PROMEDICA DEFIANCE REGIONAL HOSPITAL Community Health Needs Assessment Implementation Plan

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PROMEDICA DEFIANCE REGIONAL HOSPITAL 2016 Community Health Needs Assessment Implementation Plan 2017-2019 Approved and Adopted on December 20, 2016 1

PROMEDICA DEFIANCE REGIONAL HOSPITAL 2016 COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN 2017-2019 EXECUTIVE SUMMARY, a member of the health system ProMedica, is a committed healthcare resource in the northwest Ohio community, providing not only acute care and emergency services, but specialty medical and mental health services to patients, regardless of ability to pay. ProMedica s Mission is to improve the health and well-being of communities we serve. conducted and adopted the current community health needs assessment (CHNA) in 2016. participated in the 2015 Defiance County Health Assessment (CHA). One area of weakness of the CHNA is the relative age of available secondary and public health data. Following the formal county assessment survey process, multiple community organizations collaborated to develop a strategic plan for Defiance County, with represented on these community strategic planning groups. A resource assessment and gap analysis was compiled as part of this process. will specifically implement programs to address the following health needs, listed in order of priority: Obesity Mental Health Substance Abuse Injury Prevention The full ProMedica Defiance Regional CHNA may be accessed at www.promedica.org/chna. 2

IMPLEMENTATION PLAN The board of trustees of has determined that the following health needs (in priority order) identified in the CHNA should be addressed through the implementation strategy noted for each such need. Emphasis will be placed on serving underserved, low income and minority populations, in an effort to reduce current disparities. 1. Obesity Specific Needs Identified in CHNA: The 2015 Health Assessment identified that 70% of Defiance County adults were overweight or obese based on Body Mass Index (BMI). More than one-third (36%) of Defiance County adults were obese. 18% of Defiance County youth were obese, according to Body Mass Index (BMI) by age. When asked how they would describe their weight, 32% of youth reported that they were slightly or very overweight. 23% of children were classified as obese by Body Mass Index (BMI) calculations. Key Objective: Decrease obesity rates among adults, youth, and children. Implementation Strategies: Year one through three (2017-2019) 1. Implement OHA Healthy Hospitals Initiative (2017-2019) a. Hospital will join Good4You educational webinars hosted by OHA and HCNO (2017) b. Hospital will implement the Good 4 You Initiative in Cafeterias, Vending Machines, Meetings, and with Outside Vendors (2018) c. Hospital will help introduce the program into other areas of the community (2019) Number of areas implemented within the hospital and community 2. Increase Nutrition/Physical Education Materials Being Offered to Patients by Primary Care Offices 3

a. Work with primary care physician offices to assess what information and /or materials they are lacking to provide better resources for overweight and obese patients (2017) b. Offer education for PCP offices on nutrition and physical activity best practices, as well as referral sources (2018) c. Offer additional trainings to reach at least 50% of the total primary care physician offices (2019) Number of physician offices involved in education 2. Mental Health Specific Needs Identified in CHNA In 2015, 4% of Defiance County adults considered attempting suicide. 14% of adults had a period of two or more weeks when they felt so worried, tense or anxious nearly every day that they stopped doing usual activities. 15% of Defiance County 6th-12th grade youth had seriously considered attempting suicide in the past year and 5% admitted attempting suicide in the past year. Key Objectives: Increase Mental Health Services available to the community. Implementation Strategies: Year one through three (2017-2019) 1. Work with primary care physician offices to provide and educate on the information, resources and/or materials available for mental health services. Number of primary care physician offices of whom services were provided 2. Improve access to mental health services by expanding the Partial Hospitalization Program in order to supplement Inpatient Services with and Outpatient Program. Number of patients served by the Partial Hospitalization Program annually 4

3. Unmasking Mental Health Initiative will seek to raise $100,000 which will be directly used to increase Mental Health Services such as a telemedicine program aimed at improving access for Youth Services Number of youth served by the program 3. Substance Abuse Specific Needs Identified in CHNA In 2015, the Health Assessment indicated that 10% of Defiance County adults were considered frequent drinkers (drank an average of three or more days per week, per CDC guidelines). The 2015 Health Assessment identified that 8% of Defiance County youth in grades 6-12 were smokers, increasing to 13% of those ages 17 and older. Key Objective: Decrease substance abuse among the adult and youth populations in the community. Implementation Strategies: Year one through three (2017-2019) 1. Increase the number of health care providers screening for alcohol and drug abuse Number of hospital and primary care providers screening for alcohol and drug abuse 2. Introduce a screening, brief intervention and referral to treatment model to physicians offices and hospital emergency departments - pilot in one primary care physician office and hospital ED Number of patients screened 3. Increase the number of primary care offices using the model Number of primary care offices using the model 4. Injury Prevention Specific Needs Identified in CHNA: 5

