Community Health Needs Assessment Mercy Hospital Ardmore 2012
Contents Table of Contents Introduction... 2 Description and Basic Community Demographics... 2 Who was Involved in Assessment?... 2 Community Assessment Process....3 Primary Health Needs Identified... 4 Implementation Plans for the Identified Primary Health Needs... 4 Our Mission: As the Sisters of Mercy before us, we bring to life the healing ministry of Jesus through our compassionate care and exceptional service. Mercy Hospital Ardmore Page 1
Executive Summary Mercy Hospital, Ardmore is a hospital with 190 licensed beds and serves a six county area. In 2011, the second round of community round tables was conducted to dialogue with community members and public health experts. Mercy Planning and Research provided analysis of both internal and external demographics, utilization, chronic conditions and health status. The needs assessment process involves a review of both quantitative and qualitative information to attain the full scope of our community s needs. This summary is documentation that Mercy Hospital, Ardmore is in compliance with IRS requirements for conducting community health needs assessments. Description of Community The service area of Mercy Hospital, Ardmore is comprised of six counties (Carter, Jefferson, Johnston, Love, Marshall and Murray) with a population of 110,000. The main campus includes the hospital and four medical buildings. The hospital is a full-service tertiary hospital with 190 licensed beds, 874 co-workers and seven clinic locations. Critical Access Hospitals are located in Healdton, Marietta and Tishomingo. A relationship with Valley View Hospital in Ada has expanded Mercy s service responsibility to that community. Mercy Clinic is a physician-governed group practice comprised of 33 physicians, including seven specialists. 12 mid-level practitioners work alongside the physicians in serving the area. This provider partnership gives patients access to the best quality care in the country with access to an entire health care team and advanced services. Mercy Clinic providers also have access to an electronic health record that is shared at Mercy facilities in four states, and patients may connect to their own health record and health teams anywhere they connect to the internet through MyMercy. Oklahoma faces a health crisis 14% of the state population is uninsured. In the Mercy Ardmore service area, the average across six counties is 24.6%. For this particular community the Medicare population comprises 19% of our population. The Medicaid population comprises 21% of our population. Being uninsured is a huge barrier to accessing the health services needed to be healthy. Lack of access to quality health care impacts more than the uninsured individual it impacts families, employers, and the community. Who was involved in assessment? At the center of involvement in the needs assessment were the people of our community. In April of 2010 and again in July of 2011, Mercy held community roundtable events to dialogue directly with local community members about their needs, ideas, and concerns related to healthcare. Common themes included: Education on health/wellness, Access to health care services for all Obesity and the incurred health risks Fitness, nutrition and mental health Mercy Hospital Ardmore Page 2
A focus on partnerships, education, and technology were listed as ways to improve health/wellness in the community. Mercy Planning and Research provided analysis of both internal and external demographic, utilization, chronic condition and health status. Sg2 was also engaged by Mercy as a partner to analyze current utilization and future demand for health care services. Press Ganey Associates assist Mercy on an on-going basis measuring and providing benchmark data on patient satisfaction on in-patients, ambulatory surgery, and emergency room patients. Mercy co-workers collaborate with community partners for ongoing assessment of the needs in the community.our community collaborative partners include: Oklahoma State Department of Health, Carter County Health Department, and Oklahoma Turning Point Coalition. How the assessment was conducted Our needs assessment involved the following five steps to attain the full scope of our community s needs. 1. Examining existing community health needs assessments. Oklahoma Health Improvement Plan (OHIP) This is a comprehensive plan to improve the health of all Oklahomans developed by the Oklahoma State Board of Health, 2010-2014. County Readiness Assessment Report, 2011 This assessment was completed by the Carter County community under the direction of the Carter County Health Department and the Turning Point Coalition to assess the level of community readiness in addressing nutrition and fitness. Wellness Now-2011-2012 This community health improvement initiative addresses fitness and nutrition. It is designed to pool community resources and expand partnerships to targeted areas with the most needs as a united force and achieve real results. Data from Mercy s Health Information Systems Department Data from Mercy s own records was pulled and used to assess the needs of the community. 2011 State of the State Health Report This is a report that reviews multiple indicators that contribute to Oklahoma s overall health status. It also summarizes Oklahoma health as a whole and identifies county specific trends. 2012 County Health Rankings The County Health Rankings & Roadmaps program helps communities create solutions that make it easier for people to be healthy in their own communities, focusing on specific factors that we known affect health, such as education and income. Oklahoma Turning Point Turning Point starts at the local level, building broad community support and participation in public health priority setting and action, engaging and linking affected people at the local level. Local field consultants in each county of Mercy Hospital Ardmore Page 3
