Nursing Leadership Drives Implementation of Community Health Needs Assessment and Best Practice Strategies Session Number: C512

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1 Nursing Leadership Drives Implementation of Community Health Needs Assessment and Best Practice Strategies Session Number: C ANCC National Magnet Conference Wednesday, October 5, :30 AM Judy Dillon, RN, MSN, MA, Alison Enimpah, MSN, RN-BC, CCRN Kim Fields, RN, BSN, CPN Lauren Zug, MSN, NP-C Penn State Health Milton S, Hershey Medical Center Hershey, Pennsylvania

2 The Presenters for this presentation have disclosed no conflict of interest related to this topic.

3 Annual Statistics Beds: 548 Total Admissions: 28,654 Total Outpatient Visits: 1,034,663 ED Visits: 72,493 Births: 3,376 Surgical Procedures: 30,028

4 Location

5 Nursing Department Profile Total RNs: 2,460 Percent Certified: 42.9% Percent BSN: 72.4%

6 Objectives Review Mission, Organizational Structure, and Professional Practice Model of Penn State Health Milton S Hershey Medical Center Discuss the movement towards population health Explore how nurses can engage in a Community Health Needs Assessment (CHNA) and Implementation Strategy Provide a panel discussion on Nursing Community Health Initiatives Understand the importance of Community Benefit and why we should care

7 Penn State Hershey Medical Center Mission Enhance the quality of life through improved health, professional preparation of those who will serve the health needs of others, and the discovery of knowledge to benefit society. Community Education Patient Care Research

8 Community Mission Chart

9

10 Shifting Paradigm From: Service Delivery Hospital/Health System Centric Focus on Quality Volumes/Outputs Community Health Planning To: Population Based Care Patient and Family Centered Outcomes/Impact Community Collaboration

11 Making the Shift Clinical Services Community Engagement Community Transformation

12 A bed Jobs A safe place to live Fresh food Transportation Heat

13 Affordable Care Act Requirements of Community Health Needs Assessment (CHNA): Identify community health needs Seek community input Implement plan Document the CHNA Make plan widely available Monitor progress Three-year cycle

14 National Expenditures/Community Benefit Top Decile Hospitals: 20% of operating budget spent on community benefits. Bottom Decile Hospitals: approximately 1% of operating budget spent on community benefits. 6/NEJMsa

15 Expenditures- PSHMC: FY 2014 Note: $mils Reseach-Ed, $74.3, 47% Health Ed, $56.1, 35% Charity, $14.3, 9% Other, $0.6, 0% 6.4% before College Means Tested, $14.8, 9% of Medicine Transfers 12% with College of Medicine Transfers

16 CHNA Overview Collaborating with five other organizations: PinnacleHealth, Holy Spirit, PPI, Carlisle Regional, and Hamilton Health Center 5 Counties 1. Cumberland 2. Dauphin 3. Lebanon 4. Perry 5. York Consultant: Tripp Umbach

17 2015 Community Need Index (CNI) Map 4.00 to 5.00 (Significant socio-economic barriers) 3.00 to to to 1.99 (Lowest level of socio-economic barriers)

18 Primary Data Community Stakeholder Interviews (56) Hand-Distributed Surveys (883) Provider Health Survey (654) Public Commentary (63) Community Forums (2)

19 Secondary Data

20 #1. Access to Health Services #2. Health Education #3. Healthy Lifestyles Prioritized Regional Community Health Needs Primary Care Specialty Care Dental Care Lack of Physical Activity Inadequate Nutrition/ Obesity

21

22 Three Nursing Driven Community Health Initiatives Drive Thru Flu Shots Alison Enimpah, MSN, RN-BC, CCRN Lebanon School Initiatives Kim Fields, RN, BSN, CPN Pantries and Wellness Support (PaWS) Lauren Zug, MSN, NP-C

23 Video- Drive Thru Flu Shots

24 Introduce yourself and describe your community health initiative.

25 Drive Thru Flu Shots 2014 to present Improve Health: targeted population (families & underserved) Better Care: facilitated access Lower Costs: no charge

26 Lebanon School Initiative 2011 to present Improve Health: early detection Better Care: improved technology, timely referral process, individual attention Lower Costs: quality testing, streamlined follow-up

27 PaWS 2014 to present Improve Health identification of untreated chronic conditions, education & coaching Better Care: facilitation of referrals Lower Costs: access to primary care

28 Video- Lebanon

29 Who does Penn State Health Milton S. Hershey Medical Center collaborate with for your program?

30 Child Life Emergency Preparedness Employee Health EMS Events Management Facilities Penn State College of Nursing Penn State College of Medicine Marketing Nursing Pharmacy Physician Risk Management Security Shuttle Service Supply & Distribution The Lion Drive Thru Flu Shots Internal Partners

31 Drive Thru Flu Shots External Partners PA Department of Health Police Churches Local schools & colleges People Movers Senior Centers Low Income Housing Agencies

32 Lebanon School Initiative Internal Partners Audiology Penn State College of Nursing Information Technology Ophthalmology Nursing Pediatric Research Penn State PRO Wellness Children s Hospital Pediatric Residency Program

