Seattle Children s Community Benefit Report 2014

Transcription

1 Seattle Children s Community Benefit Report

2 Our Mission We believe all children have unique needs and should grow up without illness or injury. With the support of the community and through our spirit of inquiry, we will prevent, treat and eliminate pediatric disease. Our Vision We will be the best children s hospital. We will provide patients and their families excellent care with compassion and respect. We will provide superior, accessible, cost-effective service. We will attract and retain the best talent at all levels of the organization. We will be one of the top five pediatric research institutions. We will be the nation s premier pediatric educators. We will achieve worldwide prominence by integrating patient care, research, education and advocacy. Letter from Our Chief Executive Officer At Seattle Children s, we are always thinking of the health and well-being of children, teens and families and the communities they live in. Together with our partners families, schools, public health departments and community-based organizations we are tackling five priority areas to address some of the greatest needs of our communities: Increase access to quality healthcare for all children and teens. Improve coordination of care for children with chronic conditions. Improve health equity and access in South King County. Promote healthy eating and active living and prevent obesity. Enhance access to mental and behavioral health care. COVER Top: In partnership with Kohl s department stores, we provided 4,025 free custom fit bike helmets to children and teens. Bottom Left: We partnered with two Head Start preschools to provide water safety education and free life jackets to kids, parents and caregivers. Volunteers taught water safety in Amharic, Cantonese, Spanish, Somali, and Vietnamese. Bottom Right: Our organic garden is one of the ways Seattle Children s is involved in healthy eating activities. In 2014 we provided education, promoted policies, improved access to care, conducted research and advocated for improvements to make our communities safer and healthier. In my ten years as CEO of Seattle Children s, we have seen the hospital s commitment to community benefit increase in all areas: uncompensated care, research, education of health professionals and community programs and services. I am proud of what has been accomplished and excited to share stories that highlight this work. I also recognize that our work is far from done. With the support of our partners, we are committed to working toward a healthy community. After all, that is our passion, our duty and our privilege. Sincerely, Thomas N. Hansen, MD CEO

3 What is community benefit? A community benefit is a program or service that meets at least one of these objectives: Improves access to healthcare Enhances the health of the community Advances medical or health knowledge Relieves or reduces the burden of government or other community efforts Community benefits are classified in the categories of uncompensated care, research, health professions education and community health improvement. Total 2014 Investment in the Community: $183,377,000* Research $29,930,000 Community Programs and Services $9,941,000 Contents 2 Community Programs and Services 4 Health Professions Education 6 Research 8 Uncompensated Care 9 Our Community Benefit Priorities Learn more about how we contribute to the community at where you will also find our Community Health Assessment and Community Benefit Implementation Plan. Health Professions Education $22,919,000 Uncompensated Care, Including Medicaid Payment Shortfall $120,587,000 * Does not include grants and contributions that support community benefit programs. Seattle Children s Community Benefit Report

4 Community Programs and Services The care we provide inside Seattle Children s is only one measure of our mission. In partnership with the community, we strive to prevent underlying causes of illness and injury, provide a voice for families who are not always heard and promote public policies that improve child health. We work in the community to make children and families safer and healthier where they live. Supporting student success A growing body of evidence shows a link between student health and educational success. Seattle Children s works with schools and students in the community and in the hospital to prevent illness and injury from affecting a child s well-being and progress in the classroom. Our onsite school serves 1,300 hospitalized children a year. The school s six teachers and four instructional aides coordinate lessons with each child s regular teachers and work with their school to ensure a successful return. Our Odessa Brown Children s Clinic (OBCC) operates a free Teen Clinic at Garfield High School, with approximately 1,400 clinic visits every school year. Open during school hours, the Teen Clinic offers a range of healthcare services. OBCC also provides medical and mental health services at Beacon Hill International School, Madrona K-8 and Wellspring Family Services, a daycare center for children who are homeless. We work with school nurses through the Office of the Superintendent of Public Instruction (OSPI) to improve shared care planning for students with chronic conditions. Our 21 athletic trainers work with athletes at public and private high schools across the Puget Sound area each sports season. Last year they helped over 12,000 student athletes. A teacher helps a patient keep up to date with her school work while receiving care at Seattle Children s. 2 Seattle Children s Community Benefit Report 2014

