Community Health Needs Assessment Implementation Strategy Tallahassee Memorial HealthCare 1300 Miccosukee Road FY 2016 I. General Information Contact Person : Warren Jones Date of Written Report: September 28, 2016 Link to Website on Which Written Report Was Made Publicly Available: www.tmh.org Date Written Report Made Publicly Available: September 29, 2016 Date Written Report Required to be Made Publicly Available (per Notice 2011-52): September 30, 2016 Date of Prior Written Report (if applicable): February 13, 2014 Name and EIN of Hospital Organization Operating Hospital Facility: Tallahassee Memorial HealthCare, Inc., EIN 59-1917016 Address of Hospital Organization: 1300 Miccosukee Road, Tallahassee, FL 32308 123.456.7890 1
Health Needs Planned to Be Addressed By Facility List of Significant Health Needs the Facility Plans to Address: Children s Concerns Early intervention in maternal health Infant Mortality Personal Health Hypertension Obesity Diabetes Lack of access to healthy food options or food options in general Behavioral Health Access to Care Health Navigators High cost of healthcare Too many uninsured Built Environment Crime activity related to drugs 2
Identification and Description of How Facility Plans to Address Each Significant Health Need: Health Need #1: To reduce Hypertension, Infant Mortality, and improve Maternal Health, Tallahassee Memorial intends to address an underlying behavior that contributes to each of these areas through the reduction of tobacco use in the service area. Describe actions the Facility intends to take to address the health need and the anticipated impact of those actions: For the Region: 1. TMH will amend its intake process and electronic medical record to include mandatory questions for each patient about their tobacco use and give them the opportunity to receive a referral for tobacco cessation resources. 2. TMH will partner with the Big Bend Area Health Education Center (AHEC) to connect interested patients to tobacco cessation resources. For the at-risk targeted neighborhoods reporting significantly higher tobacco usage: 1. TMH will provide targeted marketing, outreach, and education on the dangers of tobacco use in the five at-risk neighborhoods. 2. TMH will provide information on smoking cessation resources and education to local churches, groups, and businesses in the 5 at-risk targeted neighborhoods. Identify Facility s specific programs and resources the Facility plans to commit to meeting the need 1. Colleague man hours used to identify, educate and refer tobacco using patients and public. 2. Significant communication, both internally and externally, targeted to tobacco using patients and public. 3
Describe anticipated impact of committed programs and resources on the health need: Our anticipated impact: 1. TMH will address tobacco use and offer smoking cessation resources to at least 90% of admitted patients. 2. At least 95% of patients indicating they would like smoking cessation resources will receive at least one referral to a partner organization. We will evaluate our success by the following measurements 1. Increase in number of people accessing smoking cessation support resources from TMH providers. 2. Decrease number of smokers in six neighborhood service area in Leon County. 3. Increase in number of people accessing smoking cessation support resources. Describe facility s priorities in meeting these needs: We are focused on connecting people to resources so they stop using tobacco products. Describe any planned collaboration with governmental, non-profit, or other health care organizations, including related organizations, in meeting the health need: 1. Big Bend Area Health Education Center (AHEC) 2. Florida Department of Health in Leon County 3. Tobacco Free Florida 4. Piggly Wiggly 5. Winn Dixie 6. Tallahassee Orthopedic Clinic 7. Tallahassee Memorial Physician Partners 8. American Heart Association 4
9. American Cancer Society 10. American Lung Association 11. Tallahassee Pulmonary Clinic Identify all organizations with which the hospital collaborated in developing the implementation strategy: Florida Department of Health in Leon County and the United Way 5
Health Need #2: To reduce Infant Mortality. Describe actions the facility intends to take to address the health need and the anticipated impact of those actions: For the Region: 1. TMH will continue its work toward earning the Baby Friendly Accreditation by 2017. 2. Work with the March of Dimes and Florida Perinatal Collaborative to focus on neonatal intensive care units and their breastfeeding rates for babies in the Neonatal Intensive Care Unit. 3. TMH will partner with the community breastfeeding group comprised of Florida State University, regional health departments, regional pediatricians, Capital Area Healthy Start, Whole Child Leon, and Women s Infants and Children s (WIC), which reviews policy for businesses and physician practices with the goal of improving breastfeeding rates and providing support for breastfeeding women. 4. TMH will work with partner organizations to disseminate educational materials to families on safe sleeping practices. For the at-risk targeted neighborhoods: 1. TMH will work with service organizations in the six at-risk neighborhoods to provide information on how to access prenatal care. 2. TMH will target residents in the six at-risk neighborhoods for TMH FOR LIFE events and activities including health screenings, health education and resources, nutrition support, and walking events. Identify facility s specific programs and resources the facility plans to commit to meeting the need: 1. Colleague man hours and funding for the Baby Friendly Accreditation. 2. Colleague man hours working with partners to increase breastfeeding in the Tallahassee Memorial Neonatal Intensive Care Unit. 3. Colleague man hours to work with community partners to increase the number of breastfeeding mothers and families with safe sleeping habits. 6
Describe anticipated impact of committed programs and resources on the health need : Our anticipated impact and measurements: 1. Achievement of Baby Friendly Accreditation by 2017. 2. Increase breastfeeding at TMH by 5% in 2017, 10% in 2018, and 20% in 2019. 3. Implementation of the Florida Perinatal Quality Collaborative NICU and MOM (Mothers Own Milk) Project. 4. Increase NICU mothers who breastfeed by 10% in 2017, 20% in 2018, and 25% in 2019. 5. 100% of discharged maternal patients from the Family Care Unit and NICU will receive educational materials on safe sleeping practices. Describe facility s priorities in meeting these needs: We want to ensure that, pregnant moms receive primary care, prenatal, and perinatal care and education, that they deliver healthy babies and that the babies thrive. Tallahassee Memorial will continue to work with the Florida Hospital Association to stress the need to expand Medicaid coverage. Describe any planned collaboration with governmental, non-profit, or other health care organizations, including related organizations, in meeting the health need: 1. Tobacco Free Florida 2. Piggly Wiggly, Winn Dixie. 3. Florida State University 4. Regional health departments 5. Regional pediatricians 6. Capital Area Healthy Start 7. Whole Child Leon 8. Women, Infants, and Children (WIC) 9. March of Dimes 7
