Before You Begin

Step 1

Map Development

Step 2

Build Relationships

Step 3

Develop Community Profile

Step 4

Increase Equity With Data

Step 5

Prioritize Needs and Assets

Step 6

Document and Communicate Results

Step 7

Plan Equity Strategy

Step 8

Develop Action Plan

Step 9

Evaluate Progress

Jointly Develop an Action Plan

Now it is time to put into action the plan to address the prioritized community health needs selected and developed in Step 7. This will be an ongoing process as you work to improve health by turning strategies into concrete, equitable actions. If you have developed Population Health Driver Diagrams (Step 7) to address the health priorities identified in your CHA, you can continue to use and update them as you implement strategies with multiple stakeholders. Teams can be formed for each primary driver, and these teams can determine specific secondary drivers to address.

View additional resources to futher your CHA journey.

Step 8 Resources

Continue Engaging Stakeholders

Work with internal and external stakeholders throughout implementation to support ongoing community buy-in. Refer to the Community Engagement section for additional information about how to sustain stakeholder involvement.

Assemble an Implementation Subcommittee and Team for Each Strategy

Over the course of your CHA, many professionals and stakeholders will have participated or contributed to the process. Some hospitals may call on these individuals, as well as their advisory committee, to form a subcommittee focused on implementation.

The implementation team can meet periodically to assess progress and challenges and make any modifications to the action plan.

As you consider the makeup of the implementation team, reflect on these questions:

  • Is the committee representative of the community served, especially those groups who have experienced historic marginalization or systemic racism?
  • Are there community efforts already underway?
  • Who will be doing the work? Are all partners clear on their roles?
  • What skill sets are needed to make the strategy a success?
  • Are there gaps in staffing and skills that need to be filled? Can those gaps be filled by people in your organization and/or community partners? Will you need to hire any new staff?

Many prioritized community health issues in your CHA may already have hospital-community partnerships working to address them. In that case, offer your new findings as a means to support the ongoing work and respectfully increase its impact as needed.

Develop an Action Plan

Develop an action plan for each strategy that addresses a priority need, with a detailed description of specific activities, roles and timelines.

Questions to address include the following:

  • What specific, concrete actions are needed to achieve the stated objectives?
  • What specific changes need to occur?
  • What organizations or individuals will take the lead on each action step, and who will be responsible for ensuring completion? Who else will participate, and what roles will they play?
  • What is a realistic time frame for the implementation of each step?
  • When will the implementation strategies be completed? How will they be maintained?
  • How will you know if you’re making — or failing to make — progress? What metrics will you measure, and are they stratified by race/ethnicity and preferred language? How often will you measure? Set benchmarks to monitor progress along the way. Make sure this matches your evaluation approach and that metrics measure the outcomes you want to see.
  • Is the plan flexible enough to adapt to changing circumstances or challenges?
  • How will you continue to involve community members throughout the process to avoid contributing to a sense of only engaging the community on the hospital’s timeline?

Develop a Budget

Go through a budgeting process to estimate how much the strategies will cost to implement. Remember to include resources for the programs as well as the staff who will implement and evaluate them. Build in budget dollars to compensate community partners for work they would not otherwise be doing. Once a budget is in place, you will need to determine funding sources. Your hospital may be willing to financially back the entire strategy, or you may piece together resources from your organization, grants, in-kind support and partners. Here again, keep in mind that community members and other partners may believe the hospital has more resources than it really does. Consider the long-term sustainability of the project when you are budgeting; improving community health takes time, and any initiative will require multiple budget cycles. A good resource to reference is the Beyond the Grant workbook from Rethink Health.



Use influence and status to champion the importance of health equity and dismantling racism and discrimination.

Hospitals have credibility, status and relationships that can influence public understanding of the root causes of health inequity. This influence can be directed by acknowledging historic and current patterns of racism and their impact and by promoting values of equity and inclusion in both internal and external communications. Use your reputation and credibility to “change hearts” and to advance health equity.

Source: Raising the Bar.