Public Health Nursing Vol. 31 No. 3, pp. 193–195 0737-1209/© 2014 Wiley Periodicals, Inc. doi: 10.1111/phn.12124
EDITORIAL
The Academic Health Department: The Case for Building Partnerships to Enhance the Health of the Public Ten years have passed since the Institute of Medicine reports, The Future of Public Health in the 21st Century (2003) and Who Will Keep the Public Healthy? (2004), and 3 years since its report, The Future of Nursing: Leading Change, Advancing Health (2011). These publications agreed that greater gains in the public health workforce competency, research, evidence-based practice, and service delivery are achieved when public health academic–practice partnerships are forged. The development of academic health departments (AHDs) is one important example of such a partnership. Defined as a formal affiliation between an academic institution and a public health practice organization, characteristics of AHDs include: ● A formalized written agreement between the two entities; ● Shared personnel, resources, and compensation; ● Collaborative education and training for students and staff; ● Joint research, grants, projects, and services; ● Shared provision of public health services; and, ultimately ● A shared role in executing the three core functions of assessment, assurance and policy for healthy communities (Council on Linkages, nd). The AHD model has the potential to address the needs for a well prepared public health nursing workforce that includes new graduates, current staff, and faculty development; serve as a hiring pipeline for nursing graduates; provide interprofessional education and practice opportunities; expand the expertise necessary to anticipate and meet community needs; strengthen the partners’ ability to conduct and disseminate rigorous communitybased participatory research; and engender entrepreneurial and innovative approaches to com-
munity issues. Ultimately, a strong AHD serves the community by modeling a culture of shared resources in economically constrained and rapidly shifting higher education and health care systems— thus providing further evidence to the public of the value of academia and public health services in their communities. Unfortunately, there is scant dissemination about the impact of the AHD model and less than optimal guidance about the facilitators and barriers to expanding the model. Visibility for the emergence of the AHD concept for the health professions schools was apparent in the work of Keck (2000) who suggests that future effective public health organizations will be those that develop partnerships with academic and community organizations that share the mission of public health. He describes the 50-year-old academic partnerships of schools of nursing and health departments in northeastern Ohio. The founding health departments expanded their partnership from nursing students to include medicine, health education, nutrition, and public health students. The partnership resulted in the Akron health department becoming an official teaching health department— complete with self-study criteria from which to judge the capacity to serve as a teaching facility. This AHD has produced students with experience in public health practice and research and who think positively about health departments, their roles, and capacity. Joint research projects have been conducted and consulting expertise from the partners has provided contracts for evaluation, organizational development, and medical support services according to Keck (2000). More recently, Hovarter and Zahner (2014) disseminated the findings of the 6-year grant funded academic–practice partnership, Linking Education
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and Practice, to improve population-based public health nursing in Wisconsin. Three outcomes from the grant project included: increased competency for contemporary public health nursing practice; broad exposure and penetration among students, faculty and practicing nurses of population care; and, improved education for undergraduate nursing students and nurses new to public health practice. Joint publications, presentations and research with teams of academic and public health practice partners resulted. This statewide partnership also demonstrated improved educational offerings and self-reported public health nursing competencies by participants in the statewide academic–practice partnership with public health agencies. While the AHD model has been only minimally evaluated, it is completely appropriate that we think globally and act locally to execute the AHD concept in practice. The potential to develop an AHD partnership is highly viable today since accessible baccalaureate and higher degree nursing programs exist in most communities with public health organizations. As a current example, the Kansas City, Missouri Health Department (KCMO), a public health agency with nearly 150 years of experience serving Kansas City residents by protecting them from disease and disability, has entered a new phase in its long history. Recognizing the need for partnership with academic institutions nearby, the Department responded to the challenges in the IOM reports and began its evolution to becoming an AHD by partnering with the University of Missouri Kansas City School of Nursing and Health Studies. It became the first local health agency in the nation to meet voluntary state accreditation standards in 2004 and one of only two metropolitan health departments to recently achieve national accreditation. As one of the outcomes of this process, ten Master of Public Health (MPH) students from academic institutions in Missouri and Kansas have completed internships or practicums at KCMO over the past 4 years, most with durations of at least 360– 400 hr. Five of these students were offered permanent positions on graduating, demonstrating success in recruiting and training the next generation of public health leaders. Working with this AHD has provided UMKC SoNHS with a venue for engaging faculty and students in wide-ranging practice, research and service