5 Highlights of Community Programs and Services 4,025 children and teens received free bike helmets and were individually fit 356 children received low cost car or booster seats 700 children, teens and adults received free or low cost life jackets 4,000 high school students received free heart screenings in partnership with the Nick of Time Foundation 520 youth received care at Odessa Brown Children s Clinic run teen clinic at Garfield High School 195 children, teens, and families experiencing homelessness received free healthcare 785 and took part in programs about eating healthy staying active 1,810 individuals received healthcare-related legal advice from the Washington Medical-Legal Partnership people served through the Journey Program, which provides grief and loss services rides to and from the airport for patients and families Seattle Children s Community Benefit Report

6 Health Professions Education The health of future generations of children depends on educating the next generation of doctors, nurses and other healthcare professionals specializing in pediatrics. Seattle Children s is the site of the University of Washington pediatric residency and fellowship programs and serves as a training site for nurses and other healthcare professionals. We also offer continuing education and outreach education programs for providers in the community. Above: Seattle Children s is one of three hospitals in the state that has volunteered to care for Ebola patients if the need arises. We have been working very closely with Washington State Department of Health in developing guidelines so that providers across the state are ready to care for patients who develop Ebola and other similar diseases. Left: SMARHT conference attendees learn about the effects of social media on teens. Conference explores social media impacts The Social Media and Adolescent Health Research Team (SMAHRT) at Seattle Children s explores the health risks and opportunities created by technology s omnipresent role in adolescent life. SMAHRT hosted its first conference last year, Using Social Media to Improve Health, Catalyze Research and Empower Communities. Session topics ranged from cyber bullying to how technology affects sleep to how to use social media as a research tool. One of the highlights was a panel discussion by a group of adolescent and young adult cancer survivors who talked about the role of social media in their treatment and recovery. The three-day conference addressed how social media can cause problematic behavior, like overuse of the Internet, but can also lead to positive actions, like supporting healthy diets. Researchers, educators, public health professionals, healthcare providers and parents from Washington, Oregon, Ohio, Massachusetts, and Missouri attended. Participants said they appreciated hearing about the latest research, learning new ideas to use social media to engage teens and meeting other professionals interested in this topic, says Dr. Megan Moreno, who leads SMAHRT. We plan to hold future conferences every other year. 4 Seattle Children s Community Benefit Report 2014

7 Highlights of Health Professions Education Providers in Training 886 physicians in training 600 nursing students 138 pharmacy, social work, dentistry and other students 751 medical students More than 4,530 healthcare and mental healthcare professionals attended continuing education conferences 3,400 healthcare providers and state employees were educated on child abuse and neglect prevention 65 Medical, nursing and psychiatry Grand Rounds lectures offered to providers in Washington, Alaska and Montana 200 national and international providers, ethicists and trainees attended the annual Bioethics Conference 498 students learned about healthcare professions 273 participants attended science cafes to learn about research at Seattle Children s 498 students particpated in healthcare job shadows 7,543 students received science education from the Science Adventure Lab Seattle Children s Community Benefit Report

8 Research We provide more than healthcare to our patients. Our researchers and scientists work in the hospital, laboratory and community to find cures for pediatric diseases and improve the lives of children in our region and throughout the world. Walking and pedaling to fight obesity The days when nearly half of all children walked or pedaled to school are gone. Only a handful 12% to 13% travel to school by foot or bike today. That may be part of the reason why more than one third of children and adolescents are obese or overweight and why many do not get the recommended 60 minutes of daily physical activity. Dr. Jason Mendoza is studying whether walking school buses and bicycle trains can increase physical activity among children. Bike trains and walking school buses involve adults leading groups of children along set routes to make biking and walking to school safer and more enjoyable. Mendoza is analyzing health and physical activity data from participants in a bike train study last year at four Seattle elementary schools, and continues to gather data from participants in ongoing walking school buses in Seattle and Federal Way. Mendoza is focusing on students from low-income neighborhoods because they are at greater risk for obesity, diabetes and later in life cardiovascular disease. We want to help children build physical activity into their daily routine now and throughout their lives, he says. Students at Mark Twain Elementary School take the walking school bus to school. 6 Seattle Children s Community Benefit Report 2014

