Avista Adventist Hospital

Transcription

2012 Community Health Needs Assessment
Avista Adventist Hospital- Community Health Needs Assessment 2012
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TABLE OF CONTENTS
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INTRODUCTION..............................................................................................................................................3
1a
Brief description of hospital, history and services provided ....................................................................3
1b
Mission statement, vision and values.......................................................................................................4
1c
Organizational commitment to community benefit .................................................................................5
1d
Commitment statement to the uninsured and underinsured ..................................................................6
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COMMUNITY HEALTH NEEDS ASSESSMENT ..................................................................................................8
2a
Community ...............................................................................................................................................8
2a i
Definition of community served by the hospital .............................................................................8
2a ii
Demographics of the community ....................................................................................................9
2a iii
Uninsured persons, low-income persons, and minority groups ....................................................10
2b
2c
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Data collection ........................................................................................................................................12
2b i
Process used to gather data ..........................................................................................................12
2b ii
Information gaps ............................................................................................................................15
Health needs of the community .............................................................................................................15
2c i
Process to identify and prioritize needs ........................................................................................15
2c ii
Prioritized list and description of community health needs ..........................................................16
2c iii
Healthcare resources available in the community to meet the needs ..........................................16
CONTACT INFORMATION.............................................................................................................................18
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INTRODUCTION
1A
BRIEF DESCRIPTION OF HOSPITAL, HISTORY AND SERVICES PROVIDED
More than 100 years ago the Seventh-day Adventist church established a sanitarium in Boulder Colorado,
dedicated to providing healthcare for the surrounding community. However, as time passed the hospital
realized the original facility and location had limitations that would inhibit its ability to grow.
In 1990, a new hospital was opened in Louisville, where
the beautiful facility now called Avista Adventist Hospital
sits upon a hill with magnificent views of the Rockies.
The community response has been overwhelming, and
because of the remarkable growth Avista has
experienced, the hospital has expanded to nearly double
its original size. This expansion has increased capacity,
reduced waiting times for several critical services, and
allowed for the addition of important, new capabilities
and technologies.
Today, Avista Adventist Hospital is a full service, 114-bed acute-care hospital with a medical staff of more than
600 physicians. In addition to providing first-rate critical care services (emergency, trauma and intensive care),
Avista is the home to the area's leading birthing services and largest Neonatal Intensive Care Unit. Known for
devotion to whole person care and tireless attention to creating a safe, compassionate and healing
environment, Avista and its 642 associates have been recognized for excellence by an impressive list of
independent organizations that assess quality and patient satisfaction.
Avista is connected to Centura Health, Colorado's health care leader, and its integrated statewide network of
13 hospitals, seven senior living communities, medical clinics, affiliated partner hospitals, Flight for Life®
Colorado, and home care and hospice services. Avista's and Centura Health's strength lies in their ability to
deliver world-class care to people where and when they need it most. Together, they provide care that
transcends the walls of a hospital and connections to top expertise and technology that only Avista Adventist
Hospital and Centura Health can make.
Avista’s Distinctive Services
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Avista recognized for excellence—recipient of award for continuous performance improvement
from Colorado Performance Excellence (CPEx)—consistent high scores in consumer satisfaction, as
measured by national survey of patient experiences (HCAHPS)
Avista named "Top Performer"—recognized for high performance on key quality measures by The
Joint Commission, the leading accreditor of U. S. health care organizations
Award-winning Intensive Care Unit—recipient of Beacon Award for Critical Care Excellence—
recognized as leader in excellent patient outcomes, healthy work environment and high professional
goals
Award-winning New Life Center—recognized by HealthStream Research for being in the top tier of
hospitals for patient satisfaction—features 28 labor, delivery and postpartum suites, a Level IIIB
nursery and a private spa room for new mothers
Award-winning Total Joint and Spine Care Center—recipient of award by HealthStream research in
recognition of outstanding patient satisfaction—led by surgeons trained at some of the nation's top
teaching institutions
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Pain management program offers the latest treatments for painful conditions often with fewer side
effects, less risk of complications and less reliance on medication
Emergency Department features private rooms, a special area for children, and dedicated diagnostic
equipment for fast test results
Surgical services with state-of-the-art operating suites
Critical care services
Patient & Community Resources
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Ask-A-Nurse®—free health information and help finding a doctor at 303-777-6877
A network of physicians who access the same electronic medical records so they have the latest
information on each patient, regardless of whether he/she enters the hospital, Emergency
Department, or a physician's office
Community education classes for childbirth prep, exercise, joint pain, spine care and more
Free online symptom checker at avistahospital.org
For more information about Avista Adventist Hospital, visit www.avistahospital.org.
