Needs Assessment Implementation Plan Advocate BroMenn Medical Center () Date Endorsed by Governing Council: March 18, 2014 PRIORITY AREA: Target Population: GOAL: Obesity among individuals with diabetes. Low income adults who receive services from the Care Clinic. Reducing obesity among adults with diabetes by improving diabetes self-management skills. Healthy People 2020 Alignment: D-5 Improve glycemic control among persons with diabetes. D-14 Increase the proportion of persons with diagnosed diabetes who receive formal diabetes education. PERFORMANCE MEASURES How We Will Know We are Making a Difference Short Term Indicators Source Frequency Increase knowledge of diabetes self-management by 12.5%. Survey Pre & post program Decrease body mass index by a minimum of one from starting value (obtained prior to starting the diabetes education class) to value obtained at 6-month follow-up appointment. Decrease in HbA1c or stabilization of HbA1c from starting value obtained prior to attending diabetes education class. Care Clinic data Care Clinic data 6 month post class Annually Long Term Indicators Source Frequency Reduction in body mass index of greater than one from starting value obtained prior to attending diabetes education class. Care Clinic data Annually OBJECTIVE #1: Offer diabetes education class to 20 patients of the Care Clinic by 2014. Evidence Base: Evert, A.B., Boucher, J.L., Cypress, M., Dunbar, S.A., Franz, M.J., Mayer-Davis, E.J., et al, (2014). Nutrition Therapy Recommendations for the Management of Adults with Diabetes. Diabetes Care, 37(supplement 1), S120-S143. The individual with diabetes should be referred to a diabetic education or medical nutrition program soon after diagnosis. 1. Identify patients of Care Clinic appropriate for class. 6/1/2014 and ongoing prior to each class Care Clinic staff High risk patients identified 2. Contact patients of Care Clinic and invite to class. 6/1/2014 and ongoing two weeks prior to class Care Clinic staff Committed class participants 1
CHNA Advocate BroMenn Medical Center: Obesity among individuals with diabetes 3. Fill out patient information sheet on each class participant and give to Diabetes Educator. 6/31/2014 and ongoing prior to beginning session of class Care Clinic staff Diabetes Educator, knowledge about class participants OBJECTIVE #2: Conduct two diabetes education classes in 2014 for patients at the Community Care Clinic. Evidence Base: Evert, A.B., Boucher, J.L., Cypress, M., Dunbar, S.A., Franz, M.J., Mayer-Davis, E.J., et al, (2014). Nutrition Therapy Recommendations for the Management of Adults with Diabetes. Diabetes Care, 37(supplement 1), S120-S143. Healthy eating is one of the most challenging aspects of diabetes management for most individuals with diabetes. Diabetic and nutrition education can improve clinical outcomes and decrease costs to Medicare and other insurances. 1. Meet to generate ideas on effective strategy for increased class attendance. 4/30/2014 Director of Care Clinic Family Health Care Clinic Manager, class attendance 2. Determine date for diabetes education class. 5/16/2014 Director of Care Clinic Diabetes education class scheduled 3. Prepare course material for diabetes management class. 6/31/2014 and ongoing prior to each class Educational materials 4. Provide giveaways and exercise vouchers for class participants. 6/31/2014 and ongoing prior to each session Giveaways Exercise vouchers motivation for attendance for class participants 5. Order food for class participants. 6/31/2014 and ongoing Expense of food motivation for class attendance and knowledge of healthy snacks 6. Conduct diabetes education self-management classes. July 2014 and ongoing Care Clinic staff knowledge of diabetes selfmanagement and increased support 2
CHNA Advocate BroMenn Medical Center: Obesity among individuals with diabetes OBJECTIVE #3: Evaluate expansion of diabetes self-management program to include patients of Advocate BroMenn Medical Center s Family Health Care Clinic (low-income adults) into the diabetes education classes currently offered exclusively to the patients of the Care Clinic. Evidence Base: Haas, L., Maryniuk, M., Beck, J., Cox, C., Duker, P., Edwards, L., et al, (2014). National Standards for Diabetes Self-Management and Support. Diabetes Care, 37 (supplement 1), S144-S153. Access to diabetes selfmanagement education support is a crucial issue in success of the diabetic patient. Nationwide, the majority of diabetic and pre-diabetic patients do not receive diabetic education. Providers can identify socioeconomic and cultural factors as well as health insurance shortfalls and prepare a specific curriculum that takes into account any educational or cultural differences that will affect long-term outcomes of the diabetic patient. 