9 Removing barriers to care for teens with depression When primary care doctors diagnose teens with depression, they typically refer them to mental health specialists. But that means families must find a specialist, make an appointment and travel to a new care setting all of which makes it more difficult for teens to get evidencebased treatment. Dr. Laura Richardson developed an intervention that integrates mental health treatment into primary care by having teens diagnosed with depression meet with a care manager in the primary care clinic. The care manager works with patients and their parents to choose a treatment. Depending on their choice, the care manager provides psychotherapy in the clinic and/or works with the primary care physician to make sure patients receive antidepressant medication. Studying concussion in kids Seattle Children s is dedicated to providing the best care possible for children with concussion. We are part of the Sports Concussion Program, an affiliate program among Seattle Children s, Harborview Medical Center and UW Medicine. Currently, there is no objective way to diagnose concussions and no objective evidence that shows which treatments are most effective. In a study comparing two groups of 13- to 17-year-olds, Richardson found 86% of the intervention group received evidence-based treatment for their depression versus only 27% of those getting typical care. In addition, 67% of the intervention group had at least a 50% reduction in depression symptoms compared to 39% of the others. The intervention reduced the burden of starting treatment and showed integrated care works much better for teens with depression than the current system, Richardson says. Better care requires better research, but most concussion research focuses on college or professional athletes. A new Youth Concussion Research Program at Seattle Children s Research Institute supported with a grant from the Satterberg Foundation aims to improve concussion care for kids. Their brains are undergoing enormous changes, but we don t know if concussions differ in the developing brain than in mature brains, says Dr. Fred Rivara, who leads the research program. We want kids to live active lives, but keep their brains healthy, too. Seattle Children s Community Benefit Report

10 Uncompensated Care A serious illness or injury can strike any child at any time. The unexpected cost of hospitalization hits many families hard, creating mountains of medical bills that can be impossible to pay in full even for those with insurance. In 2014, we provided $120.5 million in uncompensated care to children in Washington, Alaska, Montana and Idaho. Meeting a continuing need The Affordable Care Act expanded the number of adults with healthcare coverage, but it did not change the need for uncompensated care for children and teens. Nearly half of our patients are covered by Medicaid and the Children s Health Insurance Program (CHIP), known as Apple Health for Kids in Washington state, which provides comprehensive medical coverage for low-income children but does not pay for the full cost of the services. In addition, families with private insurance still face high deductibles and coverage limits that can create thousands of dollars in out-of-pocket expenses that many cannot afford. Providing uncompensated care remains fundamental to our mission, says Hugh Ewart, who leads state and federal government relations at Children s. By bridging the gap between the full cost of care and what Medicaid, CHIP and private insurance pay, we ensure children in our region receive the medical care they need. The need for uncompensated care is growing $28.0M $35.8M $86.0M $103.4M $120.5M Since 1907, Seattle Children s has provided care to patients regardless of their families ability to pay. 8 Seattle Children s Community Benefit Report 2014

11 Our Community Benefit Priorities In 2013, we completed a Community Health Assessment that described the health of children, teens and families in Washington state and King County. The assessment helped us identify five priority areas to improve community health. Together with our partners in the community, we made progress on more than 40 projects that address some of the health needs of children and families in our region. Here are highlights from work in each priority area. Access to Quality Healthcare Seattle Children s was founded on the promise that no child will be turned away, regardless of a family s ability to pay. To keep that promise, we help eligible families enroll in public insurance programs such as Medicaid (known as Apple Health in Washington state), work with King County Hospitals for a Healthier Community to promote participation in the Washington Health Benefit Exchange and maintain our financial assistance program for families earning up to 400% of the poverty level. Helping families navigate the ACA Seattle Children s took numerous steps in 2014 to help families obtain the insurance coverage they needed through the Affordable Care Act (ACA). Nine of our staff members at the hospital and the Odessa Brown Children s Clinic were trained as certified assisters for the Washington Health Benefit Exchange so they could help families resolve any issues they faced finding and enrolling in qualified plans. We also contacted patients 18 to 21 years old to make sure they understood their options as young adults, posted extensive ACA information for families online and established a dedicated phone line to answer questions. In addition, we educated families and state and federal decision makers about the importance of ensuring that all insurance plans in the exchange offer all pediatric specialty services within their provider networks. Access to healthcare helps keep kids and teens healthy. Visit to learn more about our five priorities. Seattle Children s Community Benefit Report

