Philadelphia experienced the closure of seven community hospitals between 1990 and 2020, steadily reducing access to care and straining the remaining hospital systems. In 2020, an eighth major safety net provider announced that it, too, would close. Recognizing the potential harm of yet another shutdown in a neighborhood with the City’s highest mortality rates and worst health outcomes, three of Philadelphia’s major healthcare systems came together in an unprecedented effort to prevent the hospital’s closure. This collaboration ensured the continuation of essential services for the most vulnerable residents of Southwest Philadelphia. The resulting public health campus now offers a comprehensive array of onsite health services, including emergency and primary care, dental, and mental /behavioral health.

Historically, this community has been plagued with mistrust, given the loss of trust caused by the dissolution of the old hospital. Would the community, welcome this new resource? Could perceptions regarding the former hospital’s reputation be changed? How would a multi-system healthcare center, providing streamlined care coordination and internal referrals contribute to improved health outcomes?

Place Based Evaluation-Evidence and Theory

In response to these questions, partnership leaders identified the need for a community-focused, place-based evaluation (PBE) to provide a nuanced understanding of the unique challenges facing the community (Hoffman, 2017). The PBE will assess the impact of the initiative at the community level (Nickel, 2020).

Evaluation Planning

Insights from community members, health providers, initiative leaders, and campus users/patients were fathered through interviews/intercept surveys. Some preliminary findings highlight the need for partnership and capacity building, trust building with partners and community members and community based participatory research. The PBE now includes a representative survey of households in the campus’ catchment area, and a component for eliciting ongoing community member feedback about instruments, outcome measures, and information dissemination.

Conclusion

Practitioners and evaluators in other cities can learn from Philadelphia’s experience with challenges encountered and results achieved when convening disparate partners to safeguard health care access for their most vulnerable populations.

Practice Recommendations

Based on our preliminary finding some recommendations include:

• Partnership/trust Building
• Capacity Building
• Community-Based participatory research
• Community asset mapping
• Access to electronic health records