Hospitals Collaborating to Assess and Address Changing Community Health Needs MARGARET DROZD, MSN, RN, APRN-BC DIRECTOR COMMUNITY MOBILE HEALTH SERVICES SAINT PETER S UNIVERSITY HOSPITAL
Hospitals Collaborating to Assess and Address Changing Community Health Needs SAINT PETER S UNIVERSITY HOSPITAL AND ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL
Patient Protection and Affordable Care Act New obligation on nonprofit hospitals driven by the IRS to maintain their tax-exempt status as a non-profit They have to proactively and measurably improve the health of their communities - not just provide quality care to individual patients - and to document the evidence of their success.
Objectives Assess community health needs Prioritize and create community health improvement plan Establish partnerships and a Steering Committee Define the scope of assessment Engage the community and conduct the assessment Collect and analyze data Prioritize identified community health needs Create community health improvement plan Implement community health improvement plan internally Release community health improvement plan and solicit external support
Steering Committee Project Partners Other Project Partners Middlesex/Somerset County Health Departments New Brunswick Tomorrow Rutgers Center for State Health Policy Puerto Rican Action Board Central Jersey Community Development Corporation UMDNJ RWJ Medical School Community Health South Brunswick Health Department ParamCare Mt. Zion AME Church Woodbridge Health Department Spotswood Public Schools Middlesex County Chronic Disease Coalition Coalition for Healthy Communities
Role of Community Partners Review and evaluate prior assessment reports and public health data Build on existing assessments and internal information and plan to supplement by gathering community level data Assist with conducting surveys, focus groups, key informant interviews, community forums Identify community assets Assist in the process of prioritizing community health needs
Putting It Together
Assessment Catchment Area
Hospitals Collaborating to Assess and Address Changing Community Health Needs Professional Research Consultants, Inc. (PRC) Analyzed Community Telephone Survey findings Generated a Summary Report of Findings (Online Access ) UMDNJ-Department of Family Medicine Chapter: Focus Group and Key Informant Findings Assessment Products Rutgers Center for State Health Policy (RCSHP) Chapter 1: Analysis of 2010 BRFSS Data Chapter 2: Avoidable Hospitalizations and Emergency Department Visits: An Analysis of New Jersey Hospital Discharge Data Chapter 3: Interpretation of 2012 Community Phone Survey Bibliography of relevant prior local area health assessment work conducted by CSHP.
Hospitals Collaborating to Assess and Address Changing Community Health Needs Survey questionnaire developed and translated into Spanish Telephone Survey 1,000 telephone surveys completed 250 cell phone 750 landline
Hospitals Collaborating to Assess and Address Changing Community Health Needs Key Informant Interviews (26) Community Based Organizations (CBOs) Healthcare providers School nurses Safety net clinic personnel Social work and outreach personnel Mental health services providers Developmental disability services provider County offices, officials and health departments representatives Drug/alcohol service providers Domestic violence service provider Emergency Medical Services Senior center directors Chinese-American community in the catchment area
Hospitals Collaborating to Assess and Address Changing Community Health Needs Primary qualitative study objectives What is the experience of Somerset/Middlesex County residents in accessing medical care? What are the health services and resources most needed now to improve community members health? What are the barriers to accessing health care? Focus Group Interviews (9) Focus Group Guide was developed and translated Spanish Hindi Gujarati Mandarin Focus Groups conducted (Participants - 108) Gender 71% female 29% male Race/Ethnicity 19% African-American 25% Hispanic 22% South Asian 21% Caucasian 13% Chinese
Hospitals Collaborating to Assess and Address Changing Community Health Needs Why isn t it obvious? Access Who to call? Where to go? Why isn t it easy? Highlights Is it accurate? Information Internet Word of Mouth Is it reliable?
Hospitals Collaborating to Assess and Address Changing Community Health Needs Highlights Behavioral Risk Factor Surveillance System (BRFSS) The assessment catchment area fared worse only 3 of the 33 measures that were examined No exercise in past month No PSA test in the last 2 years Never had an HIV test Telephone Survey Population segments less likely to have participated in some type of organized health promotion activity in the past year include: Lower income residents Asian residents Hispanic residents Uninsured adults
Year 1 Secondary Data Analysis 2010 Behavioral Risk Factor Surveillance System (BRFSS) Data Avoidable Hospitalizations and ED Visits: An Analysis of New Jersey Hospital Discharge Data Community Telephone Survey Focus Groups Key Informant Interviews Bibliography of relevant prior local area health assessment work conducted by CSHP
Year 2 Identify /Prioritize Health Needs Develop a Community Health Improvement Plan (CHIP) Incorporate the CHIP into the Hospital Strategic Plans Target services and maximize resources Disseminate the CHIP and solicit external support
Coordination and Communication Goal 1: Strengthen coordination and communication among community health partners. Access to Care and Health Information Goal 2: To ensure that every person has access to health and wellness services that meet the culture and language needs of Middlesex and Somerset counties. Promoting Healthy Behaviors Goal 3: To build a community that promotes, supports and fosters healthy behaviors and preventive care services across Middlesex and Somerset counties. Disease Specific Issues with a focus on Obesity, Diabetes, and Mental Health Goal 4: To achieve physically and mentally healthy communities by addressing obesity, diabetes, and mental health in Middlesex and Somerset counties.
Activities/Outcomes Coordination and Communication Develop a sustainable structure for health system partner collaboration, coordination, and communication. Create mechanisms for sharing information about evidence-based programming between providers.
Activities/Outcomes Access to Care and Health Information Medical Interpreters Training Domestic Violence Training for Healthcare Providers Health Literacy Initiatives ( Library Project) Connect individuals to insurance coverage/medical homes (Accountable Care Act) Healthcare Provider Training (Cultural and Linguistic Competency) Promote existing health and wellness services to link individuals to services
Activities/Outcomes Promoting Healthy Behaviors Promote physical activity initiatives (Fun in the Park) Promote fruits and vegetables consumption (NB Food Alliance) Organize and conduct health screening events throughout the community (Cardiovascular, Breast, and Prostate Cancer ) Support policy changes to encourage/ promote healthy behaviors.
Activities/Outcomes Disease Specific Issues with a focus on Obesity, Diabetes, and Mental Health Chronic disease prevention education and training programs for service providers and consumers Workplace Wellness
Successes A better understanding of community health needs More targeted services Expansion of services beyond New Brunswick Collaboration and partnership between the two local hospitals Show the community health partners the hospitals ability to work together Positive community feedback regarding the joint programming
Working together to create a healthy, safe and supportive community for all.