1. Collaborative meeting to discuss the feasibility of expanding diabetes selfmanagement program to include patients of the Family Health Care Clinic at Advocate BroMenn Medical Center. 4/30/2014 Family Health Care Clinic Manager, Family Practice Physicians, Information sharing to make informed decision 2. Decision made regarding expansion of diabetes selfmanagement program to include Family Health Care Clinic patients. 6/30/2014 Director of Care Clinic Family Health Care Clinic Manager, Family Practice Physicians, Decision for class participation SUSTAINABILITY PLAN Advocate BroMenn Medical Center is committed to continuing to partner with the Care Clinic and others and search for ways to help vulnerable populations in the community better manage obesity and diabetes. 3
Needs Assessment Implementation Plan Advocate BroMenn Medical Center () Date Endorsed by Governing Council: March 18, 2014 PRIORITY AREA: Target Population: GOAL: Mental Health Individuals suffering from mental health issues having to resort to emergency room services as a primary access point for care. Reduce the number of people utilizing the emergency room as the primary access point for behavioral health resources. PERFORMANCE MEASURES How We Will Know We are Making a Difference Short Term Indicators Source Frequency 75% of Mental Health First Aid course participants will be able to identify the Mental Health First Aid action plan. Evaluation Upon course completion 90% of Mental Health First Aid course participants will score a minimum of 85% on Mental Health First Aid course exam. Examination Post course Long Term Indicators Source Frequency Decrease repeat visits to the Advocate BroMenn Medical Center emergency room with a behavioral health related diagnosis by 5% from 2010 to 2015. Emergency Room data Annual Decrease repeat visits to the Advocate Eureka Hospital (AEH) emergency room with a behavioral health related diagnosis by 5% from 2010 to 2015. AEH Emergency Room data Annual OBJECTIVE #1: Collect data on repeat visits for individuals with a behavioral health related diagnosis by December 2014 for Advocate BroMenn Medical Center to create a baseline. Evidence Base: Currently, repeat visits data is collected on inpatients but not on patients seen in the emergency room. Developing a process to collect this information will prove to be beneficial and help identify the scope of the issue for behavioral health related diagnoses seen in the emergency room at Advocate BroMenn Medical Center. This will help the hospital better understand how to engage with other community partners in addressing mental health issues in the community. 1. Meet with key staff to determine process for obtaining emergency room repeat visit data. 6/30/2014 ED Trauma/Quality Coordinator, Information Systems staff, Process for collecting data 4
CHNA Advocate BroMenn Medical Center: Mental Health 2. Establish a baseline of frequency of repeat visits to the BroMenn Medical Center emergency room with a behavioral health related diagnosis. 12/31/2014 emergency room data ED Trauma/Quality Coordinator, Repeat visits data OBJECTIVE #2: By December 31, 2014, train 50 McLean and Woodford County community members in Mental Health First Aid. Evidence Base: The top International Classification of Disease Codes (ICD-9 s) by volume for Advocate BroMenn Medical Center s emergency room visits in 2010 was mental health/psychiatric cases. Mental Health First Aid USA is an international evidenced-based program managed, operated and disseminated by the National Council for Behavioral Health, Maryland Department of Mental Health and Hygiene, and the Missouri Department of Mental Health. The program is based on a standard curriculum designed to educate the general public about mental health, recognize individuals with mental health problems, and provide skills that students can use to help those who are having a mental health crisis access help. http://www.mentalhealthfirstaid.org/cs/ (click here) 1. Determine location for Mental Health First Aid course. 2/28/2014 Location of course determined 2. Schedule Mental Health First Aid course for community members of McLean and Woodford Counties. 3/31/2014 Linden Oaks at Edwards Scheduled Course 3. Engage hospital leaders, local health departments and other community organizations to strategize on collaborating on Mental Health First Aid community courses. 4. Present Mental Health First Aid course information to Delegate Church Association. 3/31/2014 Leadership Team, & AEH McLean County Public Health Department Woodford County Health Department John M. Scott Health Resources Center 3/31/2014 Coordinator of Church Relations, Plan for collaboration knowledge of delegate church leaders 5
