Community Health Needs Assessment - Implementation, Monitoring and Evaluation

Community Health Needs Assessment - Implementation, Monitoring and Evaluation

Your Community Health Needs Assessment is complete with lots of community involvement.  Your community has assisted in prioritizing the most important health issues.  Your hospital has selected and prioritized the health issues and goals that it will work on, and has justifications for the issues it will not work on.  There is still one more requirement to be met: an implementation plan with monitoring and evaluation of efforts.  Stratasan suggests creating a Health Issues dashboard containing as much of the following information as possible.

  • Your hospital's prioritized health issues
  • Action items related to health issues
  • Measurable goal statements
  • Pre-CHNA health indicator score
  • Your hospital's goal for the health indicator
  • National or state median for comparison
  • Best practice or national benchmark for the health indicator
  • Healthy People 2030 goal
  • Source of the data
  • Timeframe for update of the indicator

For example, if the hospital selects diabetes as a community issue to improve, it may have an action of increasing exercise in the population through community exercise programs, a fitness center, and physicians' offices prescribing exercise for their patients.  The health indicator score may be physical inactivity defined as the percent of adults aged 20 and over reporting no leisure time physical activity.

The pre-CHNA score was 26% and the current year's available data may indicate 27% physical inactivity.  This is in comparison to national and state benchmarks of 21% and 30% respectively.  The Healthy People 2030 goal is a 10% improvement, so the goal would be set to reduce down to 24%.  The source of the data is the CDC's Behavioral Risk Factor Surveillance System (BRFSS) survey.  

A concern relative to the implementation plan is the efficacy of initiatives that hospitals and other community organizations are undertaking.  Are they actions proven to result in health improvement? contains interventions and resources to assist hospitals select evidence-based actions.

The drawback to many of the health indicators it he lag time in measurements.  Unless the hospital is performing its own survey of the population, many of the national surveys, BRFSS and National Health Interview Survey or American Community Survey, will lag behind at least one year.

According to a report form the CDC regarding Best Practices for Community Health Needs Assessment and Implementation Strategy, "A key concern in the community benefit arena is the relative capacity of hospitals to monitor and evaluate the effectiveness of programs and activities.  This becomes more important in the context of health reform, with the anticipation of a reduced demand for charity medical services, and increased emphasis on addressing the underlying causes of persistent health problems."

The key is to select actions that are evidence-based and will result in actual health improvement and to measure the results even if the measure lags behind the efforts. The IRS allows a hospital to keep the same implementation plan for three years.  The measures will eventually reflect the actions of the hospital and the community.  If the hospital finds its actions are not improving the measure, they may make adjustments to the implementation plan.

For help with your Community Health Needs Assessment and Implementation Plan, contact us at

chna Community Health Needs Assessment