Ross County Community Health Needs Assessment … · Web viewAuthor sjones2 Created Date 10/28/2016 09:05:00 Title Ross County Community Health Needs Assessment – 2013 Adena Regional

Adena Regional Medical Center

ROSS COUNTY 2016 COMMUNITY HEALTH NEEDS ASSESSMENTIMPLEMENTATION STRATEGIES

ADENA HEALTH SYSTEM0 | P a g e

Adena Regional Medical Center (ARMC) is a part of the Adena Health System. Since 1895, Adena Health System has remained focused on its commitment to provide patients with the best healthcare and personal service. Today, Adena Health System includes three hospitals (Chillicothe, Greenfield and Waverly) and five regional clinics, with a total of 311 beds. Adena provides quality healthcare for the more than 500,000 residents within its 12-county, southern Ohio service region, which includes Adams, Athens, Fayette, Gallia, Highland, Hocking, Jackson, Pickaway, Pike, Ross, Scioto and Vinton Counties.

Adena offers its patient’s leading edge services in the areas of heart health, cancer diagnosis and treatment, women's health; children's health; and orthopedics. The skilled physicians and medical staff at Adena provide a number of specialty services that are typically found in larger medical centers. These include: open heart surgery; da Vinci robotic surgery; cardiac intervention; cancer care; advanced orthopedic procedures; high level MRI testing; and a Level II pediatric nursery.

Progress on the 2013 Community Health Needs AssessmentAdena Health System and Adena Regional Medical Center completed a community health needs assessment and implementation strategies plan in 2013. The plan identified one primary health need, obesity, and two secondary community health needs: mental and behavioral health; smoking (Figure 1).

2013 Ross County Community Health Needs AssessmentCommunity Health Focus and Priorities

Focus Health Priorities Strategies

Primary Obesity High Blood Pressure Joint/Back Pain Heart Disease

Employee Health Initiatives Community Programming Regional Initiatives

Secondary Mental/Behavioral Health Stress Depression Drug Abuse

Smoking Cancer Chronic Respiratory Disease

Advocacy Referral Resources Cessation Resources Screening

Figure 1: Adena’s 2013 Community Health Needs Assessment PrioritiesA community health plan was developed around these health priorities using four primary strategies: advocacy; referral; cessation resources; and screening services. Community health programming was then developed around these issues and piloted with Adena Health System employees as part of the

1 | A d e n a H e a l t h S y s t e m C H N A I m p l e m e n t a t i o n S t r a t e g i e s

employee health and wellness program. Programs were refined and then expanded for implementation into the Ross County community (Figure 2).

Figure 2: Adena’s 2013 Approach to Community Health Program Development

As a result of these efforts, Adena Health System developed multiple programs focused on educating the public on obesity. Advocacy efforts and cessation resources were developed and promoted for mental and behavior health issues, as well tobacco use. Figure 3 provides an outline of the programs that were developed and implemented from 2013 to 2016 for the Adena community health plan. Table 1 outlines the actions, progress and outcomes.

Figure 3: Adena’s 2013 Through 2016 Health Priorities Programming


Adena Employee Health & Wellness Plan

Employerl Health & Wellness

Community Health Impact Initiative

Primary Health PriorityOBESITY

Move More InitiativeHealthy KidsDiabetes ExposWalk With a Doc

Secondary Health PriorityMENTAL/BEHAVIORAL

HEALTH

Baby Centered RecoveryRoss County Heroin Partnership Advisory Council

Secondary Health PrioritySMOKING

Adena Quit ClinicLung Cancer Screenings

Health Priority 2013Proposed Implementation Strategies

2014 Actions/Progress 2015 Actions/Progress

Primary Health PriorityObesity Employee Health Initiatives

AHS Community Health Advancement will collaborate with community partners to implement broader scale health and wellness programs, centered around movement, nutrition and wellbeing, previously developed and piloted by the AHS internal employee health and wellness program. In addition, partnerships with local community agencies will be facilitated as part of a diabetes management initiative for high-risk diabetic patients.

In 2014, AHS restructured its internal Health & Wellness team to create an evidence-based health and wellness platform by developing and refining programs for health system employees (residents of the service region) that could be implemented on a larger scale in the community.

The team successfully created a model built around three components proven to drive improved individual health and wellness: movement; nutrition and wellbeing. The team coordinated programming within these three areas – campus based walking program, Weight Watchers at Work, and stress management classes – in addition to established offerings including Family Fit and Adena Fit. A communication plan was built around the programming to ensure effective communication to employees. In addition, a competitive challenge for employees, Move More Adena, was also coordinated to encourage 90 minutes of activity per week, as well as a venue to market other employee health and wellness offerings. The team successfully engaged more than 35% of the total employee population through these initiatives in 2014.

In 2015, AHS continued its internal efforts around Employee Health and Wellness by expanding and implementing evidence-based health and wellness programming built on three different pillars – movement, nutrition and well-being. Some programming was also expanded into the greater Ross County Community.

The team continued the campus based walking program, Weight Watchers at Work, Adena Fit, and stress management classes. The communication plan developed in 2014 was expanded into social media, representatives from the organization’s Health & Wellness committee rounded to departmental meetings and coordinated a Health & Wellness Fair to ensure effective communication to employees. The Move More challenge was kicked off again in May of 2015 with more than 700 Adena employees participating.

An initiative improving healthier eating options in the Adena Regional Medical Center cafeteria was also implemented. The overall fruit and vegetable consumption was increased and labeling of fresh serve items was introduced in 2015.

All of the Health & Wellness Programming again engaged more than 35% of the total employee population through these initiatives in 2015.

Community ProgrammingAHS Community Health Advancement will collaborate with community partners to implement broader scale health and wellness programs, centered around movement, nutrition and wellbeing, previously developed and piloted by the AHS internal employee health and wellness program. In addition, partnerships with local community agencies will be facilitated as part of a diabetes management initiative for high-risk diabetic patients.