CHNA Advocate BroMenn Medical Center: Mental Health 5. Order equipment, supplies, decorations, and food for Mental Health First Aid Course. 4/15/2014 Expense Ordering complete 6. Develop, post, and mail marketing material for Mental Health First Aid Course. 7. Register Mental Health First Aid course participants. 5/1/2014 Public Affairs and Marketing, Linden Oaks at Edwards 6/23/2014 Wellness Client Specialist, Flyer/Invitations Registered participants 8. Hold Mental Health First Aid Course. 6/28/2014 Course materials Audiovisual Food Classroom Linden Oaks at Edwards Mental Health First Aid Instructors Certified Mental Health First Aiders 9. Collaborative meeting between hospital and health department to evaluate Mental Health First Aid course and determine possibility/need for second course. 7/30/2014 Leadership, & AEH McLean County Public Health Department Woodford County Health Department Continued collaboration Second course scheduled SUSTAINABILITY PLAN Advocate BroMenn Medical Center is committed to identifying ongoing resources to provide the appropriate level of care for those suffering from a mental health issue and will continue to collaborate with the local health departments and the delegate church association to provide education to the community. 6
Needs Assessment Implementation Plan Advocate BroMenn Medical Center () Date Endorsed by Governing Council: March 18, 2014 PRIORITY AREA: Childhood Obesity Target Population: Low income, obese children, ages 7 14. GOAL: Reduce obesity among low income children. Healthy People 2020 Alignment: NWS-10 Reduce the proportion of children and adolescents who are considered obese. PA-3 Increase the proportion of adolescents who meet current Federal physical activity guidelines for aerobic physical activity and for muscle-strengthening activity. PERFORMANCE MEASURES How We Will Know We are Making a Difference Short Term Indicators Source Frequency Show a 25% increase in physical activity for parents and children who complete the Y-Fi program. Survey Pre & post program Show a 25% increase in nutrition and exercise knowledge for parents and children who complete the Y-Fi program. Decrease body mass index from value obtained at the start of the Y-Fi program by 6 month follow-up. Survey Survey and/or appointment Pre & post program One time Long Term Indicators Source Frequency Decrease body mass index within one year of starting the Y-Fi program. Physical with primary care physician Biometrics such as cholesterol, blood pressure, and glucose will be within a normal range within one year of starting the Y-Fi program if results were outside of the recommended range prior to starting the program. Physical with primary care physician Annually Annually OBJECTIVE #1: By 2014, have 75 children and his/her parent(s) referred to the Y-Fi program. Evidence Base: Research indicates that regular exercise and learning about healthy eating in conjunction with working with a primary care physician assists an individual in maintaining or achieving a healthy weight. According to the Illinois Youth Survey, the percent of 6th 12th grade students in McLean County that are obese increased from 5.1% in 2010 to 8% in 2012. The percent of 6th 12th grade students in McLean County that are overweight increased from 11% in 2010 to 15% in 2012. The Y-Fi program provides 1:1 guided exercise and nutrition education to low-income obese children and their families. 1. Meet with pediatric physicians in McLean County to inform them about the Y-Fi program. May 2011 Y-Fi brochure Script pad handout Director of YMCA Physicians informed about Y-Fi program 7
CHNA Advocate BroMenn Medical Center: Childhood Obesity 2. Select a Pediatric physician champion for the Y-Fi program. June 2011 Director of YMCA Pediatric Physician champion to increase referrals 3. Pediatric physicians refer children with high body mass index to Y-Fi program. August 2012 Pediatric physicians School nurses Referral 4. Initial consultation set up with YMCA for parent(s) and child or children. Physician s office staff Parent brings in script referral directly Consultation for parent and child with YMCA OBJECTIVE #2: By 2014, have 50 children and his/her parent(s) participate in the 16-week Y-Fi program. Evidence Base: According to the Illinois Youth Survey, the percent of 6th 12th grade students in McLean County that are