1B
MISSION STATEMENT, VISION AND VALUES
Our Mission: We extend the healing ministry of Christ by caring for those who are ill and by nurturing the
health of the people in our communities.
Our Vision: To fulfill a covenant of caring for our communities to become their partner for life.
Our Core Values:
Compassion- In serving our customers, their families and each other, we will:
o Honor the individuality of each person;
o Treat each person with dignity, taking the time to be present, to listen, to explain and to
understand;
o Create a caring environment that exudes humanity, humility, grace and love.
Respect- In working with each other, we will:
o Encourage and value the contributions of each person, and make each feel supported, reassured
and empowered;
o Listen well, communicate openly and honestly, and encourage others to do the same;
o Treat others as we would like to be treated ourselves, relating so well with them that they actively
seek to associate with us.
Integrity- In all of our interactions, we will:
o Foster trust by being truthful, empathetic and consistent;
o Be authentic and courageous, aligning what we are thinking, saying, feeling, and doing;
o Be responsible for and follow through on the commitments we make.
Spirituality- In honoring the missions, ministries, and heritages of our Catholic and our Adventist sponsors, we
will:
o Add meaning and purpose to the lives of our associates, physicians, and partners;
o Celebrate the role of spirituality in healing for each individual;
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Serve each other and our communities in harmony with the inclusiveness, wholeness and touch
that characterized Christ's healing ministry.
Stewardship- In managing the natural, human, and financial resources to which we have been entrusted, we
will:
o Seek ways to appropriately utilize resources, allowing us to
become more effective and productive;
o Act responsibly, taking only those actions that align with our
mission;
o Be accountable to the organization and to each other for our
actions and the outcomes they produce.
Imagination- In seeking to grow our ministry, we will:
o Look beyond the challenges of the present and envision what is
possible;
o Cultivate and reward innovation and risk taking;
o Embrace continuous learning and positive technological
advancement.
Excellence- In all we do, we will:
o Put forth our personal and professional best, providing the
highest quality of care of which we are capable;
o Commit ourselves to continuous improvement, seeking to set the recognized performance
standards within our industry;
o Deliver a superior experience for all of our customers, sensing their needs and exceeding their
expectations.
1C
ORGANIZATIONAL COMMITMENT TO COMMUNITY BENEFIT
Colorado’s needs are growing. To live our mission in an economy that challenges more people than ever
before, Centura Health continues to lead the way in helping Coloradans access quality health care. The
connected network of facilities, entities and foundations that form the Centura Health family are serving
community needs through education, preventive care, safety initiatives, health advocacy, counseling and
support groups.
Our work in our communities is born out of the second part of our mission, which compels us to serve others
“…by nurturing the health of our communities.” From access for the uninsured, to serving as a voice for health
care in the state legislature, to community classes and education to build strong, healthy communities,
Centura Health is a partner for life. We are more committed than ever before to making our world a better
place, and we seek to make the most impact in every community we touch.
Avista Adventist Hospital is fulfilling its commitment to community benefit by expending significant amounts
of money in the following specific ways:
• Charity Care
• Unreimbursed Medicaid
• Unreimbursed Medicare
• Community Benefit
Avista Adventist Hospital provided $11.7 million in total community benefit in fiscal year 2012.
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Avista Adventist Hospital has been a leader for several years in bringing community stakeholders together to
identify community health improvement opportunities and work collaboratively to find solutions. Avista,
through its CEO, was a founding member of the Boulder County Civic Forum which is the research arm of The
Community Foundation. The Boulder County Civic Forum was founded in 1995 and is an organization that is
supported by businesses, government, foundations, and individuals. The mission is to “Promote healthy
decision making that will sustain the environmental quality, economic vitality and livability of the Boulder
County region through information, research, education and dialogue.” More than 400 community members
came together to identify four visions for a healthy community including; a vision for the people, for the
environment, for the economy, and for culture and society. The 50 indicators selected to measure these
visions are still used today more than 15 years later. Avista’s annual sponsorship, in partnership with other
Boulder County hospitals, has allowed for the biennial publication of Boulder County TRENDS
(www.commfound.org/trendsmagazine). The publication reports on the tracking of community indicators and
offers a longitudinal gauge of what the community is doing well, where improvement is possible, and how to
get involved.