12 A provider talks to young adults about managing their care at the Teen Heart Transplant Transition Day. Coordinated Care for Chronic Conditions Caring for children with complex chronic conditions 25% of the children we care for requires specialized care from many different providers, both at Seattle Children s and in the community, who need to work as a team. We strive to identify children with medical complexity, coordinate their care across all services and support their transition to adult care to help them reach their full potential. Identifying those in need The first step in providing care coordination for children with medical complexity is identifying children and families who need assistance. Drs. Tamara Simon and Rita Mangione-Smith led the development of an algorithm that distinguishes patients who are medically complex from those who are not and tells healthcare providers which families are most likely to benefit from care coordination. The algorithm, which applies a standard set of criteria to discharge data and other administrative data, has been adopted by 20 healthcare organizations nationwide. Without a definitive methodology, medical complexity is open to interpretation by a child s individual providers, Mangione-Smith says. The algorithm is an objective way to assess medical complexity so those who need care coordination don t slip through the cracks and so limited resources go to those most in need. Preparing teens for adult medical care Transitioning from pediatric medical care to adult medical care can be challenging for teens, particularly those with special healthcare needs. Children born with heart defects, for example, may need care their entire lives. Our Heart Center helps teens with heart defects prepare for the transition to adult care by collaborating with the University of Washington (UW) to offer the Adult Congenital Heart Disease Program. The team includes doctors and nurses from both Seattle Children s and the UW, who help teens understand their condition and teach them to manage their care as they mature into adults. At last year s Teen Heart Transplant Transition Day, patients with heart conditions ages 15 to 18 discussed diet, exercise and other important health topics, heard from young adults who have already transitioned to adult care and met adult providers and staff from the UW. 10 Seattle Children s Community Benefit Report 2014

13 Equity and Access in South King County Seattle Children s works closely with families and community organizations throughout South King County to understand the area s strengths and challenges, provide equitable access to healthy choices and foster inclusiveness. Teens share their view on community health What keeps communities healthy? We asked two dozen youth from Southwest King County, specifically Highline School District s Health Sciences and Human Services High School, Matt Griffin YMCA, Boys & Girls Club EX3 Teen Center and the International Rescue Committee s TRUE group, to describe health in their communities through photos. As part of a PhotoVoice project, each participant took at least 20 photos of the people, places and things that keep Burien, White Center, SeaTac, Federal Way and Tukwila healthy everything from a farmer s market to family and friends to a community health clinic. Some of them presented their photos at a local coffee shop. This project generated a teen perspective on health that will help guide Seattle Children s work in their communities, says Celeste Chung, one of the project leaders. Making communities healthier South Seattle and South King County residents are exercising more, eating healthier and breathing easier thanks to support from a Community Transformation Grant (CTG) awarded to Seattle Children s, the Healthy King County Coalition (HKCC) and Public Health Seattle King County. Aimed at obesity prevention and tobacco control, the CTG helped communities take a number of important steps in The Renton Housing Authority, for example, adopted a smoke-free policy for all of its buildings. The Highline and Kent school districts introduced new physical education curriculums designed to increase activity during PE class and throughout the day. Highline, Harborview, Valley and MultiCare Auburn medical centers changed their cafeteria environments and vending to provide access to healthier food and beverages. In addition to organizational changes, community members gained skills in communicating and promoting stronger policies, better systems and environmental changes to decision makers and organizational leaders. By stepping up to help shepherd this grant, Seattle Children s has been paramount in improving health equity and access in South King County, says Val Thomas-Matson, who leads the HKCC. Communication plays a crucial role in being healthy. In a community as diverse as mine, communication is important but scarce. Language and cultural barriers cause this lack of communication, but I believe this can easily be fixed if everyone said hi! more often. Khalid M, senior, Health Sciences and Human Services High School This photo was taken at Evergreen Campus at the Health Sciences and Human Services high school. This represents health in the community because something so small can provide so much health to your body. This symbolizes greens in our everyday diet to make sure we get good nutrients in our body. Lily N, senior, Health Sciences and Human Services High School Seattle Children s Community Benefit Report

