Moving Healthcare Upstream. (2018). Policy Leadership for Health Care: Transformation Formalizing Our Commitment to Communities. Wilmington, DE; Author.

Year: 2018


This paper identifies specific institutional policies and civic engagement strategies that can be used by hospitals and health systems to codify, sustain, and scale practices that address social determinants of health (SDH) in local communities. This paper synthesizes these exemplars using a framework of key principles and associated activities and policies required for system transformation that, in turn, can positively impact community health. In addition to highlighting and organizing exemplers in the field, the paper addresses the importance of this work in the current economic and policy environment, provides examples of how the strategies present in diverse environments, and highlights opportunities to align resources to build momentum in the field. Leaders from hospitals and health systems were invited to participate as policy leaders, and completed an organizational self-assessment, a follow-up phone interview, and attendance at an in-person meeting to discuss synthesized data. This work reinforced the knowledge that without buy-in to transformation-oriented principles and practices from organizational leaders, progress cannot be made at the system level. It is clear that there are certain conditional elements that are central to advancement in system transformation- including the system’s understanding and strategic adoption of key institutional characteristics necessary to achieve organizational policy change. In addition, changes to organizational functions and processes are inherent in the necessary shift from volume to value as transformation occurs.

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