10. Florida Perinatal Collaborative Identify all organizations with which the hospital collaborated in developing the implementation strategy: 1. Florida Healthy Babies 2. Leon, Gadsden, Wakulla, and Jefferson County Health Departments 3. Capital Area Healthy Start Coalition 4. March of Dimes 5. Whole Child Leon 6. Florida Perinatal Collaborative 8
Health Need #3: Improve nutritional knowledge and healthy eating habits in the population. Describe actions the facility intends to take to address the health need and the anticipated impact of those actions: For the Region: 1. Provide grocery story tours with a registered dietitian. Participants will be accompanied by a dietitian while shopping and be educated on healthier food choices. 2. Film internet cooking segments and use social media and direct email to push the healthy eating message. 3. Provide dietitian counseling during TMH FOR LIFE events. For the at-risk targeted neighborhoods: 1. Provide grocery story tours with a registered dietitian. Participants will be accompanied by a dietitian while shopping and be educated on healthier food choices. 2. Film internet cooking segments and use social media and direct email to push the healthy eating message. 3. Provide dietitian counseling during TMH FOR LIFE events. 4. Work with churches to promote healthy eating. Identify facility s specific programs and resources the facility plans to commit to meeting the need: 1. Colleague man hours in all programming. Describe anticipated impact of committed programs and resources on the health need: Our anticipated impact and measurements: 1. Follow-up surveys with participants will find that at least 20% are using the knowledge they gained during their tour or educational opportunity. 9
2. Follow-up surveys with participants will find at least 20% perceive they are eating healthier meals. Describe facility s priorities in meeting these needs: We want to ensure that even in areas of fewer choice of food participants can identify healthier options and perceive they have adopted healthier eating habits. Describe any planned collaboration with governmental, non-profit, or other health care organizations, including related organizations, in meeting the health need: 1. Piggly Wiggly, Winn Dixie, Publix. 2. Regional health departments Identify all organizations with which the hospital collaborated in developing the implementation strategy: 1. Piggly Wiggly, Winn Dixie, Publix 10
Health Need #4: Improve access to behavioral health services and providers. Describe actions the facility intends to take to address the health need and the anticipated impact of those actions: For the at-risk targeted neighborhoods: 1. Based on initial estimates from baseline reports, the level of self-reported psychosis within the neighborhoods is at alarming levels in one section, and significantly beyond expected norms in another. Moreover, rates of selfreported anxiety and depression are far beyond national norms in most of the focus neighborhoods. 2. Based on those results, stakeholders plan to develop a comprehensive assessment of the status of behavioral health needs and service in this community that will include recommendations for appropriate levels of service and a plan to achieve that level of service. Identify facility s specific programs and resources the facility plans to commit to meeting the need: 1. Continue our participation on the Leon County Cooperative to determine how we can meet the needs of this targeted population. Describe anticipated impact of committed programs and resources on the health need: Our anticipated impact: 1. Three groups of community stakeholders, including the CHNA group convened by TMH and the Leon County Health Department, collaborating with Florida State University School f Medicine s Center for Integrated Healthcare to analyze four data sets regarding behavioral health in this community and region. The results of that analysis will establish a baseline for current self-reported need for behavioral health services, access to those services, and experience of behavioral health issues including anxiety, depression, and psychosis. 2. These results establish a baseline for community functioning which may be measured at regular intervals to establish whether progress has been made through implementation of the strategic plan. 11
Describe facility s priorities in meeting these needs: The results of the neighborhood survey indicates an alarming prevalence of behavioral health issues. Our priority is to work with our community partners to determine the cause so that we can help lessen causal affects. We are also committed to working with partners to identify those in the neighborhoods with behavioral health issues and determine the best course for their care. Describe any planned collaboration with governmental, non-profit, or other health care organizations, including related organizations, in meeting the health need: 1. Tallahassee Memorial HealthCare 2. Apalachee Center 3. Florida State University College of Medicine 4. Whole Child Leon 5. Regional Departments of Health 6. Bond Community Health Center 7. Neighborhood Community Health Center 8. Law Enforcement 9. United Way of the Big Bend Identify all organizations with which the hospital collaborated in developing the implementation strategy: 1. Tallahassee Memorial HealthCare 2. Apalachee Center 3. Florida State University College of Medicine 4. Whole Child Leon 5. Regional Departments of Health 6. Bond Community Health Center 7. Neighborhood Community Health Center 12
8. Law Enforcement 9. United Way of the Big Bend 13
Health Needs Facility Does Not Intend to Address List of Significant Health Needs the Facility Does Not Plan to Address Built Environment 1. Lack of sidewalks - This is an issue that is addressed by governmental agencies. Children s Concerns 1. Lack of educational resources focusing on after school programs and tutoring - many local agencies are addressing this issue. 2. Literacy - many local agencies are addressing this issue. Access to Care 1. Transportation to appointments - local agencies are addressing this issue. 2. Dentists that accept Medicaid 3. Bond Women s and Children s Program Dental Program - This important program is currently receiving funding. 4. High drug prices - Tallahassee Memorial does provide prescription medications for post-hospitalization high-risk patients on a short-term basis. 14