Oklahoma provide leadership in assessing local public health needs and identifying key priorities. 2. Conduct roundtable discussions with community members. As previously stated, community individuals as well as experts in the public health arena were invited to attend community roundtables for input on the needs of the community. 3. Analyze and summarize the data to prioritize needs. 4. Review community benefit activities. 5. Create an action plan in partnership with the community. Health Needs Identified Analyze and summarize the data to prioritize needs (Step 3). The analysis of the combined data collected revealed the following health needs: obesity, physical inactivity, smoking, heart disease, cancer, chronic lower respiratory disease, stroke, and diabetes. Community Assets Identified The assessment identified a number of strong community assets which includes the hospital, state and city/co. health departments dedicated to identifying, planning, and implementing programs to improve public health, school systems (public/private) that consistently strive to increase fitness activities and nutritious meals, and the community-based initiative. Summaries: Assessments and Priorities To set priorities, criteria focused on identifying disproportionate unmet need, primary prevention strategies, advancements toward a continuum of care and a program that is collaborative and involves the community. The following priorities are: fitness, nutrition, diabetes, heart disease, cancer, stroke and chronic respiratory disease. Next Steps Review community benefit activities (Step 4). Using Lyon Software s CBISA tool, a review will be conducted of current community benefit activities and what Mercy was presently doing to meet the identified priorities. In addition, the community benefit activity of other in the community will be reviewed. Create an action plan (Step 5). Ongoing and new collaborations with community organizations will address ways identified needs in the community. Implementation plans will be posted by November 15, 2013. Mercy Hospital Ardmore Page 4
Ardmore Community Needs Assessment March 2013
Ardmore, OK The Ardmore Primary Service Area (PSA) comprises six counties in south central Oklahoma OK Mercy Locations Hospital Managed Hospital Clinic Urgent/ Convenient Care
UTILIZATION Mercy Hospital Ardmore MSDRG Code Top Acute Inpatient Discharges March 1, 2012 February 28, 2013 Note: Accounts for 26% of their total 9,002 Acute IP Discharges MSDRG Description Source: Epic Hospital Billing Report Inpatient Discharges % of Total Age Breakouts Inpatient Discharges < 18 % 18-44 % 45-64 % 65-79 % 80+ % 775 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES 526 6% 33 6% 493 94% 0 0% 0 0% 0 0% MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER 470 EXTREMITY W/O MCC 317 4% 0 0% 5 2% 106 33% 157 50% 49 15% 392 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC 257 3% 17 7% 39 15% 106 41% 51 20% 44 17% 313 CHEST PAIN 207 2% 0 0% 31 15% 95 46% 62 30% 19 9% 766 CESAREAN SECTION W/O CC/MCC 195 2% 5 3% 190 97% 0 0% 0 0% 0 0% 194 SIMPLE PNEUMONIA & PLEURISY W CC 189 2% 13 7% 13 7% 49 26% 59 31% 55 29% 945 REHABILITATION W CC/MCC 185 2% 0 0% 3 2% 54 29% 88 48% 40 22% 871 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC 169 2% 1 1% 17 10% 48 28% 65 38% 38 22% 192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC 155 2% 0 0% 6 4% 64 41% 72 46% 13 8% 195 SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC 150 2% 53 35% 16 11% 33 22% 28 19% 20 13% TOTAL 2,350 26% 122 5% 813 35% 555 24% 582 25% 278 12% 3
UTILIZATION Mercy Hospital Ardmore Top Inpatient Admissions from the ED March 1, 2012 February 28, 2013 Note: Accounts for 32% of their total 5,826 ED Admissions MSDRG Description ED Inpatient Admissions % of Total ED Age Breakouts Inpatient Admissions < 18 % 18-44 % 45-64 % 65-79 % 80+ % Chest pain 784 13% 0 0% 89 11% 380 48% 213 27% 102 13% Pneumonia 341 6% 37 11% 27 8% 103 30% 93 27% 81 24% Altered mental status 178 3% 1 1% 22 12% 57 32% 59 33% 39 22% Fever 91 2% 9 10% 15 16% 27 30% 21 23% 19 21% COPD with acute exacerbation 87 1% 0 0% 4 5% 35 40% 36 41% 12 14% Syncope 84 1% 1 1% 9 11% 26 31% 20 24% 28 33% Community acquired pneumonia 81 1% 2 2% 7 9% 26 32% 27 33% 19 23% Abdominal pain 75 1% 5 7% 24 32% 21 28% 21 28% 4 5% UTI (lower urinary tract infection) 74 1% 3 4% 7 9% 11 15% 18 24% 35 47% Acute appendicitis 74 1% 26 35% 35 47% 10 14% 3 4% 0 0% TOTAL 1,869 32% 84 4% 239 13% 696 37% 511 27% 339 18% Source: Epic - Report ED0004: Inpatient admits from the ED (patient class includes emergency, inpatient, surgery, surgical OP/extended care, and observation) 4
UTILIZATION Mercy Hospital Ardmore Top ED Visit Volume By ICD9 Codes March 1, 2012 February 28, 2013 Note: Accounts for 20% of their total 39,970 ED Visit Volume ED % of ED Age Breakouts ICD9 CodeDiagnosis Volume Volume <18 % 18-44 % 45-64 % 65-79 % 80+ % 789.00 Abdominal pain, unspecified site 1,674 4% 247 15% 966 58% 339 20% 90 5% 32 2% 465.9 Acute upper respiratory infections of unspecified site 1,016 3% 566 56% 378 37% 52 5% 14 1% 6 1% 784.0 Headache 819 2% 62 8% 516 63% 194 24% 40 5% 7 1% 462 Acute pharyngitis 768 2% 346 45% 368 48% 41 5% 10 1% 3 0% 382.9 Unspecified otitis media 743 2% 621 84% 104 14% 14 2% 4 1% 0% 599.0 Urinary tract infection, site not specified 684 2% 112 16% 294 43% 93 14% 99 14% 86 13% 786.50 Chest pain, unspecified 633 2% 26 4% 263 42% 230 36% 84 13% 30 5% 490 Bronchitis, not specified as acute or chronic 630 2% 118 19% 350 56% 111 18% 39 6% 12 2% 786.59 Other chest pain 601 2% 20 3% 221 37% 247 41% 79 13% 34 6% 486 Pneumonia, organism unspecified 590 1% 109 18% 103 17% 147 25% 132 22% 99 17% TOTAL 8,158 20% 2,227 27% 3,563 44% 1,468 18% 591 7% 309 4% Note: 1,581 (4%) of ED discharges did not list diagnosis Source: Epic - Report ED0018: ED Visit Reason 5