More Than a Name... Moving from Fragmentation to Strategic Focus

More Than a Name... Moving from Fragmentation to Strategic Focus Marcos Pesquera, RPh, MPH Executive Director Sue Heitmuller, MA Manager Community Benefit & Health Ministry

Objectives for Today s Discussion 1. Understand why a faith-based healthcare organization integrated a strategy for population-based care into the community benefit infrastructure. 2. Identify the key players for integrating a population-based care model into your organization. 3. Describe the structure and process for establishing organizational priorities. 4. Identify how to align available resources with CHNA implementation and implement focused interventions to address community health needs of greatest concern.

Mission of AHC We demonstrate God s care by improving the health of people and communities through a ministry of physical, mental and spiritual healing.

Health Care Environment Federal Standards & Requirements ACA Requirements New CLAS Standards NQF Joint Commission Organizational Limitations Meet need to improve impact in environment Small system, in metropolitan environment Limited resources State Requirements Maryland Healthcare Quality and Cost Council Healthcare Services Cost Review Commission

Realignment of Community Benefit Interventions with Care Continuum Resources Deliverables Capabilities Intervention/ Partners Continuous Improvement *Center on Health Disparities /Health and Wellness/ Mission Integration *CHNA Development *CHNA Implementation Plan *Local & hospital data *Wellness Outreach *Cultural Competence *Community Partnership Fund aligned *Care Transition *Places of Worship *Local Health Department *Partnerships With Non Profits and Safety Net *Program results, Evaluation and Reporting *Population Health

Data Collection

Adventist HealthCare Health Equity Report 1. Snapshot of Diversity: Patient population demographics 2. Hospital Settings: Where we see our patients 3. Cancer Diagnoses by Race/Ethnicity, Age, and Type 4. Inpatient Clinical Quality Indicators 5. Hospital Readmission Rates 6. Patient Experience

Changing Demographics in Maryland Census 2010 (2013 estimates) population statistics Non-Hispanic White Black or African American Adventist HealthCare County/State Service Areas Frederick County Montgomery County Prince George s County Maryland 77.3% 48.7% 15.2% 54.4% 9.2% 18.2% 65.4% 30.0% Asian 4.1% 14.4% 4.3% 5.8% Hispanic/Latino 7.6% 17.5% 15.2% 8.4% Foreign Born* 9.2% 31.4% + 19.8% 13.5% 2010 Census data, Baltimore, Montgomery, & Prince George s Counties Population Statistics: Race/Ethnicity, Language, & Foreign Born Status

Statistics About Languages in Maryland Homes Census 2010 population statistics Frederick County Montgomery County Prince George s County Maryland Language other than English spoken at home About one third of these residents do not have a family member (over 14 years of age) who speaks English well and are linguistically isolated, causing them to face barriers when accessing health care services. 11.9% 38.1% 19.8% 16.2% Census population statistics Frederick County Montgomery County Prince George s County All of Maryland White 3% 12% 6% 6% Black or African American 4% 21% 8% 7% Asian 81% 85% 82% 80% Hispanic/ Latino Percent of County Residents Speaking Non-English Languages by Race/Ethnicity 62% 90% 87% 81% A majority of Latino and Asian American residents in Maryland speak a language other than English at home.

Population Health Model County Health Rankings Model 2012 UWPHI

Organizational Integration Health & Wellness Health Disparities Mission Integration Community Benefit Strategic Alignment 12

Center on Health Disparities Structure Blue Ribbon Panel Recommendations Training & Education Health Care Services Research Institute Improving patient-provider relationships & trust to achieve better outcomes Expanding services to underserved communities Transforming evidencedbased research into practice Improving the Health of Our Communities

Health & Wellness Health and Wellness Tobacco Cessation Community Health Cancer Outreach Maternal/Child Health Youth Health Cardiac & Vascular Outreach Classes Cessation Classes Additional Services Individual Counseling Nicotine Replacement Therapy Follow Up & Referrals Classes Exercise Nutrition/Cooking Diabetes Management Stress Management CPR Additional Services Massage Therapy Support Groups Flu shots Cancer Education Cancer Screenings Breast Colorectal Oral Bladder Skin Thyroid Prostate Support Groups Breastfeeding / Lactation support Discovering Motherhood Classes Baby Care Basics Fatherhood Childbirth Preparation Brother / Sister Grandparenting Infant Massage Pediatric Health Fairs Classes Asthma Education Babysitting CPR for Teens First Aid for New Parents Infant CPR & Safety Home Alone Education and Screening Heart Disease Blood Pressure Carotid Artery Peripheral Artery Disease 14

Mission Integration & Spiritual Care Mission Integration & Spiritual Care Chaplaincy Program Health Ministry & Faith Community Nurse Community Benefit Washington Adventist Hospital Shady Grove Adventist Hospital Adventist Rehabilitation Hospital Adventist Behavioral Health Adventist Behavioral Health - Eastern Shore & Adventist Home Health 15

Resource Alignment Integration of Organizational Interventions Program evaluations to evaluate effectiveness Mobilize, Empower, and Cross-Train Staff Alignment with Entity Goals Re-organization Inventory of staff roles and responsibilities Strategic Alignment Evaluation of Mission, Resources, & Impact

Community Benefit Council Purpose Statement: To develop, oversee and monitor the community benefit process for the organization and ensure that the organization complies with Federal and State requirements in order to maintain its nonprofit status. Marketing Strategy & Business Development Finance Mission Integration and Spiritual Care

Achieving Consensus: CHNA Development Process Phase One Data Collection Primary Data Secondary Data Community Defined Social determinants of health Prioritized Health Needs Resource Alignment Align Existing Resources Identify Resource Gaps CHNA Report Finalized Phase Two Board of Trustees Report Distribution

CHNA Implementation Plan Focus Areas Strategies Measurable Tasks Collaborative Partners Evaluation Methodology

Capability Integration to Achieve Population Health COMMUNITY PARTNERS COMMUNITY PARTNERS Biometric Screenings INTERVENTIONS INTERVENTIONS

Beginning your Implementation Plan Focus Areas What are your top 5 areas of focus for community health improvement? Strategies What essential interventions are needed to address these needs? 1 2 3 4 5

Capacity Gaps & Leveraging Resources Capacity Gaps What capabilities are needed to address those strategies? Internal Collaboration What existing departments contain at least one capability or possess the ability to contain it? External Partnerships Who do we need to partner with to leverage resources and capabilities? 1 2 3 4 5

Focus Area: Lead Essential Interventions Responsibility Start Date Completed by 1 2 3 4 Metrics/Goals (Measurable) Internal Resources External Resources/ Partners 1 1 1 2 2 2 3 3 3 4 4 4 Milestones/Timeline (Short- & Long-term) Barriers/Success Inhibitors 1 1 2 2 3 3

Closing Thoughts Patients Alone Confused Overwhelmed Community Local Hospital Working in Isolation Local Government Community Groups Grassroots Organizations Local Businesses

Closing Thoughts Patients Empowered Supported Motivated Community WorkingTogether

Thank You! Contact Information: Marcos Pesquera, Executive Director Center for Health Equity and Wellness E-mail: mpesquer@adventisthealthcare.com Sue Heitmuller, MA Manager Community Benefit & Health Ministry sheitmul@adventisthealthcare.com Like Us on Facebook: http://www.facebook.com/healthdisparities Visit Us on the Web: www.adventisthealthcare.com/disparities