ACS Great American Smoke Out

Olympic Community of Health

Update on the Olympic Community of Health

Guest blog by Barbara Malich

The Olympic Community of Health (OCH) is moving through the early formative steps required by the Washington State Health Care Authority and currently we are defining a governance model, developing program activity ideas with aspirational goals that might be relevant to our three county region (Kitsap, Jefferson, and Clallam), as well as preliminary work on developing sustainability models for this new organization.

The more inspirational work is being done by the Peer Learning/Leadership Group in defining how the work can be accomplished given substantial differences in population, level of engagement, and capacity for change.  I am representing our region to this statewide leadership group.  It is, in many ways, quite daunting.

A first step is to better understand the “over-arching” goal/purpose the state envisions for the leaders of the Accountable Communities of Health (ACHs):

The ACH leader must commit to this statement—

     “I am an architect and steward of a participatory process that sustainably aligns resources to achieve equitable health and wellbeing for all members of my community.  I cultivate diverse partnership where we authentically engage with our communities to set health priorities and act on our commitments.  We embrace a holistic approach to transcend, disrupt and transform the complex, multiple, funding streams and delivery systems to optimize the impact of resources.”

At OCH we define this in conjunction with the Institute for Healthcare Improvement’s Triple Aim:  Better Health, Better Care, Lower Cost.

So let’s back up a little to consider how we define health:

The most commonly quoted definition of health is that formalized by the World Health Organization (WHO) over half a century ago; “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.”  This definition is by its very nature HOLISTIC. I have lived by this concept throughout my work-life in community based healthcare here in Kitsap County at PCHS.

I believe by holistically approaching all elements of society, we generate a thoughtful, tolerant, and engaged society. I see the importance of holistic engagement in education, in community visioning, and especially in governing.

Looking at life through the lenses of all the factors present results in understanding, compassionate realism, and may open the door to the potential of change.

I do believe we must be cognizant and sympathetic to the health care systems issues that surround us.  Health care delivery is a major part of our national, regional, and local economies.  It pervades our systems of higher education.  It is the economic engine that is driving conversation in our country.  But even that is a complex concept—it is not just health care systems, it also includes big pharmaceuticals, big insurance companies, and big universities/churches/ and other fundamental/foundational elements of our society.

The ACHs are, by design, intended to disrupt this—through a redistribution of funds, a refocusing of priorities, and by intensely and consciously listening to the community voice as it emerges.  It will take us far beyond our traditional definitions of public health, community/behavioral health, specialists, hospitals, and the other integrated factors of daily life— access to affordable housing, living wage jobs and reintegration of those at highest risk (the homeless, those emerging from incarceration, and those confused/immobilized by mental health and chemical dependency).  We will need to manage chronic and acute conditions as we disrupt the very systems on which people depend.  We need to engage with providers—they have the most access to the patients who will become the community voice—and the providers and the systems employing them are speaking loudly against change.

Holistic means all-encompassing—beyond the traditional barriers, beyond the existing institutions, and beyond our current horizon.  The OCH Vision:  engage our communities in plans for innovation, integration and transformation—all while keeping an eye on cost-reduction, maintenance of the systems needed  to support our populations as we move towards this transformed system, and to help our communities to “connect the dots” to understand why this work is important.

The focus on “winners” and “losers” has to stop.  We all may win if the transformation is allowed to occur.