Featured case: The Camden Coalition of Healthcare
Providers: Weighing Opportunity with Capacity

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The case

Jeffrey BrennerWho – the protagonist

Dr Jeffrey Brenner, Executive and CEO of the Camden Coalition of Healthcare Providers (the Coalition).

What?

Dr Brenner was frustrated and challenged in his private practice, as he faced mounting debt from shifting medical policies, and both he and his patients struggled with the daily stresses the underserved city of Camden caused.

Dr Brenner decided to start a breakfast club for local practitioners to discuss their experiences practicing in Camden. The Coalition is now a not-for-profit organisation committed to elevating the health of patients facing the most complex medical and social challenges.

Why?

nurses

Dr Brenner wanted the Coalition to take the next step and launch a Housing First demonstration project, which would provide rapid access to permanent supportive housing for homeless individuals with mental health and addiction issues. After a series of meetings with his executive leadership team, they were still undecided.

When?

It was June 2015 when the Housing First demonstration project was being considered, just 13 years after the Coalition started as a modest breakfast club.

Where

Where?

Camden is in the state of New Jersey, with the Delaware River separating the city from Philadelphia in Pennsylvania.

Key quote

We are not going to walk out of the door today with a go or no-go decision. We are going to chew on this for a little while and evaluate our options.” – Dr Jeffrey Brenner, Executive and CEO of the Coalition, on the Housing First demonstration project.

What next?

Should the Coalition go ahead with the project, as it would be a huge risk financially, and a poorly delivered programme could be harmful to patients?

Even if they did give the green light to the project, the Coalition already had a complex portfolio of activities – would they lose their brand identity?  

 
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The Camden Coalition of Healthcare Providers: Weighing Opportunity with Capacity
Ref HMSCPC04.0
Teaching note
Ref HMSCPC04.1

Also available:
Jeff Brenner, Executive Director, Camden Coalition of Healthcare Provders, Camden, New Jersey (Video)
HMSCPC04.2
Camden Coalition of Healthcare Providers: Housing First Flash Forward
HMSCPC04.3

The author

Erin Sullivan

Erin Sullivan

Erin discusses the case's adaptability and how the case method is used in medical subjects.

No end to the discussion

Erin said: “Whenever we teach this case in class there is always more discussion than our time allows for.

No end

“With this particular case, we ask the students to ‘vote’, both at the beginning and end of class, on their decision for what the Coalition should do with regards to Housing First: buy, build or partner.

“Forcing students to take a side in the first moments of class generally sets up a good conversation. Students really enjoy digging in and understanding the Coalition’s care delivery model, and the intervention they deliver for their underserved patient population.

“Once students understand the basic operations of the Coalition, we then move on to discuss the Coalition’s value to the community and their partners, so that students gain a sense of the Coalition’s role within the broader community.

“After assessing the Coalition’s successes and failures, we ask the students to revisit the buy, build or partner question and vote again. Through re-visiting the vote, instructors get to see if students have changed their minds throughout the course of the case discussion, and if so, further discuss the rationale behind their changed position.

“We also have a ‘Flash Forward’ which details what the Coalition decided to do, which generally sparks further conversation.”

Right place, right time

“At the time we wrote the case, the Coalition was undergoing a phase of substantial growth. They had just reached 70 employees and had a number of programmes operating in addition to their flagship hotspotting intervention,” Erin continued.

“We spent an entire week immersed with the Coalition. We spoke with programme directors, data managers, and Coalition leadership. Throughout our week there, we had the opportunity to learn an incredible amount about who they are, what they do, and how they see the role of complex care evolving.

“The biggest challenge in producing this case was fitting the surplus of information into just a single case. This challenge then led us to develop two cases featuring the Coalition: this case concerning their strategic decision regarding their Housing First project, and a second case that focused on a major shift in operations at the Coalition.”

medicalcases

Medical cases

She added: “The US health system is currently plagued by multi-dimensional problems that require solutions spanning political, social, biomedical and technological disciplines.

“Through embracing the case method as an instructional tool, we find that we foster more participant-centered discussions, whereby students wrestle with complex scenarios. We strongly believe case studies are uniquely positioned to help medical sector learners acquire problem-solving and decision-making skills in the greater context of healthcare delivery. 

“Furthermore, the case method can be used to immerse students in real-life challenges within health systems, characterised by complex and sometimes insufficient information.

“Ultimately, our original cases focus on best practices and challenges in exemplar health systems, to better prepare medical sector learners to be leaders and managers in today’s increasingly complex health system.”

Adaptability

Erin concluded: “Examining strategy always challenges organisations and organisational leadership to reflect and assess their own direction and scope. By engaging with this case, students are afforded the opportunity to consider the Coalition’s current scope of work along with a tempting opportunity to expand that scope.

“This sets the students up to be able to contemplate whether the project in question would detract from, or align with, the Coalition’s strategy, mission, and sustainability.

“Given that the case examines questions beyond healthcare delivery, including the social determinants of health and the Coalition’s strategy to address them, we find that the case is adaptable and popular among educators across sectors.”

About the authors

Erin Sullivan is the Research and Curriculum Director at the Harvard Medical School Center for Primary care.
e Erin_Sullivan@hms.harvard.edu

Sophie Arabadjis is a Case Writer and Researcher at the Harvard Medical School Center for Primary care.

 

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