Sunday, January 14, 2001

Community Engagement

I've asserted that "all emergency departments are local" and that among other attributes, leadership entails involvement with your community. Several months ago in discussing the concept of the pareto optimum, I briefly discussed, but didn’t detail, engagement with the community you serve. Engaging your community goes beyond the minimum of delivering excellent clinical care in your ED, it is a value-added service that helps you demonstrate to hospital administrators that you think in terms of the big picture and not narrowly, only in your own financial interest. Of course, contributing to the quality of the relationship between your hospital and your community is very much in your self-interest.

Regardless of whether your ED is in competition with nearby hospitals or yours is the only ED in town we know that while the expression might be a clich√©, the ED is truly the bridge between the community and the hospital. How can you as an emergency physician support that bridge? The key is becoming known for your support of your community’s agenda both within and outside of your hospital.

Most folks are preoccupied by the details of their life. They don’t spend a lot of time thinking about your hospital, your ED or your staff. Only in time of need do they think of the hospital, the ED and you. Engagement is essentially a political function. You are seeking to place your ED in a favorable light in the minds of your community members. You do this by meeting them on their "turf" and addressing their interests.

Every community hosts school and religious institutions. Many include volunteer ambulance corps as well. All of these locations and organizations provide opportunities for your engagement. Seek them out whether or not they seek you out. Use the hospital’s public relations staff if they are available, but even if they are not, make the calls yourself.

Prepare yourself before you call by finding out about the organization from hospital resources such as your public relations or development office. Learn about the number of members or participants and how broadly the organization or school affects the community. Clearly the only high school in the region has a different influence within the community than one high school out of a dozen in the town. Prepare by seeking the help of your public relations, development or printing department in the creation of both publicity materials such as posters and "leave behinds" a handout that will serve to remind both those who attend and those who don’t that you’ve visited and you represent the hospital, the ED and emergency medicine physicians. A standard drape for a podium and a table showing your hospital ED’s logo along with your practice’s if you have one is useful. Don’t rely on the standard hospital table drape; insist upon one that clearly touts the ED, even if you have to pay for it yourself. Remember you are representing the ED to the community and you want to emphasize that association.

Prepare a presentation that will be relevant to the audience. Speaking from your heart about alcohol related motor vehicle crashes that have killed or injured teen-agers in your community, whether high school students or those off at college will have still greater impact if done as a brief presentation and discussion. Engaging another point of view can be helpful as well. I recall that some years ago several of my colleagues participated in "Doctor-Lawyer" presentations at high schools on the topic of drinking and driving. Even absent physical injury, the legal impact of underage alcohol use can catch an audience’s attention.

Tragedy is not the only "hook" for an audience and might better be reserved for a time when you’ve already become known as a supporter of community groups. Speaking to the gardening society about how to handle pesticides, fertilizers and herbicides—in other words hazardous materials disposal which you can prepare for by getting the information from your community’s trash disposal department or service will have much more impact coming from you and the hospital ED then any bill-stuffer or reminder slipped through a mail slot. While this or other topics of interest to a community group may at first blush seem "out of your field" in speaking to a lay audience, it’s more important for the topic to be of interest to the group than that it is of interest to you. Then too remember that your community organizations are pleased to have your interest and participation, so while you may not practice environmental toxicology, you already know more, including how to prepare to speak on the topic, than does any member of your audience. Selecting topics of interest and organizations to approach is easily done by attending to the news in your community. Weekly community newspaper(s), school, church or association newsletters are good sources of topics of interest.

Along with speaking to outside organizations where you facilitate the introduction and the contact with the organization, you want to make yourself available to hospital personnel who have need for hospital spokespersons. Set up an appointment with whoever handles hospital public relations. Offer to speak to them on background when issues come up elsewhere in the hospital. Tout your expertise as a generalist who will take the time, even if the cardiologist won’t to explain what angioplasty means and why having it available at your hospital—or not—matters in your community. Then take the telephone calls that are sure to come and do your best to answer the questions. Pretty soon you’ll find that your name will get out to local reporters who need background information on a medical story or who are looking for a local twist on a national or regional story. Since all of this contact with the press is intended to bring your hospital and ED to the favorable attention of your community, more than it’s intended to advance personal recognition, be sure to talk about the hospital and ED and refer the press back to hospital contacts.

Building community relationships begins with serving the community through excellent medical care, but includes communicating more broadly with the many "micro-communities" in every town.

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