AHS Community Health Advancement collaborated with a variety of community partners to coordinate and deliver community programs aimed at promoting movement and nutrition. Programs included:

Sponsorship and participation in the Healthy Kids’ Event at the Ross County Fair with Chillicothe Gazette, Healthy Start for Kids, YMCA and Ross County Public Library. With more than 200 in attendance, his event provided entertainment infused education on reducing sugar in your diet, reducing screen time and ways to get more active

Sponsorship of the Ross County Public Library’s Healthy Kids portion of the Bookworm program. AHS provides small incentives to kids as they complete certain healthy activities during the program such as reducing screen time, eating healthier and getting active. More than 2,000 children participated in the program.

AHS Community Health Advancement again collaborated with a variety of community partners to coordinate and deliver community programs aimed at promoting movement and nutrition. Programs included:

Sponsorship and participation in the Healthy Kids’ Event at the Ross County Fair with Chillicothe Gazette, Healthy Start for Kids, YMCA and Ross County Public Library. With more than 125 in attendance, his event provided entertainment infused education on reducing sugar in your diet, reducing screen time and ways to get more active

Sponsorship of the Ross County Public Library’s Healthy Kids portion of the Bookworm program. AHS provides small incentives to kids as they complete certain healthy activities during the program such as reducing screen time, eating healthier and getting active. Approximately 2,000 children participated in the program.

The Move More challenge was expanded into the community with six local employers (including the second and third largest employers in the region) promoting the challenge to their own employees. While employee participation for Adena employees was down 15% for 2015, participation overall with community involvement was increased by 22% from the previous year.

AHS hosted the region’s first Diabetes Expo at the PACCAR Medical Education Center, which included concurrent education sessions on diabetes management, nutrition, fitness to more than 130 participants.

Regional InitiativesAHS will coordinate a Community Health Advancement office to coordinate and implement regional information and awareness campaigns designed to inform the public on the obesity epidemic, its impact on individual health and effective strategies at reducing and controlling weight, specifically movement, nutrition and weight.

The Community Health Advancement office was restructured in 2014. The Director for the office immediately started with coordination of the Employee Health & Wellness Committee which completed and began execution of its plan in August. In addition, a Corporate Events Coordinator was added to support the director facilitate event set-up and delivery, as well as align health and wellness programming with community events.

The community health focus and message, “Move More, Eat Well” was finalized and implemented in 2015. Banners for approximately 15 community events (county fairs, festivals, senior health fairs, employee health fairs and health expos) were displayed throughout six counties (Fayette, Ross, Highland, Pike, Jackson, and Pickaway) as well brochures and educational information on physical activity and nutrition were distributed. Social media posts on benefits to proper nutrition and fitness were also posted on Facebook throughout the year. There were also two one hour radio programs featuring Adena physicians and representatives aired during 2015.

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Table 1: Adena Community Health Needs Assessment Implementation Strategies Actions and Progress

Health Priority 2013 Proposed Implementation Strategies 2014 Actions/Progress 2015 Actions/ProgressSecondary Health PrioritiesMental & Behavioral Health Advocacy

AHS/ARMC will support a variety of community partners including public health and social services to advocate for expanded access to mental and behavioral health services. This includes participating in Medicaid Expansion efforts to enable patient access to services.

AHS/Community Health Advancement will inform legislators and public officials on the lack of mental and behavioral health services within the region, as well as possible strategies to address the need.

AHS supported multiple community partners in 2014 to advocate for expanded access to mental and behavioral health services. Two physicians from AHS are members of the Ross County DART Force, currently executing a community plan to address the growing heroin epidemic in the region.

As one of 3 health system participants in the Strong Start Ohio project (from the Governor’s Office of Health Transformation) AHS began delivering prenatal care to pregnant women with addiction issues using a CenteringPregnancy® model at the Adena Regional Medical Center Campus.. This project provided a monthly opportunity to inform the State of Ohio about barriers to achieving positive birth outcomes, including access to longer-term addiction treatment in southern Ohio.

The AHS Director of Community Health Advancement also served on the Southeast Ohio Medicaid Expansion Committee, to participate in efforts to expand Medicaid coverage to the region’s residents. This group also informs state government on the need and benefit of affordable health care in southern Ohio.

AHS continued its support of multiple community partners in 2015 to advocate for expanded access to mental and behavioral health services. One physician, one community health representative and one social worker participated on the Ross County Heroin Partnership Advisory council and assisted with facilitating and developing a community-wide strategic plan around the Heroin epidemic.

AHS continued delivery of prenatal care to high-risk pregnant women, including those with addiction issues using a CenteringPregnancy® model at the Adena Regional Medical Center Campus. A total of 200 women were served in 2015 with those participating in the program achieving better birth outcomes overall than those opted not to participate. This project provided a monthly opportunity to inform the State of Ohio about barriers to achieving positive birth outcomes, including access to longer-term addiction treatment in southern Ohio and will be reimbursed for in 2016.

The AHS Director of Community Health Advancement continued participating in the Southeast Ohio Medicaid Expansion Committee, around efforts to expand Medicaid coverage to the region’s residents. This group also informs state government on the need and benefit of affordable health care in southern Ohio.

Referral ResourcesAHS/ARMC will continue to operate the regions only acute inpatient, psychiatric unit for insured, uninsured and under insured patients.

AHS/ARMC will collaborate with local mental and behavioral health providers to provide referrals to community mental health, behavioral health and material assistance resources.

AHS/ARMC will provide financial and human resources to help maintain the local 2-1-1 network, a phone and web-based community resource platform that provides updated and on-demand to local social service, material assistance, mental and behavioral health resources.

AHS continued to operate the region’s only acute inpatient, psychiatric unit for insured, uninsured and under insured patients in 2014 at the Adena Regional Medical Center.

AHS Women’s & Children’s, Primary Care and Pain Management service lines made referrals for patients needing mental and behavioral health services in Ross County to the Adena Counseling Center, Paint Valley Mental Health Center, Adena Women’s and Children’s CenteringPregnancy® program, the Ross County Health Department’s Vivitrol Program.