May/June 2014
projects. The School has actively engaged in nursing practice in the community—with projects in assessment, assurance and policy development, and in practice and evaluation opportunities with the 10 Essential Services of Public Health. In a new project, the recruitment of students representing diversity in the community are being jointly resourced by the partnership in the summer program to provide an action-oriented orientation to public health and to catalyze career interests in public health nursing and practice. Regular monthly communications with the current Dean of the SoNHS explore additional opportunities for students and faculty in a variety of settings within the KCMO or the community to expand engagement in clinical, research practices, or additional areas. This developing AHD approach recognizes that it is necessary to graduate nurses prepared to enter the workforce with a strong basis in public health practice and research as well as theory. Early evidence of the strength of the partnership can be found in the fact that the former Dean of UMKC SoNHS, continues to serve as Co-Chair of the Mayor’s Health Commission, an advisory Board to the Mayor and the Health Department, on issues related to community health policy. The Commission serves as a forum for leading community health advocates to advise the Mayor, City Council and the Department about policies and priorities in for the entire community. Future outcome evaluations will provide details about specific ways that this partnership impacts the public health system and population health indicators in Kansas City. We strongly suggest that such collaboration can work in your community. Consider our challenge to you to join us in this experiment to bring real solutions for healthy communities. Realizing the recommendations of the IOM reports through the execution of an AHD model is a local solution to the global challenge of a healthy world. Rex Archer, M.D., M.P.H. Kansas City, MO Ann H. Cary, Ph.D., M.P.H., R.N. Kansas City, MO Bert Malone, M.P.A. Kansas City, MO
Archer et al.: Academic Health Department
References Council on Linkages. (nd). Academic health departments: Core concepts. Retrieved from http:// www.phf.org/programs/council/Pages/default. aspx Hovarter, R., & Zahner, S. (2014). Linking education and practice for excellence in public health nursing. Webnair sponsored by the American Association of Colleges of Nursing. March 3, 2014.
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Institute of Medicine. (2003). The future of the public’s health in the 21st century. Washington, DC: National Academy Press. Institute of Medicine. (2004). Who will keep the public healthy?. Washington, DC: National Academy Press. Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academy Press. Keck, W. C. (2000). Lessons learned from an academic health department. Journal of Public Health Management and Practice, 12(1), 47–52.
EDITORIAL
The Academic Health Department: The Case for Building Partnerships to Enhance the Health of the Public Ten years have passed since the Institute of Medicine reports, The Future of Public Health in the 21st Century (2003) and Who Will Keep the Public Healthy? (2004), and 3 years since its report, The Future of Nursing: Leading Change, Advancing Health (2011). These publications agreed that greater gains in the public health workforce competency, research, evidence-based practice, and service delivery are achieved when public health academic–practice partnerships are forged. The development of academic health departments (AHDs) is one important example of such a partnership. Defined as a formal affiliation between an academic institution and a public health practice organization, characteristics of AHDs include: ● A formalized written agreement between the two entities; ● Shared personnel, resources, and compensation; ● Collaborative education and training for students and staff; ● Joint research, grants, projects, and services; ● Shared provision of public health services; and, ultimately ● A shared role in executing the three core functions of assessment, assurance and policy for healthy communities (Council on Linkages, nd). The AHD model has the potential to address the needs for a well prepared public health nursing workforce that includes new graduates, current staff, and faculty development; serve as a hiring pipeline for nursing graduates; provide interprofessional education and practice opportunities; expand the expertise necessary to anticipate and meet community needs; strengthen the partners’ ability to conduct and disseminate rigorous communitybased participatory research; and engender entrepreneurial and innovative approaches to com-
munity issues. Ultimately, a strong AHD serves the community by modeling a culture of shared resources in economically constrained and rapidly shifting higher education and health care systems— thus providing further evidence to the public of the value of academia and public health services in their communities. Unfortunately, there is scant dissemination about the impact of the AHD model and less than optimal guidance about the facilitators and barriers to expanding the model. Visibility for the emergence of the AHD concept for the health professions schools was apparent in the work of Keck (2000) who suggests that future effective public health organizations will be those that develop partnerships with academic and community organizations that share the mission of public health. He describes the 50-year-old academic partnerships of schools of nursing and health departments in northeastern Ohio. The founding health departments expanded their partnership from nursing students to include medicine, health education, nutrition, and public health students. The partnership resulted in the Akron health department becoming an official teaching health department— complete with self-study criteria from which to judge the capacity to serve as a teaching facility. This AHD has produced students with experience in public health practice and research and who think positively about health departments, their roles, and capacity. Joint research projects have been conducted and consulting expertise from the partners has provided contracts for evaluation, organizational development, and medical support services according to Keck (2000). More recently, Hovarter and Zahner (2014) disseminated the findings of the 6-year grant funded academic–practice partnership, Linking Education