14 Obesity Eating healthy foods and being active are lifelong habits. We are a leader in communitywide efforts to promote healthy eating and active living and to prevent and reduce obesity among all children, teens and families. We educate caregivers, promote polices and support programs so all children, teens and families are empowered to make healthy changes. Sharing a combination for better health By following five tips represented by the numbers , all children and their families can take small but powerful steps toward a healthier lifestyle. Seattle Children s works in the community to encourage all children and their families to follow In 2014 we developed a tool kit with hands-on activities to teach young children about healthy choices and trained childcare workers from Neighborhood House Early Learning and the Horn of Africa Services to use the kit in their classrooms. In partnership with Kitsap County Public Health, MultiCare Mary Bridge Children s Hospital, Spokane Health District, Inland NW Health Services and other organizations, we also hosted meetings to promote healthy eating and active living choices for children, teens, adults, and families across Washington state. Helping families ACT! healthy Seattle Children s and the YMCA have helped hundreds of children who are obese and overweight and their families lead healthier lifestyles through the Actively Changing Together! (ACT!) program. The evidence-based program has grown from four Seattle-area YMCAs when it started to 17 locations ranging from Olympia to Marysville to Yakima. Children 8 to 14 years old are referred to ACT! by health providers. They and their families attend 12 weekly sessions and get free YMCA memberships during that time. The 90-minute sessions include fitness activities for the child with their family and on their own, guidance for parents in developing a healthy family lifestyle and preparation of a light meal during which families learn about nutrition. When kids see their parents eating a wide variety of foods and being active, they re more likely to do the same, says Mary Jones Verbovski, a Children s dietitian who leads ACT! sessions. A Combination for Better Health Start the day with breakfast 7 days a week. Eat 5 servings of fruits and vegetables a day. Keep screen time under 2 hours a day. Be active for at least 1 hour a day. Aim for 0 sugarsweetened drinks. Children and families learn about at a community health fair. 12 Seattle Children s Community Benefit Report 2014

15 Art class at the Alyssa Burnett Adult Life Center. Mental and Behavioral Health Access to mental and behavioral health services is vital to keeping our community healthy; however, less than 20% of children in Washington state who need mental health services receive it. Through education, training, research and care coordination, we work to increase access to mental health services and expand the community s capacity to serve more families. Tracking treatment progress Mental health treatment is difficult to monitor objectively. Dr. Freda Liu worked with Dr. Corey Fagan and Jon Hauser of the University of Washington to incorporate tracking measures for children in a monitoring program they developed for adults. The program, called OwlOutcomes, uses computerized surveys to track progress between each therapy session. Parents and patients (if they re old enough) respond to statements in the surveys about the severity of their symptoms. The responses are plotted on graphs that show how the severity changes over time. All of the providers in our Psychiatry and Behavioral Medicine Clinic were trained to use the program last year. Families and providers alike appreciate learning how treatment is working and what progress they re making toward their goals, Liu says. Providing a resource for young adults Children with developmental disabilities and their families rely on public schools to meet many of their unique educational and social needs. As these children become young adults, they often struggle to find resources in the community. Seattle Children s opened the Alyssa Burnett Adult Life Center in Bothell last year to fill this gap. Charlie and Barbara Burnett and a nonprofit they founded, Tessera, donated $7 million to launch the center, named after their daughter, a young woman on the autism spectrum. The center, affiliated with the Autism Center at Seattle Children s, offers classes ranging from music to fitness to cooking, and provides a place to meet for young adults with developmental disabilities of all kinds. These are lifelong conditions, says Dr. Gary Stobbe of the Autism Center. Our commitment to the individuals and families doesn t stop at a certain age. Seattle Children s Community Benefit Report

16 4800 Sand Point Way NE Seattle, WA TEL TTY Subscribe to my Good Growing my Good Growing is a free newsletter for parents and caregivers. Each newsletter includes health and safety information. my Good Growing reaches 2,800 subscribers 6 times a year. To learn more visit Seattle Children s, Seattle, Washington. All rights reserved.