AHS provided copying and promotion resources for the Ross County and regional 2-1-1 network, including print copies of the brochure and referrals to the networks through the Health System service lines.

AHS continued to operate the region’s only acute inpatient, psychiatric unit for insured, uninsured and under insured patients in 2015 at the Adena Regional Medical Center.

AHS Women’s & Children’s, Primary Care and Pain Management service lines made referrals for patients needing mental and behavioral health services in Ross County to the Adena Counseling Center, Paint Valley Mental Health Center, Adena Women’s and Children’s CenteringPregnancy® program, the Ross County Health Department’s Vivitrol Program.

Cessation ResourcesAHS/ARMC will commit human and financial resources to expanding its opiate addiction program for pregnant women, as well as expanding access to male and non-pregnant women through an Ambulatory Detox program.

AHS served a total of 25 women addicted to opiates as part of its CenteringPregnancy® program in 2014. In addition, a work team was convened to review community need, demand and opportunities for expansion of current AHS mental and behavioral health opportunities.

AHS served a total of 114 women addicted to opiates as part of its CenteringPregnancy® program in 2015. The work team convened to review community need, demand and opportunities for expansion of current AHS mental and behavioral health opportunities also developed relationships with Maryhaven and Compass Community Health to assist with expanding drug addiction support services, including housing, in Ross County.

ScreeningAHS/ARMC will implement screening tools within its Emergency Department and primary care clinics to assist physicians in identifying patients with mental health or social service needs.

In 2014, each AHS implemented a screening policy to identify possible mental and behavioral issues with patients presenting in the emergency rooms of Adena Health System hospitals.

In 2015, AHS continued its screening policy to identify possible mental and behavioral issues with patients presenting in the emergency rooms of Adena Health System hospitals.

Smoking Cessation ResourcesAHS/ARMC will provide financial and human resources to coordinate a smoking cessation program.

Along with provider smoking cessation counseling provided to patients self-identified as smokers, AHS has convened a work team to identify additional opportunities to identify and provide intervention to current smokers.

The Adena Quit Clinic was piloted at the PACCAR/Kenworth Trucking Company in 2015. A total of 45 participants were served as part of the program that utilizes pharmacists, trained in the US Public Health Services’ 5 A’s methodology, to assist tobacco users in cessation. The program will be expanded to Adena employees in 2016.

ScreeningAHS/Adena Cancer Center offers a free lung screening program to current and former smokers and in identified high-risk groups. Testing identifies the early signs of lung cancer or other disease.

AHS Cancer Center provided 194 patients with free lung screenings in 2014, with 13 patients who were identified with early stage lung cancer.

AHS Cancer Center provided 662 patients with free lung screenings in 2015, with 16 patients who were identified with early stage lung cancer.


Figure 5: Partners for a Healthier Ross County’s Structure

Figure 4: Partners for a Healthier Ross County Participating Agencies

Partners for a Healthier Ross County

To truly improve health through solutions that address social, cultural, and biological determinants of health, Adena physicians and caregivers recognize the need to partner directly with surrounding community. Adena’s vision is to be instrumental in helping to create healthy, thriving communities. For this reason, community engagement – along with patient care and education – is a key strategy in impacting the health of the community.

Since 2015, Adena has actively participated in the Partners for a Healthier Ross County, a community health coalition consisting of 19 local agencies (Figure 4), as well as community members. This coalition worked during 2016, utilizing the Mobilizing Action Through Planning and Partnerships (MAPP) process developed by the National Association of City and County Health Officials (NACCHO) and the Centers for Disease Control (CDC), to complete Ross County’s first collaborative community health needs assessment (CHNA) and a community health improvement plan (CHIP). Adena Health System has used both the CHNA and CHIP to develop its implementation strategies for 2016-2019 to ensure alignment with broader community initiatives.

Established in 1996, the Partners for a Healthier Ross County is a collaborative, community-based group whose efforts are aimed at improving the quality of life for residents of Ross County. After almost 20 years of each participating agency conducting their own community health assessment and subsequent plans, the group is collaborating in 2016 to complete Ross County’s first collaborative assessment and strategic plan.

The coalition, organized with a memorandum of understanding (MOU), is structured with a steering committee and senior advisory council (Figure 5). Both have representation from the following agencies: Adena 5 | P a g e

Health System; Chillicothe City Schools; Chillicothe Gazette; Hope Clinic of Ross County; Hopewell Health Center; Ohio Department of Job and Family Services; Ohio State University Extension; Ohio University – Chillcothe; PACCAR; Paint Valley ADAMH Board; Recovery Council; Ross County Child Protection Center; Ross County Health District; Ross County YMCA; Scioto Paint Valley Mental Health Center; Unionoto Schools District; United Way of Ross County; Veterans Administration Hospital.

Both the 2016 Community Health Needs Assessment and Community Health Improvement Plan are available on the same website as this Implementation Strategy, as well as on the websites of the other partnering agencies.

COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) Data Summary As part of the community health needs assessment (CHNA) process, Partners for a Healthier Ross County utilized both primary and secondary data to identify priority health areas for the Ross County community. Secondary data was collected on demographics, socio-economic determinants, disease prevalence, in addition to vital statistics data. A public survey and focus groups were also conducted to collect primary data around health behaviors and environmental factors contributing to poor health. This data was then reviewed by the Partners for a Healthier Ross County’s steering team and senior advisory council. These teams then prioritized the indicators via a survey process. Figure 6 outlines the primary health issues prioritized in order by Partners for a Healthier Ross County as part of the CHNA and that were used to develop the community health improvement plan (CHIP).


COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) Strategic Planning The community health priorities identified as part of the CHNA were utilized as the primary focus for developing a collaborative community health improvement plan (CHIP) for Ross County. As part of a strategic workshop (Photo 1) held on September of 2016, Partners for a Healthier Ross County utilized the “5 Why’s” method to complete a root-cause analysis of the primary health issues identified in the CHNA, as well as develop strategic questions around each health issue.


