Ellen Alkon, MD, MPH¹, Jonathan Fielding, MD, MPH², Richard Kratz, MD, MPH¹, Jeffrey Guterman, MD, MS³, and Sandra Gross-Schulman, MD, MPH, RN⁴. (1) Public Health, Los Angeles County Department of Health Services, 241 N. Figueroa Street, Room 143, Los Angeles, CA 90012, (213) 250-8623, ealkon@ladhs.org, (2) Director of Public Health, Health Officer, County of Los Angeles Department of Health Services-Public Health, 313 North Figueroa Street, Los Angeles, CA 90012, (3) Senior Medical Director, Los Angeles County Department of Health Services, 313 N. Figueroa St., Los Angeles, CA 90012, (4) Clinical Resource Management, Los Angeles County Department of Health Services, 14445 Olive View Dr, Sylmar, CA 91342

The Los Angeles County Department of Health Services is a combined department with Personal (hospital and ambulatory care) and Public Health components. In the past it often operated as if it were two separate departments. It was recognized that effective collaboration was needed to meet shared goals to improve patient care and the health of people in Los Angeles.

An Integration Task Force of Personal and Public Health leaders was formed that met from September 2003 through the end of that year. The concept of integration developed was improved connections rather than structural change. The new model has two components: improved communication through the use of modern information systems and Public Health collaboration with Personal Health to implement clinical prevention policy.

The planning process started with exploring underlying assumptions, then literature review and a plan developed with goals and strategies. The goals are increased use and related measurement of prevention strategies of proven effectiveness consistent with available resources based on an explicit elaboration of priorities and development of a logical integrated information system.

Because priority areas were selected, there was immediate implementation of several of the strategies: immunization of hospitalized patients against influenza and web-based reporting of disease in DHS hospitals. Other preventive strategies include pneumovax immunization and assessment and referral of smoking and substance abuse in hospitalized patients.

The planning process used is applicable to other combined health department, and components can be useful to other health departments working with hospitals to improve health in their community.

Learning Objectives:

• Describe an integration model that does not include structural change.
• List three ways that the two cultures of hospitals and public health were engaged during the planning process.
• Explain the importance of underlying assumptions in a public health planning process.

Related Web page: www.lapublichealth.org

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed by the Los Angeles County Department of Health Services