33 Lebanon School Initiative Lebanon School District External Partners Bloomsburg University Audiology Lebanon County Career & Tech School - Practical Nursing Students Harrisburg Area Community College - Medical Assistant Students InnerLink Jeanne Donlevy Arnold, BSN, RN

34 PaWS Internal Partners Nursing Advance Practice Clinicians Physicians Administrative Support Staff Penn State College of Nursing Penn State College of Medicine Penn State School of Public Health Sciences Department Experts

35 PaWS External Partners Pennsylvania Psychiatric Institute Penn State Extension Central PA Food Bank Food Bank Locations Corporate Sponsors

36 What nursing strategies have you implemented to best meet the health needs of your population?

37 Drive Thru Flu Shots Online registration Interdisciplinary team Volunteerism Staff education Mass immunization management

38 Lebanon School Initiative Plan ahead Education Standardization Communication Quality vs. quantity Expect the unexpected Be flexible

39 Continuity Building Trust Personalization Culturally appropriate targeted messages Relatable Reinforcement Empathy Positive environment PaWS

40 PAWS- video

41 What are your greatest opportunities for improvement?

42 Drive Thru Flu Shots Penn State Health Opportunities Access to uninsured population Outreach in underserved (urban & rural) communities Partnerships Patient education (myths why immunization is important) Funding

43 Drive Thru Flu Shots Client Opportunities Influenza Vaccination Consent Form Please complete and return this form (PLEASE PRINT). Protection Patient responsibility Name receiving vaccination: Address: City: State: Zip Code: Telephone: Birth date (mm/dd/yyyy): Emergency contact number: Please Circle YES or NO to ALL of the questions below: 1. Are you (or if completing for your child) sick today? Yes No 2. Are you (or if completing for your child) allergic to eggs, egg proteins, or to another component of the vaccine, such as arginine, gelatin, gentamicin, latex, neomycin, Yes No polymyxin or yeast? 3. Have you (or if completing for your child) ever had Guillain-Barré syndrome? Yes No 4. Have you (or if completing for your child) ever had a serious reaction to an influenza vaccine? Yes No I have been given the Centers for Disease Control and Prevention Vaccine Information Statement (VIS) (IIV, 8/7/2015). I have read the VIS and have no further questions at this time. I understand the risks and benefits of the influenza vaccine. I request and voluntarily consent that the influenza vaccine be given to (self or name of child of whom I am the Parent/Legal Guardian), and I acknowledge that no guarantees have been made concerning the vaccine s success. I understand the possible side effects and warnings and precautions that should be taken into consideration prior to administration of the vaccine. Signature: (Self or Parent/Legal Guardian) Please circle Date: Vaccine Influenza (Quadrivalent) Date Administered Dosage 1 or 2 Route IM Vaccine Manufacturer Sanofi Pasteur -Fluzone ( 6 months ) Lot Number Lot#UI443AA Exp: 6/30/16 Site/ Dosage Signature of Vaccinator If you need further assistance or have additional questions please contact Pennsylvania Department of Health at PA HEALTH ( )

44 Lebanon School Initiative Penn State Health Opportunities Staff & student involvement Improving the health of children Networking Programming Communication to parents Expansion

45 Lebanon School Initiative Client Opportunities Enhance learning environment Improve student health BMI Vision Hearing Scoliosis

46 PaWS Penn State Health Opportunities Resources Public Awareness Duplication Communication strategies Research Sustainability

47 PAWS Client Opportunities Accessibility Transportation Accountability

48 What are your outcomes?

49 CBISA-Community Benefit Inventory for Social Accountability A comprehensive way for us to measure our organization's impact on the communities we serve. Quantitative and Qualitative Program Statistics Hours Expenses Narratives and Stories Outcomes and Evaluations Partnerships Used by over 1,700 hospitals IRS 990 Schedule H Compliant

50 FY 2015 Flu Shots Initiatives Drive Thru Flu Shots All Flu Shots Persons served 600 Community benefit 53,987 Employee hours Volunteer hours 208

51 Drive Thru Flu Shots Consistent increase in flu shots delivered Extended pediatric services Positive empowerment of direct care staff Community model Client satisfaction

52 FY 2015 School Health Assessment Initiative Lebanon Persons served 5,210 All Schools Community benefit 58,482 Employee hours 1,187 Volunteer hours 659

53 Lebanon School Initiative Early identification of health concerns Improved referral process Enhances parent education Community engagement Mentorship School nurse networking

54 FY 2015 PaWS Steelton All Food Pantries Persons served 600 Community benefit Employee hours Volunteer hours

55 PaWS Empowerment Socialization Health Awareness Referrals Resources

56 FY 2015 Nursing PSHMC Persons served 53, ,850 Community benefit 187,373 2,242,617 Employee hours 3,490 35,801 Volunteer hours 1,345 21,867

57 Why Should We Care? Doing the Right Things: Demonstrate community benefit. Differentiate community benefit programs from programs designed to yield economic return. Document evidence on how community needs are met. Disseminate results and impact of community services.

58 Questions? Judy Dillon, RN, MSN, MA, Alison Enimpah, MSN, RN-BC, CCRN Kim Fields, RN, BSN, CPN Lauren Zug, MSN, NP-C

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