Heart DiseaseCancer (all forms)Unintentional Injury (all forms)Pulmonary-Respiratory DiseaseStroke

Leading Causes of Death

AdditctionObesity/DiabetesLung/RespiratoryDepression/AnxietyInfant Mortality

Top Health Issues

Drug and Alcohol useMental health managementTobacco usePoor nutritionLimited primary care use

Top Health Behaviors

Economics and povertyBasic needs access (housing, food and transportation)Safey (crime and violence)Healthcare access (preventative care and education)Air quality

Top Environmental Factors

Figure 6: Partners for a Healthier Ross County’s Community Health Needs Assessment Findings

These strategic questions were then aligned to look for common themes and intersection. Two primary strategic questions emerged as part of the workshop with specific primary goal topics to support answering the questions. Using data from the health continuum inventory and service and medical provider ratios, the team narrowed the focus to improving utilization to the community’s many medical and social services (Figure 7). Primary goals were focused around establishing continuum infrastructure: access to services; committees; measurement systems; visibility for services, both for agencies and the general public; and common health language and health literacy understanding. These goals were given back to the steering committee at the end of the workshop to further develop along with objectives and metrics. The committee worked to expand and develop the goals in two additional meetings. A project plan (Figure 8) was finalized as part of this process.


Photo 1: Partners for a Healthier Ross County’s CHIP Strategic Planning Workshop

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Figure7: CHIP Goals, Objectives and Metrics

10 | A d e n a H e a l t h S y s t e m C H N A I m p l e m e n t a t i o n S t r a t e g i e sFigure8: CHIP Work Plan

Structure The CHIP will drive the work plan for the Partners for a Healthier Ross County. There will be four subcommittees that will be convened around obesity and diabetes, lung and respiratory, depression and anxiety and infant mortality. There are currently no action groups working to address these issues specifically so new groups will have to be formed. Agencies participation as part of the Partners for a Healthier Ross County will be selected as chairs of each of these committees and tasked to pull in additional community agencies and individuals to participate as part of the sub-committees.

There is currently a task force, the Ross County Heroin Partnership Advisory Council, which was established in 2015 through a grant from the Ohio Department of Justice. Therefore, a new subcommittee around the issue is not necessary. The community health improvement plan will be aligned with the work of this group and the plan already completed by their work team.

The steering committee will continue focus on building the general community health infrastructure for Ross County by focusing on inter-agency collaboration, tools and metrics designed to improve access to the health continuum for the broader community. All the work completed by the steering committee and all five of the sub-committees will be presented at quarterly meetings to the senior advisory council of the Partners for a Healthier Ross County to provide feedback on work completed, as well as provide support for barrier removal and visibility of the continuum. Figure 9 provides an outline of the overall structure.

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CHIP

2016

Subcommittee

Addiction

Subcommittee

Obesity/Diabetes

Subcommittee

Lung/Respiratory

Subcommittee

Depression/Anxiety

Subcommittee

Infant Mortality

Steering Committee

Continuum Infrastructure

Senior Advisory Council

Oversight/Guidance

Figure9: Partners for Healthier Ross County Work Plan Structure

Metrics Overarching metrics, developed from County Health Rankings data, will guide each of the committees in developing more specific metrics after infrastructure is developed. Currently, there are no common reporting mechanisms or success measurements established between different agencies that can be used to develop specific metrics for the work plan. Therefore, overarching metrics that can point to a future state will be utilized to guide the work plan until infrastructure for the continuum can be developed by the steering committee.

County health rankings from 2014 to 2016 were utilized as a guideline. Given that Ross County is currently ranked 30th out of 88 counties for clinical care and resources, Partners for a Healthier Ross County had to consider why the community was still so unhealthy overall, even though there are resources for improved health in the community. As access, utilization and agency collaboration were found to be weak within the public health continuum, Partners believes, with improvement in these areas, that overall outcomes will be able to move from 81 (2014) to 50 by 2022. In addition, health factors will move from 69 (2014) to 45 by 2022, as seen in Figure 10. Given there are many cultural and socio-economic issues that impact overall health, higher rankings would be unachievable within a six year time frame. It is the goal of Partners to see these rankings continue to improve beyond the six year time frame.

Project Charter The above information was utilized to finalize project charter (Attachment 1) which will be used as guidance for the senior advisory council, the steering committee and the subcommittees for the Partners for a Healthier Ross County’s CHIP. This project charter summarizes participants, background information, a strengths, weaknesses, opportunities and threats (SWOT) analysis, future state vision, and work plan.


Outcomes: 50

Factors: 45

2022

Outcomes: 63

Factors: 55

2019

Outcomes: 74

Factors: 64

2016

Outcomes: 81

Factors: 72

2015

Outcomes: 81

Factors: 69

2014

Figure10: CHIP Future State Metrics

ADENA COMMUNITY HEALTH IMPLEMENTATION STRATEGIESPriorities The Adena Health System utilized the Partners for a Healthier Ross County’s CHNA and CHIP to develop a 2016-2019 Implementation Strategies Plan for the Adena Regional Medical Center (ARMC). ARMC’s community health team is dedicated to ensuring the health system’s vision of being instrumental in creating healthy, thriving communities. The findings and recommendations from Partners’ assessment and improvement plan will be aligned and tracked by AHS’s Board of Trustees and approximately 3,000 employees. In addition, it will be shared with local media and more than 11,000 social media followers and AHS’s broad community partner base. This will contribute to awareness about Ross County’s health priorities and progress in implementing community health improvement strategies.

ARMC utilized the Partners for a Healthier Ross County’s CHNA to prioritize its community health programming. Several strategies, based from successes of the 2013-2016 community health programming. A total of five strategies were identified to address the health needs of the 2016 CHIP based on the capability of ARMS and participating community agencies to address the issue. In addition, Adena Health System has dedicated four individuals from various departments to participate in the steering committee and to contribute to the multiple areas of need in the health continuum. Figure 7 outlines the 2016 Ross County community health priorities and the goals Partners for a Healthier Ross County have established for the CHIP.

