STEP 5 
Prioritize Community Health Needs and Assets

Hospitals and health systems develop priority-setting criteria and processes with transparency and in partnership with the community. A set of criteria is agreed upon to guide the priority-setting process.

Typically, three to six priorities are selected, based on:

• The magnitude of the problem or asset.
• Severity of the problem
• Community’s capacity and willingness to act on the issue
• Ability to have a measurable impact on the issue
• Availability of hospital and community resources
• Existing interventions focused on the issue
• Whether the issue is a root cause of other problems
• The priority the community places on the problem

Additional priority-setting criteria can include:

• Evidence that an intervention can change the problem
• Alignment with an organization’s existing priorities, including high-quality care for all patients
• The hospital’s ability to contribute resources and expertise to address the prioritized area
• Potential challenges or barriers to addressing the need
• The opportunity to intervene upstream, at the prevention level

Leverage data to assess and set priorities, pursuing this activity collaboratively with community members who are represented by the numbers and can offer keen insights based on their experiences.

Consider this and the following guidelines when leveraging data in your planning:

• Be transparent so stakeholders understand methods as well as why and how certain data are reported.
• Be clear about your methodology so future CHA efforts can benefit and borrow from it.
• Illustrate quantitative findings with stories to demonstrate their meaning in people’s lives.
• Analyze community cohorts that are or are not doing well on any given measure and why gaps exist.
• Look for patterns in the data as a comparison to and affirmation of explicit findings.
• Be sensitive to data ownership. Invite the people whose lives data portrays to have a say in how it is interpreted and stored and what happens to it after it is used.

Priorities are selected as part of an established process informed by contributing partners, including community stakeholders, health departments, social service agencies, policymakers and hospital leadership.

Steps to this approach include the following:

• Engage community participants by reaching out to your CHA advisory committee and other stakeholders.
• Discuss the data. Present the qualitative and quantitative data to the committee. Make sure the data is presented in a format that is accessible to the individuals on the committee. Foster an environment for open dialogue to thoroughly discuss the identified health needs.
• Review community assets. Reflect on what resources exist in your community to address the need. Take stock of what resources — staffing, in-kind, financial, etc. — could potentially be leveraged to address that need.
• Select priorities. Decide which facilitation approach you want to use to determine priority needs. Build consensus around priority needs. If you select priorities that vary from community recommendations, justify the reasons for making those choices. Consider the consequences of not addressing an issue and how that can affect the community’s well-being in the future. In the case of overlapping health needs, consider consolidating them into a single priority.
• Validate selected priorities. Reengage through discussion groups with members of your CHA advisory committee and internal stakeholders. Make sure the selected priority needs align with hospital and community sentiment.
• Present priorities to senior leadership and the hospital’s board of trustees for approval. Seek opportunities to align your hospital’s population health-management strategy with community health priorities.
• Finally, always consider how addressing the prioritized needs will impact work to reduce disparities in health outcomes in real, measurable ways. Use disaggregated data to reflect key subpopulations in your community at all times.

It may not be possible to address all community health needs at once. If there are significant needs that are not selected as priorities, describe them and state your rationale for not addressing them at present. Be sure to share this news with community members as well as internal stakeholders and senior leaders. Be prepared to provide the reasons why these needs cannot be concurrently met, advise on possible timing and plan to address them in the future.