Clinic and Community: The Road to Integration

Area of Science:

• Public Health
• Health Systems Research
• Community Health

Background:

• Growing recognition of social and environmental determinants of health.
• Need for interaction between clinical providers and community systems.
• Kresge Foundation's Safety Net Enhancement Initiative funded projects in vulnerable communities.

Purpose of the Study:

• To analyze integration efforts between clinical and community systems.
• To identify common features and steps for successful integration.
• To address health inequities through system linkage.

Main Methods:

• Qualitative analysis of integration efforts from 2011-2013.
• Analysis of steps taken by demonstration sites over a 3-year period.
• Focus on within-site and between-site integration.

Main Results:

• Increased clinical capacity through policy/practice changes and onsite services.
• Expanded definition of health by clinical providers.
• Successful changes in clinic and community policies and practices.
• Creation of mechanisms linking community resources to clinical systems.

Conclusions:

• Clinical systems require shifts in perspective, behavior, and administration for integration.
• Community systems need internal and inter-organizational changes for integration.
• Effective coordination between clinical and community environments is essential.