Adena Regional Medical Center will align its community health strategies and programming with the Partners for a Healthier Ross County’s CHNA and CHIP. Although AHS may not be able to fully address all the needs of the CHIP, AHS will contribute to the senior advisory council, steering committee and each of

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Figure11: CHIP Priorities Prioritized for Adena’s Implementation Strategies

the five subcommittees (built around the five priority health issues) as identified as part of the Partners for a Healthier Ross County. This will enable Adena Regional Medical Center to contribute to cross system collaboration, visibility, and health communication. Community health programming will focus on the five health priority areas: addiction; obesity/diabetes; lung and respiratory; depression and anxiety; and infant mortality. An analysis, based from the report data was compared to current programming (2013 – 2016) results to establish programing outlines.

Based off of current programming success, Adena Regional Medical Center will utilize five key strategies to address the five health priority areas. These include infrastructure building, advocacy, education, programming and financial support. Infrastructure development (Table 2) will consist of alignment with other, pertinent coalitions (i.e. Heroin Partnership Advisory Council and Social Services Council), as well as development of sub-committees that currently do not exist including obesity and diabetes, respiratory and lung, mental health and infant mortality. In addition, relationships with partners who may be able to provide services or parts of the continuum that are not currently in existence will also be sought. Community reporting mechanisms to measure the effectiveness of services on the continuum will also be developed.

Advocacy will also be a key strategy. Adena Regional Medical Center currently has one employee who serves on the senior advisory council for the Partners for a Healthier Ross County, three employees who serve on its steering committee and four employees who participate as part of the Ross County Heroin Partnership Advisory Council, which will be aligned with the CHIP. In addition, Adena will provide representatives to serve on each of the four new subcommittees. Adena Regional Medical Center will also utilize marketing and communications department to create public service announcement around each of the five key health issues that be delivered via local radio, newspaper and the Health System’s Facebook and Instagram pages which have more than 11,000 followers.

Education is another strategy that will be utilized by Adena Regional Medical Center. The hospital will provide education on each of the five key issues via its Walk With a Doc events held twice each month, Here for Life Education events, as well as bi-yearly health expos. Programming is also another strategy that will be utilized to address the key community health priorities. Adena’s Baby Centered Recovery will serve pregnant women with addiction issues. The Adena Family Fit program, operated in partnership with the Ross County YMCA, as well as Adena’ Move More Challenge will be utilized to address obesity and diabetes related issues. Adena’s Quit Clinic and free lung cancer screenings will be utilized to assist in addressing the lung and respiratory issues (related to smoking). All primary care physicians of Adena Health System will begin screening patients for depression and mental health issues in 2017 to help address the depression and anxiety in the community. Adena’s CenteringPregnancy® program will work to impact infant mortality through baby care education.

Adena Health System will also provide financial support to a number of programs and initiatives operated by its community partners including the MADE drug prevention and Leader in Me programs operated by public schools in Ross County. Support of Healthy Kids program operated by the local libraries as part of summer reading, as well as air quality monitoring driven by the local health department. Cribs for families in need and sleep sacks will be provided to patients leaving the hospital with a new baby to encourage safe sleep, a primary contributor to infant mortality. Adena Regional Medical Center will also support the improvement and expansion of the local 2-1-1 directory which will help navigate community members to all health and social services. Table 2 provides a summary of Adena’s programs. Tables 3 through 7 provide a breakdown of how the strategies will be utilized for each priority health issue.


Adena Strategy Addiction(Table 2)

Obesity(Table 3)

Respiratory(Table 4)

Depression(Table 5)

Infant Mortality/Child Safety

(Table 6)InfrastructureBuilding

Align PHRC with Ross County Heroin Partnership Advisory Council

Partnership with Maryhaven

Partnership with Compass

Convene PHRC Fitness and Nutrition Sub-Committee

Develop standard health continuum progress reporting

Employee Health Initiatives

Convene PHRC Respiratory and Air Quality Sub-Committee


Convene PHRC Mental Health Sub-Committee / Align with ADAMH Board


Convene PHRC Infant Mortality Sub-Committee


Advocacy Provide Adena Representative to Heroin Partnership Advisory Council

Public Service Announcements

Provide Adena Representative to Sub-Committee








Education Here For Life Education Series

Walk With a Doc

Here For Life Education Series

Walk With a Doc

Diabetes ExposHeart Health Expo


Walk With a Doc

Lung Cancer Awareness Month


Walk With a Doc


Walk With a Doc

Programming Baby Centered Recovery Family Fit

Move More

Healthy Kids Programs

Adena Quit Clinic Expansion

Free Lung Cancer Screenings

Primary Care Depression Screening

CenteringPregnancy

Financial Support MADE ProgramLeader in Me

Bookworm Air Quality Monitoring 211 Directory Cribs for KidsSleep Sacks

Table 2: Adena Health System’s Summary of Strategies for Top Health Priorities

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Table 3: Strategies, Actions, Impact, Evaluation Commitment and Collaboration to Address AddictionAddiction

Strategies Infrastructure building Advocacy Education Programming Financial support

ActionsInfrastructure BuildingAdena Health System and Adena Regional Medical Center will continue participation of hospital representatives on the Ross County Heroin Partnership Advisory Council. In addition, the hospital will facilitate partnership with Maryhaven and Compass Community Housing to provide individual outpatient therapy, medication assisted treatment and housing for recovering addicts.

AdvocacyAdena Health System and Adena Regional Medical Center will continue participation of hospital representatives on the Ross County Heroin Partnership Advisory Council. In addition, the communication and marketing department of the hospital will develop public service announcements to increase community awareness and education of drug use and services using local media and social media outlets.

EducationAdena Health System will coordinate a Here for Life education series that will provide education to approximately 50 participants during a two hour event in downtown Chillicothe. One event will focus on drug addiction, intervention and treatment options.

