and new patients) continue to come to us for care. That in itself tells me that we are appreciated.
Nearly 2,000 of our employees live in our communities, and we have more than two dozen local residents who serve on our governing boards. Our strong community focus and community connections guide our efforts, allowing us to better meet the needs of the people we serve.
When a health crisis occurs in the community, we are the first organization that community leaders contact.
AHA News: How does your governance structure help strengthen your “community connections?”
Keefe: [Cambridge Health Alliance] is governed by a 19-member board of trustees that is appointed by Cambridge’s city manager. The trustees are “of the community” – they live in our principal service areas and share our commitment to helping communities become and stay healthy. All are highly esteemed members of their respective communities and are attuned to the key issues faced by area residents. They bring to us an intuitive feel for and knowledge of the communities and work with our executive leadership team to serve the immediate needs of the community and advance our mission, vision and values.
Led by our board, we recently looked at how we could improve efficiency, as well as ensure that there was a strong mechanism to allow for community input into the board. As a result, the board established a new core committee, the “Board Community and Public Health Committee,” which includes key community leaders and reflects the diversity of the patients we serve. To ensure that the core committee is receiving more input from the community, it has also established a much broader community advisory board. The core committee and the community advisory board provide us with another communication avenue within the governance structure to ensure that we are “in touch” with our community’s health needs and respond to their needs.
To find out more about Cambridge Health Alliance’s “Volunteer Health Advisors” program and other community services, contact the alliance’s Alison Harris, aharris@challiance.org, or David Cecere, dcecere@challiance.org.