obese increased from 5.1% in 2010 to 8% in 2012. The percent of 6th grade 12th grade students in McLean County that are overweight increased from 11% in 2010 to 15% in 2012. Research indicates that regular exercise and learning about healthy eating in conjunction with working with a primary care physician assists an individual in maintaining or achieving a healthy weight. SCREENINGS/HEALTH FAIR 1. Meeting to introduce Y-Fi program and to distribute pre-program surveys. on Monday evenings Illinois State University dietary graduate student knowledge Pre-surveys distributed 2. Schedule one-on-one personal training sessions with parent and child or children. YMCA Certified personal trainer Personal training sessions for participants in Y-Fi program 3. Educate Y-Fi participants about nutrition and healthy eating. Illinois State University dietary graduate student nutrition knowledge 4. Conduct one-on-one personal training sessions with parent and child or children. for personal training and to do fitness assessments YMCA Certified personal trainer physical activity and exercise knowledge 8
CHNA Advocate BroMenn Medical Center: Childhood Obesity 5. 15 week Y-Fi session distribute post surveys. YMCA Certified personal trainer physical activity nutrition and exercise knowledge 6. Conduct 6 month follow-up appointment and/or call with Y-Fi participants. March 2013 6 months post program completion Sports Coordinator Short-term outcomes OBJECTIVE #3: By 2014, hold 3 quarterly health fairs with a health screening for Y-Fi children and their families at Advocate BroMenn Medical Center Community Wellness. Evidence Base: Offering free activities and programming for low-income families eliminates financial burden to learning about health and wellness. Family focused activity improves family dynamics and increases the success of the participants in the Y-Fi program. Educational information and free health screenings are offered to the family of the Y-Fi participants to encourage success of the entire family unit as an added benefit. Learning about exercise and nutrition in a fun environment will improve the retention of educational information for both parents and children. Knowing one s cholesterol, glucose, and blood pressure numbers increases the odds of taking action to improve one s health. 1. Determine location for health fair and screening. 3/15/2014 Location of health fair determined 2. Schedule dates for health fair and screening. 3. Meet with Advocate BroMenn Medical Center staff to strategize on health fair and screening offerings. 3/30/2014 3/30/2104 Program Manager (Women s Health), Senior Clinical Dietitian, Wellness Nurse Specialist, 3 event dates Program offerings and activities outlined for health fair Screening services offered to participants decided upon 9
CHNA Advocate BroMenn Medical Center: Childhood Obesity 4. Develop flyer for health fair and screening. 4/30/2014 7/30/2014 10/30/2014 Wellness/Outreach Specialist, Flyer 5. Order supplies, food and giveaways for health fair and screening. 4/30/2014 7/30/2014 10/30/2014 Expenses Food, giveaways, and supplies needed for event 6. Market health fair and screening and invite Y-Fi participants. 4/2014 7/2014 10/2014 Flyers Flyer/invitations 7. Develop interactive activities for Y-Fi children for health fair booths. 4/30/2014 and ongoing Expenses Wellness, Women s Center and Dietary staff, Interactive activities for health fairs 8. Obtain and select age appropriate educational information in both English and Spanish for parents and children on exercise and nutrition for health fair displays. 4/30/2014 and ongoing Educational information Wellness, Women s Center and Dietary staff, Educational handouts in both English and Spanish 9. Register Y-Fi participants for health screening. 4/2014 7/2014 10/2014 Wellness Client Specialist, Registration schedule for screening 10. Hold health screening/fair. 5/2014 8/2014 11/2014 Screening supplies Food Educational information Giveaways Health fair and screening SUSTAINABILITY PLAN Advocate BroMenn Medical Center is committed to partnering with the YMCA on this unique program developed for obese children. Hospital representatives will continue to meet with the YMCA Health and Fitness Sports Coordinator to determine if there are other ways the hospital can support the YMCA with the Y-Fi program. Discussions about bringing expert speakers from the hospital to the YMCA to present to Y-Fi program participants (as a supplement to their education through the program) are in progress. (Note: All data and website links within this document were verified as of May 15, 2014.) 10