Academic journal article Journal of Healthcare Management

Interview with Sherril B. Gelmon, DrPH, FACHE, Professor of Health Systems Management and Policy, Oregon Health & Science University and Portland State University School of Public Health

Academic journal article Journal of Healthcare Management

Interview with Sherril B. Gelmon, DrPH, FACHE, Professor of Health Systems Management and Policy, Oregon Health & Science University and Portland State University School of Public Health

Article excerpt

Sherril B. Gelmon, DrPH, FACHE, is a nationally recognized scholar on the accreditation of health professions education and a leader in service-learning and community engagement research.

As professor of health systems management and policy at the Oregon Health & Science University and Portland State University School of Public Health in Portland, Oregon, she directs the PhD program in health systems and policy and teaches courses in the theory and practice of health management and policy, with a focus on improvement science, program evaluation, organizational behavior, values and ethics, and health systems. She has conducted research for projects sponsored by the Institute for Healthcare Improvement (IHI), Robert Wood Johnson Foundation, CommunityCampus Partnerships for Health, and other organizations.

Dr. Gelmon received her doctorate in health policy from the School of Public Health at the University of Michigan, her master's degree in health administration from the University of Toronto, and undergraduate degrees in physiotherapy from the University of Toronto and the University of Saskatchewan. She was the founding chair of the International Association for Research on Service-Learning and Community Engagement, and is a past board member of the Oregon Foundation for Reproductive Health and of the Physiotherapy Foundation of Canada.

In 2011, she received the national Thomas Ehrlich Civically Engaged Faculty Award-bestowed annually on a tenured faculty member for exemplary leadership in advancing students' civic learning, community engagement, and contributions to the public good-from Campus Compact, a coalition of college and university presidents representing 6 million students.

Dr. Kash: As a researcher and teacher, you have worked with community agencies, providers, and graduate students to gather evidence of impact for education and health improvement interventions. Tell us about your experience.

Dr. Gelmon: First, we need to agree on what evidence means. We all use the word, but we don't always mean the same thing by it. To me, strong evidence is more than just strong quantitative data, because some of the richest evidence in the areas of education and community health improvement is observable and tells stories. Bar charts and statistics are nice, but they don't really tell the story. What can we conclude from pictures, voice recordings, digital communications, and the like? Then there is the question of what impact means. Impact on whom? When and where? Also, how much is needed? When we are interested in measuring the impact of an intervention, how do we determine when we will see that impact, and what evidence is required? In working toward improvement, we set benchmarks-for example, we may say that as a result of this work, 90% of the target population will be affected by the intervention. But does the intervention have an impact only if we reach 90%? Or can significant improvement in health happen if we see 75%?

So when we consider evidence, we need to know who defines impact, who measures it, and who sets the benchmark. Given those qualifiers, I would say that for students-particularly graduate students in health management and policy-one of the most important things to learn is that we don't live in a world with absolute rules. In so many situations, we must determine results without benchmarks and qualify our conclusions with, "It depends." When studying the impact of an intervention, we are interacting with people in a rapidly developing health system. We all have circumstances that affect what we can do or achieve-whether we are the consumer, the provider, the administrator, or the teacher.

To me, the most promising approach is to draw on multiple sources of evidence and look at the impact on different stakeholders. For example, I lead a research team at Portland State University that has been working for five years with the Oregon Health Authority to evaluate the implementation of the patient-centered primary care home, which is Oregon's approach to the medical home. …

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