Defiance County adults had fallen in the past 6 months due to the following: same-level fall (slipping, tripping or stumbling) (14%), stairs (2%), shower (<1%), ladders (<1%), and some other way/place (3%). 49% of parents reported their child always rode in a car seat/booster seat when a passenger in a car, decreasing to 29% of those children ages 6-11 years old. When asked how parents put their child to sleep as an infant, 61% said on their back, 10% said on their side, 10% said in bed with them or another person, 8% said on their stomach, and 5% said various methods. Children were put to sleep in the following places: pack n play (56%), crib/bassinette without bumper, blankets, or stuffed animals (50%), crib/bassinette with bumper, blankets, or stuffed animals (47%), in bed with parent or another person (42%), swing (39%), car seat (31%), floor (15%), couch or chair (11%). Key Objective: Increase educational programs throughout the community in an effort to decrease preventable injury. Implementation Strategies: Year one through three (2017-2019) 1. Increase the use of safe sleep practices a. Participate in OHA s Safe Sleep is Good4 Baby Initiative Number of parents educated on safe sleep practices 2. Implement the STEADI (STopping Elderly Accidents, Deaths and Injuries) Program a. Research STEADI Program (2017) b. Implement the STEADI assessments and education in at least one primary care physician offices (2018) c. Implement the STEADI assessments and education in at least three additional primary care physician offices (2019) Number of patients screened and educated in primary care physician offices OTHER NEEDS IDENTIFIED IN THE CHNA BUT NOT ADDRESSED IN THIS PLAN will not address all of the needs identified in the most recently conducted Defiance County Health Needs Assessment as these areas either go beyond the scope of the hospital or may be addressed by, or with, other organizations in the community. 6

To some extent limited resources do not allow hospitals to address all of the needs identified through the health assessment, but most importantly to prevent duplication of efforts and inefficient use of resources as many of these issues are addressed by other community agencies and coalitions across Defiance County that are listed in the table below. In some areas of identified need, ProMedica takes a system approach to addressing community health needs, to most efficiently use resources and to prevent duplication of services. Many health issues are addressed by physicians at a related patient visit. Each of the health needs identified in the county assessment and listed below is important, with most issues being addressed by programs and initiatives within ProMedica, its hospitals and/or other community partners of the hospital. Key health issues identified in the Defiance County Health Assessment, and the organizations providing programming to improve these health issues include: Health Issue (adult unless specified) Health Care Access Cardiovascular Health Cancer Diabetes Arthritis Asthma Obesity Tobacco Use Organizations/Coalitions Addressing Needs United Way of Defiance County Northwestern Ohio Community Action Commission (NOCAC) Defiance County Senior Services Center for Child & Family Advocacy Paramount Health Care American Heart Association ProMedica Cancer Institute American Cancer Society Zonta Club of Defiance American Diabetes Association Arthritis Foundation Defiance Area YMCA Defiance City Schools Defiance Area YMCA American Cancer Society American Lung Association American Heart Association 7

Alcohol and Drug Use Women s Health Men s Health Preventive Medicine Adult Sexual Behavior Adult Pregnancy Quality of Life Social Issues Mental Health Oral Health Youth Weight Youth Tobacco Use Defiance City Schools Defiance City Police Department Four County ADAMhs Board Zonta Club of Defiance Northwest Ohio Komen* Zonta Club of Defiance American Cancer Society American Heart Association Community Pregnancy Centers, Center for Child & Family Advocacy Community Pregnancy Centers, Center for Child & Family Advocacy Defiance City Council Defiance City Police Department Defiance Development and Visitor s Bureau Defiance County Commissioners Defiance City Council Defiance City Police Department Defiance Development and Visitor s Bureau Defiance County Commissioners NOCAC Maumee Valley Guidance Center Four County ADAMhs Board United Way of Defiance County Defiance City Schools 8

Youth Alcohol and Drug Use Youth Sexual Behavior Youth Mental Health Youth Safety and Violence Parent Health Four County ADAMhs Board Ministerial Association, Youth for Christ Center for Child & Family Advocacy Four County ADAMhs Board Maumee Valley Guidance Center Defiance College Center for Child & Family Advocacy Maumee Valley Guidance Center Help Me Grow, United Way of Defiance County Community Pregnancy Centers (Help Me Grow) ProMedica participates with many organizations addressing these health issues, that may include financial support, although may not be specific to. (Note: other hospitals or organizations may also have programs to specifically address some of these health issues that may not be known at the time of this publication.) Defiance Community Health Partners, using the Defiance County Health Assessment, prioritized several health issues identified in the hospital Community Health Needs Assessment, determining that if these issues are addressed by multiple agencies and organizations over the next three years, they could promote healthier lifestyles and safer neighborhoods for all ages, reduce chronic health diseases, and improve several socioeconomic determinants of health for Defiance County residents. As previously stated, in some areas of identified need, ProMedica is already taking a system approach to addressing these community health needs, to most efficiently use resources and to prevent duplication of services, but in some areas of need is not engaged in programs outside of related visits to our hospitals or physician offices. This 9

2016 CHNA Implementation Plan was approved by the board of trustees on December 20, 2016. 10