In addition, Adena will use its Walk With a Doc program to provide education on the topic. These events are held twice per month in Ross County and Downtown Chillicothe and have approximately 50-60 in attendance at both events. This is a one hour event where the physician leading the walk will provide a 20 education on addiction related issues.

Education will also be provided to patients who request information by physicians and providers of Adena Health System and Adena Regional Medical Center.

ProgrammingAdena Regional Medical Center will continue to deliver the Baby Centered Recovery program. This is a nine month program that provides weekly medication assisted treatment and group counseling to pregnant women with addiction issues by an Adena Social Worker. Approximately 50 women per year are served through the program.

Financial SupportAdena Health System and the Adena Regional Medical Center will provide financial support to the MADE (My Attitude Determines Everything) drug prevention program in Ross County high schools. In addition, financial support will be provided to expand the Leader in Me program in Ross County Elementary and Middle schools to aid in early drug use prevention.

Anticipated Impact It is anticipated that reduction in key health indicators, reported drug and alcohol use and overdose deaths will be seen on engaged populations in the immediate future (5 years), with the longer term (10 years) effects resulting in lower rates of death due to overdose.

Impact Evaluation AHS/ARMC will evaluate programs and initiatives to determine impact. The evaluation will be organized around the following domains: 1.) health survey data; 2.) public health

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data; 3.) aggregate patient population data; and 4.) County Health Rankings data.

Public health survey data will evaluate the initiatives and programming impact. This will include movement in risk factors such as reported drug and alcohol use. Aggregate data on patient population will be utilized to measure long term, broad based community programming and initiatives, as well County Health Rankings data.

Hospital Committed Program(s) and Resource(s)

AHS/ARMC will commit both human and financial resources directed through the Community Health Advancement office to coordinate, deliver and evaluate initiatives, and community programming.

Planned Collaboration(s) AHS/ARMC has several community partners, including 18 agencies participating in Partners for a Healthier Ross County, that have expressed interest in collaborating on regional initiatives and community programming, including Scioto Paint Valley Mental Health, ADAMH and the Recovery Council.


Table 4: Strategies, Actions, Impact, Evaluation Commitment and Collaboration to Address Obesity and DiabetesObesity and Diabetes


ActionsInfrastructure BuildingAdena Health System and Adena Regional Medical Center will participate, with Partners for a Healthier Ross County, in convening an obesity and diabetes prevention sub-committee. In addition, standard health continuum progress reporting and metrics will be developed for the group.

AHS Community Health Advancement will continue operation an internal Health & Wellness team to create an evidence-based health and wellness platform by developing and refining programs for health system employees (residents of the service region) that can later be implemented on a larger scale in the community the following year.

AdvocacyAdena Health System and Adena Regional Medical Center will provide a representative to participate on the obesity and diabetes committee of Partners for a Healthier Ross County. In addition, the communication and marketing department of the hospital will develop public service announcements to increase community awareness and education of drug use and services using local media and social media outlets.

EducationAdena Health System will coordinate a Here for Life education series that will provide education to approximately 50 participants during a two hour event in downtown Chillicothe. One event will focus on obesity related interventions include diet and exercise.

In addition, Adena will use its Walk With a Doc program to provide education on the topic. These events are held twice per month in Ross County and Downtown Chillicothe and have approximately 50-60 in attendance at both events. This is a one hour event where the physician leading the walk will provide a 20 education on fitness and nutrition.


ProgrammingAdena Health System and Adena Regional Medical Center will continue to deliver the AdenaFamily Fit program at the Ross County YMCA. This is a six week program delivered for two hours once per week to approximately 10 families or 40-50 people. Dieticians deliver education and cooking tips, while YMCA representatives lead the groups in physical activity. Fitness and proper nutrition are the focus of the program.

Adena Health System and Adena Regional Medical Center will continue to coordinate the Move More Challenge in Ross County. Approximately 1,000 people participate each year in the 12 week challenge designed to encourage at least 90 minutes of exercise per week.

Adena Health System and Adena Regional Medical Center will fund and coordinate a Diabetes Expo and a Heart Health Expo in Ross County in 2017, These four hour events have providers and clinicians speak on disease, medication and nutrition management. Community partner provide cooking and fitness demonstrations as well.

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Financial SupportAdena Health System and the Adena Regional Medical Center will provide financial support to the Ross County Bookworm/Healthy Kids Summer Challenge. Approximately 1,500 children sign up for the program each summer and are challenged to try healthy activities as part of the reading challenge. Small incentives are provided after challenges are completed.

Anticipated Impact To develop and refine evidence-based health and wellness initiatives and programming, as well as using health risk assessment tools to measure impact and success rate. By starting with its employees, AHS will have the opportunity for greater success in initiatives delivered on a broad base to community. It is anticipated that reduction in key health indicators, blood pressure, blood glucose and BMI will be seen on engaged populations in the more immediate future (5 years), with the longer term (10 years) effects resulting in lower rates of death due to heart disease.

Impact Evaluation AHS/ARMC will evaluate programs and initiatives to determine impact. The evaluation will be organized around the following domains: 1.) Health Risk Assessment data; 2.) public health data; 3.) aggregate patient population data; and 4.) County Health Rankings data.

Health risk assessment data will evaluate the initiative and programming impact of the internal Health & Wellness program on employees. This will include movement in key obesity related risk factors such as blood pressure, blood glucose, BMI and cholesterol. Aggregate data on patient population will be utilized to measure long term, broad based community programming and initiatives, as well County Health Rankings data.



Planned Collaboration(s) AHS/ARMC has several community partners, including 18 agencies participating in Partners for a Healthier Ross County, that have expressed interest in collaborating on regional initiatives and community programming, including the YMCA, other local fitness centers, and the local health department.