193
194
Public Health Nursing
Volume 31
Number 3
and Practice, to improve population-based public health nursing in Wisconsin. Three outcomes from the grant project included: increased competency for contemporary public health nursing practice; broad exposure and penetration among students, faculty and practicing nurses of population care; and, improved education for undergraduate nursing students and nurses new to public health practice. Joint publications, presentations and research with teams of academic and public health practice partners resulted. This statewide partnership also demonstrated improved educational offerings and self-reported public health nursing competencies by participants in the statewide academic–practice partnership with public health agencies. While the AHD model has been only minimally evaluated, it is completely appropriate that we think globally and act locally to execute the AHD concept in practice. The potential to develop an AHD partnership is highly viable today since accessible baccalaureate and higher degree nursing programs exist in most communities with public health organizations. As a current example, the Kansas City, Missouri Health Department (KCMO), a public health agency with nearly 150 years of experience serving Kansas City residents by protecting them from disease and disability, has entered a new phase in its long history. Recognizing the need for partnership with academic institutions nearby, the Department responded to the challenges in the IOM reports and began its evolution to becoming an AHD by partnering with the University of Missouri Kansas City School of Nursing and Health Studies. It became the first local health agency in the nation to meet voluntary state accreditation standards in 2004 and one of only two metropolitan health departments to recently achieve national accreditation. As one of the outcomes of this process, ten Master of Public Health (MPH) students from academic institutions in Missouri and Kansas have completed internships or practicums at KCMO over the past 4 years, most with durations of at least 360– 400 hr. Five of these students were offered permanent positions on graduating, demonstrating success in recruiting and training the next generation of public health leaders. Working with this AHD has provided UMKC SoNHS with a venue for engaging faculty and students in wide-ranging practice, research and service
May/June 2014
projects. The School has actively engaged in nursing practice in the community—with projects in assessment, assurance and policy development, and in practice and evaluation opportunities with the 10 Essential Services of Public Health. In a new project, the recruitment of students representing diversity in the community are being jointly resourced by the partnership in the summer program to provide an action-oriented orientation to public health and to catalyze career interests in public health nursing and practice. Regular monthly communications with the current Dean of the SoNHS explore additional opportunities for students and faculty in a variety of settings within the KCMO or the community to expand engagement in clinical, research practices, or additional areas. This developing AHD approach recognizes that it is necessary to graduate nurses prepared to enter the workforce with a strong basis in public health practice and research as well as theory. Early evidence of the strength of the partnership can be found in the fact that the former Dean of UMKC SoNHS, continues to serve as Co-Chair of the Mayor’s Health Commission, an advisory Board to the Mayor and the Health Department, on issues related to community health policy. The Commission serves as a forum for leading community health advocates to advise the Mayor, City Council and the Department about policies and priorities in for the entire community. Future outcome evaluations will provide details about specific ways that this partnership impacts the public health system and population health indicators in Kansas City. We strongly suggest that such collaboration can work in your community. Consider our challenge to you to join us in this experiment to bring real solutions for healthy communities. Realizing the recommendations of the IOM reports through the execution of an AHD model is a local solution to the global challenge of a healthy world. Rex Archer, M.D., M.P.H. Kansas City, MO Ann H. Cary, Ph.D., M.P.H., R.N. Kansas City, MO Bert Malone, M.P.A. Kansas City, MO
Archer et al.: Academic Health Department
References Council on Linkages. (nd). Academic health departments: Core concepts. Retrieved from http:// www.phf.org/programs/council/Pages/default. aspx Hovarter, R., & Zahner, S. (2014). Linking education and practice for excellence in public health nursing. Webnair sponsored by the American Association of Colleges of Nursing. March 3, 2014.
195
Institute of Medicine. (2003). The future of the public’s health in the 21st century. Washington, DC: National Academy Press. Institute of Medicine. (2004). Who will keep the public healthy?. Washington, DC: National Academy Press. Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academy Press. Keck, W. C. (2000). Lessons learned from an academic health department. Journal of Public Health Management and Practice, 12(1), 47–52.
