Case study: Johns Hopkins Community Health Partnership: A model for transformation

Healthc

To address the challenging health care needs of the population served by an urban academic medical center, we developed the Johns Hopkins Community Health Partnership (J-CHiP), a novel care coordination program that provides services in homes, community clinics, acute care hospitals, emergency departments, and skilled nursing facilities. This case study describes a comprehensive program that includes: a community-based intervention using multidisciplinary care teams that work closely with the patient's primary care provider; an acute care intervention bundle with collaborative team-based care; and a skilled nursing facility intervention emphasizing standardized transitions and targeted use of care pathways. The program seeks to improve clinical care within and across settings, to address the non-clinical determinants of health, and to ultimately improve healthcare utilization and costs. The case study introduces: a) main program features including rationale, goals, intervention design, and partnership development; b) illness burden and social barriers of the population contributing to care challenges and opportunities; and c) lessons learned with steps that have been taken to engage both patients and providers more actively in the care model. Urban health systems, including academic medical centers, must continue to innovate in care delivery through programs like J-CHiP to meet the needs of their patients and communities.

Berkowitz SA, Brown P, Brotman DJ, et al. Case study: Johns Hopkins Community Health Partnership: A model for transformation. Healthc (Amst). 2016;4(4):264-270. PMID: 27693204. DOI: 10.1016/j.hjdsi.2016.09.001.

Publication Year: 
2016
Resource Type: 
Journal Article
Study Design: 
Case Study
Social Determinant of Health: 
Economic Security
Health Care Access
Housing Quality
Social Support
Transportation
Population: 
Complex Patients
Medicaid-insured
Medicare-insured
Outcomes: 
Health & Health Behaviors
Process Outcomes
Screening Research: 
No