Table 5: Strategies, Actions, Impact, Evaluation Commitment and Collaboration to Address Respiratory and Lung IssuesRespiratory and Lung


ActionsInfrastructure BuildingAdena Health System and Adena Regional Medical Center will participate, with Partners for a Healthier Ross County, in convening lung and respiratory sub-committee. In addition, standard health continuum progress reporting and metrics will be developed for the group.

AdvocacyAdena Health System and Adena Regional Medical Center will provide a representative to participate on the lung and respiratory committee of Partners for a Healthier Ross County. In addition, the communication and marketing department of the hospital will develop public service announcements to increase community awareness and education on the dangers of smoking and lung cancer screening events using local media and social media outlets.

EducationAdena Health System will coordinate a Here for Life education series that will provide education to approximately 50 participants during a two hour event in downtown Chillicothe. One event will focus on respiratory related interventions including smoking cessation.

In addition, Adena will use its Walk With a Doc program to provide education on the topic. These events are held twice per month in Ross County and Downtown Chillicothe and have approximately 50-60 in attendance at both events. This is a one hour event where the physician leading the walk will provide a 20 education on smoking cessation and the dangers of smoking.

Education and smoking cessation will also be provided to patients who request information by physicians, providers and pharmacists of Adena Health System and Adena Regional Medical Center.

ProgrammingAdena Health System and Adena Regional Medical Center will continue to deliver the Adena Quit Clinic located on the campus of the Adena Regional Medical Center. This is a three month program delivered in 15 minute appointments with a pharmacist every two weeks to approximately 40-50 people per year.

Adena Health System and Adena Regional Medical Center will also continue to coordinate free lung cancer screenings (CT scan) for more than700 patients each year at the Adena Cancer Center located on the campus of the Adena Regional Medical Center.

Financial SupportAdena Health System and the Adena Regional Medical Center will provide financial support to the respiratory sub-committee and local health department to install ambient air quality monitoring equipment in Ross County.

Anticipated Impact It is anticipated that reduction in key health indicators, reported tobacco use and lung cancer occurrence will be seen on engaged populations in the immediate future (5 years), with the longer term (10 years) effects resulting in lower rates of death due to lung cancer.

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Impact Evaluation AHS/ARMC will evaluate programs and initiatives to determine impact. The evaluation will be organized around the following domains: 1.) health survey data; 2.) public health data; 3.) aggregate patient population data; and 4.) County Health Rankings data.Public health survey data will evaluate the initiatives and programming impact. This will include movement in risk factors such as reported tobacco use, lung cancer occurrence and death. Aggregate data on patient population will be utilized to measure long term, broad based community programming and initiatives, as well County Health Rankings data.



Planned Collaboration(s) AHS/ARMC has several community partners, including 18 agencies participating in Partners for a Healthier Ross County, that have expressed interest in collaborating on regional initiatives and community programming, including the Ross County Health District and the Ohio EPA.


Table 6: Strategies, Actions, Impact, Evaluation Commitment and Collaboration to Address Depression and AnxietyDepression and Anxiety


ActionsInfrastructure BuildingAdena Health System and Adena Regional Medical Center will participate, with Partners for a Healthier Ross County, in convening a mental health sub-committee. In addition, standard health continuum progress reporting and metrics will be developed for the group.

AdvocacyAdena Health System and Adena Regional Medical Center will provide a representative to participate on the mental health committee of Partners for a Healthier Ross County. In addition, the communication and marketing department of the hospital will develop public service announcements to increase community awareness and education on mental health issues using local media and social media outlets.

EducationAdena Health System will coordinate a Here for Life education series that will provide education to approximately 50 participants during a two hour event in downtown Chillicothe. One event will focus on depression related interventions including smoking cessation.

In addition, Adena will use its Walk With a Doc program to provide education on the topic. These events are held twice per month in Ross County and Downtown Chillicothe and have approximately 50-60 in attendance at both events. This is a one hour event where the physician leading the walk will provide a 20 minute education on depression and recognizing symptoms.


ProgrammingAdena Health System and Adena Regional Medical Center will screen primary care patients starting in 2017. Adena provides more than 170,000 primary care visits per year. Referral to counseling and other community resources will be provided as needed.

Financial SupportAdena Health System and the Adena Regional Medical Center will provide financial support to the mental health subcommittee, as well as Scioto Paint Valley Mental Health to support operation and improvement of the 2-1-1 directory housed by their organization. This phone directory provides navigation to many healthcare and social services, including mental health resources.

Anticipated Impact It is anticipated that reduction in key health indicators, poor mental health days and quality of life ratings will be seen on engaged populations in the immediate future (5 years), with the longer term (10 years) effects resulting in lower suicide rates and overdose deaths.

Impact Evaluation AHS/ARMC will evaluate programs and initiatives to determine impact. The evaluation will be organized around the following domains: 1.) health survey data; 2.) public health data; 3.) aggregate patient population data; and 4.) County Health Rankings data.

Public health survey data will evaluate the initiatives and programming impact. This will

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include movement in risk factors such as reported poor mental health days and low quality of life ratings. Aggregate data on patient population will be utilized to measure long term, broad based community programming and initiatives, as well County Health Rankings data.



Planned Collaboration(s) AHS/ARMC has several community partners, including 18 agencies participating in Partners for a Healthier Ross County, that have expressed interest in collaborating on regional initiatives and community programming, including the Scioto Paint Valley Mental Health Center, ADAMH, Recovery Council and Integrated Services.


Table 7: Strategies, Actions, Impact, Evaluation Commitment and Collaboration to Address Infant MortalityInfant Mortality


ActionsInfrastructure BuildingAdena Health System and Adena Regional Medical Center will participate, with Partners for a Healthier Ross County, in convening an infant mortality sub-committee. In addition, standard health continuum progress reporting and metrics will be developed for the group.

AdvocacyAdena Health System and Adena Regional Medical Center will provide a representative to participate on the infant mortality subcommittee of Partners for a Healthier Ross County. In addition, the communication and marketing department of the hospital will develop public service announcements to increase community awareness and education on the mental health issues using local media and social media outlets.

