Collaborative imperative: A city-county initiative to improve community health through the transition of clinical preventive health services

In 1997, the Committee on Medicine and Public Health Collaboration at the New York Academy of Sciences released a monograph detailing national models of medical and public health collaboration to improve access to care. This “Collaborative Imperative” was considered as the next stage in improving quality and access to clinical and preventive care for the population.In the decade since this publication; the stressors facing the nation's public health entities (i.e., local public health departments, public hospitals, clinics and related research institutions) have only increased. In this context it has become critical for public health partners to leverage resources and expertise to improve both the delivery of and access to heatlh services. To address these challenges joint partnership was formed between the San Antonio Metropolitan Health District (Metro Health) and the Bexar County Hospital District d/b/a University Health System (UHS) in October 2006. Through a collaborative health planning process all clinical preventive health services were transitioned from Metro Health to UHS with the broader goal being that such a transition would a) enhance the quality of services, b) reduce duplication, and utilize resources more efficiently, and c) support a seamless system of care for patients. This presentation will discuss the transition process, evaluation findings, challenges encountered, opportunities and lessons learned. Public health partnerships have the potential to leverage and combine resources (clinical expertise, infrastructure, and preventive services) in an era of increasing demand and limited resources for the delivery of health services.