Table 3 Recommendations for community engagement in safety-net systems for social service integration
From: A collaboration team to build social service partnerships within a safety-net health system
# | Recommendation | Policy Considerations |
1 | Evaluate organizational readiness and adaptability for collaboration with the community (before engagement) | • Conduct an internal assessment and planning process to evaluate community engagement readiness. This stage should reflect on whether any feedback received or gaps identified would be considered for systems change. The health system should explore feasible ways to adapt to potential suggestions from the community; however, if not possible, transparent explanations for decision-making should be provided. • Develop a clear purpose for community partnership/engagement for improving healthcare and social needs outcomes, which can be modified collaboratively throughout engagement processes. Concrete steps and guidance for the engagement should be defined, such as including community engagement and collaboration as an organizational value or developing a strategic plan for community engagement and collaboration. Create long-term goals to inform short-term goals (i.e., a 10-year strategic plan). • Identify power-sharing strategies, such as community positions on committees, compensation, consensus-building, or voting power, specifically focusing on those with lived or community expertise • Increase organizational readiness to discuss racism and its historical impact on communities of color; develop a framework to incorporate race and health equity into organizational practices (training, data, program planning, evaluation, etc.). |
2 | Include community input and create equilateral, mutually-beneficial community partnerships | • Incorporate community-participatory venues and processes for consensus building, bi-directional knowledge exchange, and community feedback, including planning, policy, programming, budgets, and evaluation. • The community should be supplied with funding and financial resources when providing expertise or services to improve the health systems' breadth, depth, or strategic plan. Compensate, pay, and credit the community as advisors or consultants for community time, expertise, and feedback. • Throughout the partnership, the health system should try to uplift and increase the community's exposure by highlighting their communal strengths, resources, and resiliency. |
3 | Put a value on, elevate, and respect community expertise and lived experience | • Community expertise and lived experience provide specialized cultural, socioeconomic, or community knowledge for health policy and programming, giving insight into the local community's cultural values, resources, assets, needs, and preferences. Lived experience or community expertise is critical for informing health systems to increase the quality of care by obtaining end-user feedback for the most vulnerable patients. In collaboration with social services, health systems must value the importance of community expertise and lived experience to elevate and respect the knowledge of the community they serve. • Recognize how lived experience expertise provides value for the health system by building trust, improving patient satisfaction, improving quality of care, reducing health disparities, and addressing factors within the communities' well-being, including social determinants of health. |
4 | Hiring from and for the community | • Hiring health system employees should reflect the community served to better address the community's needs, cultural unity, and behavioral norms. To develop and utilize culturally humble talent acquisition, consult the community for recruitment, hiring, and training assistance. • Consider peer support and leadership roles that emphasize lived experience as a skill and tool for patient engagement. |
5 | Professional development and staff sustainability in community collaboration and engagement | • Provide education, skill-building, career opportunities, mentorship of impacted community members, and leadership opportunities for Black, Brown, and people from affected focus communities. Invest in developing and specialization skills to build best practices for community engagement. A plan for employees for job readiness, training, and engagement or health systems skills prep should exist. Develop guidelines for recognizing autonomy, flexibility, accountability, and time investment for engagement work. • Offer staff opportunities for growth based on strengths and quality of work—the dedicated collaboration team position allowed for a richer conversation about short and long-term solutions • Increase awareness within health system leadership for best practices for authentic longitudinal community engagement and cultural humility. Train and incorporate leadership with community experience. |