EducationAdena Health System will coordinate a Here for Life education series that will provide education to approximately 50 participants during a two hour event in downtown Chillicothe. One event will focus on infant mortality risk factors, proper baby care and parenting.

In addition, Adena will use its Walk With a Doc program to provide education on the topic. These events are held twice per month in Ross County and Downtown Chillicothe and have approximately 50-60 in attendance at both events. This is a one hour event where the physician leading the walk will provide a 20 minute education on safe sleep and baby care.

Education will also be provided to patients by physicians and providers of Adena Health System and Adena Regional Medical Center at the time of delivery and at each well child visit during the first year of life.

ProgrammingAdena Health System and Adena Regional Medical Center will continue delivery of its CenteringPregnancy® program for expectant mothers. This nine month program consists of monthly, group medical visits, education and resource referral delivered in a one-and-a-half hour visit. The groups are facilitated by an OBGYN and RN.

Financial SupportAdena Health System and the Adena Regional Medical Center will continue to provide financial support for cribs and car seats for families in need, as well as sleep sacks for each of the approximately 1,100 new babies born at the Adena Regional Medical Center each year. The sleep sacks assist with safe sleep.

Anticipated Impact It is anticipated that reduction in key health indicators, reported safe sleep behavior adherence, will be seen on engaged populations in the immediate future (5 years), with the longer term (10 years) effects resulting in lower infant mortality rates in Ross County.

Impact Evaluation AHS/ARMC will evaluate programs and initiatives to determine impact. The evaluation will be organized around the following domains: 1.) health survey data; 2.) public health data; 3.) aggregate patient population data; and 4.) County Health Rankings data.

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Public health survey data will evaluate the initiatives and programming impact. This will include movement in risk factors such as reported safe sleep adherence. Aggregate data on patient population will be utilized to measure long term, broad based community programming and initiatives, as well County Health Rankings data.



Planned Collaboration(s) AHS/ARMC has several community partners, including 18 agencies participating in Partners for a Healthier Ross County, that have expressed interest in collaborating on regional initiatives and community programming, including the Ross County Health District, Children and Family First Council and Ohio Department of Job and Family Services.

ADDITIONAL INITIATIVES AND RESOURCES

While Adena Health System/Adena Regional Medical Center has targeted programs towards many of the significant priority health needs identified in the 2016 CHNA, there are also other initiatives and resources that address these – and other – health concerns in the community.

Adena Family Medicine - Residency ClinicThe Adena Family Medicine - Residency Clinic is a hospital clinic providing affordable, quality health care. The Clinic pairs accessible primary care medical services provided by physician interns and residents of Adena’s Graduate Medical Education program, family and internal medicine preceptors and a certified nurse practitioner also providing services to patients in the clinic.

For more information, go to: http://www.adena.org/locations/department.dT/residency-clinic

The Clinic at Walmart – Chillicothe and Washington Court HouseIn 2012, AHS entered into agreements to enhance access to high quality, affordable health care services in Chillicothe and Washington Court House at local Walmart stores in these respective locations. In each community, Adena opened and maintained a walk-in, retail clinic with extended evening and weekend hours. The clinic and its team specialize in quick, walk-in appointments for cold, flu, sinus infections, immunizations, sports and school physicals.

Adena Sports Medicine – Athletic Training ProgramThe Adena Health System provides 10 local public high schools within the service region with free athletic injury prevention, diagnosis, and evaluation services at an annual cost of more than $400,000 to Adena health System. A total of 8 athletic trainers work within the school’s athletic departments and focus on educating students, parents and coaches on sports medicine topics, including concussion identification and treatment. The staff is also readily available at athletic events and provides yearly sports physicals.


http://www.adena.org/locations/department.dT/residency-clinic

Hope Clinic of Ross CountyThe Adena Health System provides both financial and volunteer resources to the Hope Clinic of Ross County. Hope clinic provides free medical, dental and vision care to uninsured individuals one evening per week at its location in Chillicothe. More than a dozen Adena nurses and physicians volunteer their time at the clinic.

Community Health Programs AHS/ARMC offers community health programs and events in various locations throughout the year to help our community lead healthier lives through wellness education and the prevention of illness and injury. Topics include, but are not limited to the following: cancer; diabetes; heart disease; bone and joint care; childbirth; multiple sclerosis; stroke; and wellness. Following these health seminars, an evaluation form is distributed to request feedback about both the content of the program as well as the speaker. It also asks for other topics of interest and general feedback.

Adena Health System and Adena Regional Medical Center also provide free and reduced cost breast health screenings and diagnostics for qualifying patients as a grant recipient of Komen Columbus. More than 75 women are provided services through this program each year.

Adena also is a facilitator of the Safe Communities programming as part of a grant from the Ohio Department of Safety. Education and outreach on use of seatbelts and the dangers of impaired and distracted driving are delivered at local public high schools, community fairs, festivals and events. A year long social media campaign is also coordinated as part of this program.

Community Events AHS/ARMC also participates in general health fairs/community events, employer health fairs and senior health fairs, often organized by other community organizations. At the general health fairs/community events, Adena provides bone density screenings, “Ask the Doctor”, diabetes information, pediatricians - general information, and geriatricians - general information. There is no invasive testing – e.g., blood sugar, cholesterol, HIV testing, etc. – at any of these events.

APPROVAL OF CHNA AND IMPLEMENTATION STRATEGIESThe Board of Trustees of the Adena Health System and the Adena Regional Medical Center, at its regular meeting on November 7, 2016, approved the adoption of the Community Health Needs Assessment completed in collaboration with the Partners for a Healthier Ross County. In addition, the implementation strategies outlined by Adena’s Director of Community Health Advancement were also approved for Adena Health System and Adena Regional Medical Center.


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Documents

Ross County Community Health Needs Assessment … · Web viewAuthor sjones2 Created Date 10/28/2016 09:05:00 Title Ross County Community Health Needs Assessment – 2013 Adena Regional