The key concepts below outline critical elements of effective evaluation to support maximum impact throughout the CHI process.
Evaluating both process and outcomes is essential to understanding the impact of your CHI efforts. For the most effective evaluation, use your findings to refine your efforts and thereby increase the chances of maximum impact and success.
- A shared, user-friendly measurement system that includes indicators and tools, such as dashboards, is established
- A system to continuously monitor and manage the process is implemented that generates the data needed, including short and intermediate outcomes of the program, and/or policy design and implementation (community change process and outcomes)
- Implementation is adjusted and adapted based on continuous evaluation results
Tools for Getting Started
Tools are listed below in an order roughly aligned with the order of the key concept(s) they support above.
- Evaluating Complexity: Propositions for Improving Practice
- This tool brings together knowledge about systems change, complexity, and evaluation.
- Metrics: How to Select Them, How to Use Them
- This site provides background on metrics as well as tips and steps for selecting and using them in population health improvement.
- A Practitioner’s Guide to Advancing Health Equity—Meaningful Community Engagement for Health and Equity
- Go to pages 30–33 for a collection of health-equity considerations for policy, systems, and environmental strategies. Included are questions for you to consider and examples of how to integrate health equity into local practice.
- Providing Feedback to Improve the Initiative
- Go to the Main Section and Checklist tabs for guidance on how to effectively organize and share evaluation feedback with those participating in the initiative—partners and other stakeholders—on a regular basis.
Relevant Excerpts from the Internal Revenue Service (IRS) Final Rule
The IRS Final Rule on Community Health Needs Assessments (CHNA) for Charitable Hospitals contains language related to select key concepts above. An excerpt of this language is provided below. To see the full regulation, click on the hyperlinked references below this paragraph.31
“[T]he CHNA report adopted for the hospital facility by an authorized body of the hospital facility must include…(F) An evaluation of the impact of any actions that were taken, since the hospital facility finished conducting its immediately preceding CHNA, to address the significant health needs identified in the hospital facility’s prior CHNA(s).”32
“[A] hospital organization must either attach to its Form 990 a copy of the most recently adopted implementation strategy for each hospital facility it operates or provide on the Form 990 the URL(s) of the Web page(s) on which it has made each implementation strategy widely available on a site. Section 6104 requires Form 990 to be made available to the public by both the filing organization and the IRS, and members of the public may obtain a copy of a hospital organization’s Form 990 from one of the privately-funded organizations that gathers and disseminates Forms 990 online, or by completing IRS Form 4506-A, ‘Request for Public Inspection or Copy of Exempt or Political Organization IRS Form.’”33
Note: The above statements do not constitute legal advice or regulatory guidance from CDC. Questions regarding the application of law to a specific circumstance or circumstances should be submitted to an attorney or other qualified legal professional.
31Additional Requirements for Charitable Hospitals; Community Health Needs Assessments for Charitable Hospitals; Requirement of a Section 4959 Excise Tax Return and Time for Filing the Return, 79 Fed. Reg. 78,953 (December 31, 2014) (to be codified at 26 C.F.R. pts. 1, 53, and 602), available at IRS Final Rule on Community Health Needs Assessments (CHNA) for Charitable Hospitals .
32Id. at 79,002.
33Id. at 78,965.
CHI Guiding Principles
The following resources contain additional information about the underlying principles of collaborative CHI. The key concepts found in this section were derived from a review of these guiding principles.
- County Health Rankings and Roadmaps
- Georgia Health Policy Center Sustainability Framework
- Improving Community Health through Hospital–Public Health Partnerships
- Primary Care and Public Health: Exploring Integration to Improve Population Health (Institute of Medicine 2012)
- Principles to Consider for the Implementation of a Community Health Needs Assessment Process (Rosenbaum 2013)
- Robert Wood Johnson Foundation Culture of Health Prize Criteria
- A Framework for Program Evaluation: This practical framework summarizes and organizes the steps and standards you will need to effectively evaluate your efforts.
- A Public Health Performance Evaluation Primer: Go to pages 4–9 (starting with Step 5) for an overview and case-study examples of performance measurement and evaluation, as well as descriptions of how to use Run Charts to achieve programmatic goals.
- Collecting and Analyzing Data: This tool provides the “why, when, and how” of data collection and analysis to help you draw conclusions about your work.
- Community Quality Collaboratives: Go to the Tools on Measures, Data, and Reports on Quality and Efficiency section for a number of tools and resources that community collaboratives use when identifying, querying, and reporting on data.