Avista has also been a key contributor to the Boulder County Health Improvement Collaborative (BCHIC) since
the organization’s inception in 2009. The mission of BCHIC is to “improve the quality, safety, efficiency and
accessibility of health care and public health services for all patients in our community through collaboration
and the timely, secure exchange of clinical data.” Projects include: health information exchange
implementation in Boulder County, development of a community data sharing contract, and care
collaboration across providers for Boulder County’s neediest patients. Avista staff members have contributed
significant time and expertise, and the hospital has been a financial contributor.
1D
COMMITMENT STATEMENT TO THE UNINSURED AND UNDERINSURED
According to Centura.org, more than 700,000 Coloradans are without health insurance and, as a result,
growing numbers are facing difficulties paying for medical care. Centura Health believes that hospitals should
have the ability to offer discounts to those who are unable to obtain insurance and do not meet charity care
criteria. It is the policy of Centura Health to provide uninsured patients with discounted rates for all hospital
bills. The discount is applied to all hospital inpatient, outpatient and Emergency Room bills that have been
screened and do not have third-party insurance, Medicare, Medicaid, Champus, or other governmental payer
programs and do not meet the Centura charity guidelines. Centura Health strives to compassionately serve
uninsured patients with an understanding of the financial burdens they may face. Centura supports and
advocates for meaningful and appropriate changes in legislation that improve access to affordable, quality
medical care for the uninsured.
Centura Health will treat uninsured patients in the following manner:
Uninsured patients will be treated fairly and with respect during and after treatment, regardless of their
ability to pay.
Uninsured patients will be provided with financial counseling, including assistance applying for local, state
and federal health care programs such as Medicare, Medicaid and the Colorado Indigent Care Program.
Uninsured patients will be informed of and assisted in applying for charity care available through Centura
Health as appropriate.
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Centura Health utilizes a charity discount schedule that takes into account state or federal poverty
guidelines to aid in the qualification of patients seeking assistance in meeting their financial obligations.
Financial counselors will attempt to meet with all uninsured patients prior to discharge from the hospital.
Financial counselors will use best efforts to personally contact uninsured patients before any collection
activities are initiated.
Uninsured patients that do not qualify for assistance will receive a 30 percent discount off billed charges.
This will automatically be adjusted during the billing process, so that all statements and collection efforts
will be based on the discounted amount.
Centura will also offer an additional 15 percent Prompt Pay Discount for accounts paid in full within 60
days of receiving the first statement of patient liability.
If at any point an alternative payment source is identified, all discounts stated in this policy will be
reversed.
A call center is available so that patients may speak to an individual who can help them with questions on
their bills; the call center phone number is prominently displayed on all billing correspondence.
Hospital-based physicians and related entities will be encouraged to follow the Centura Health Principles
Regarding Uninsured Patients but this is done at their discretion.
Centura Health will not engage in the following activities:
Centura Health will not pursue legal action for nonpayment of hospital bills against any patient who has
worked with Centura to demonstrate his or her inability to pay and who is unemployed or otherwise
financially unable to pay.
Centura Health will not pursue legal action for nonpayment if the only way to collect payment would be
to place a lien on the patient's home.
Centura Health always has distinguished itself from other hospitals and systems in its treatment of the
uninsured:
Centura Health hospitals will continue to treat patients in their emergency rooms without regard to the
patient's ability to pay. All patients will continue to be triaged and treated as appropriate.
Centura Health has provided numerous outreach programs to the community in its pursuit of healthy
communities and constantly seeks opportunities to advance its health care ministry.
It is not the practice of Centura Health to place a lien on a patient's home when it is the patient's only
asset.
Centura Health will continue to work for increased access and coverage for the uninsured through
legislative and community activity.
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It is the practice of Centura Health not to pursue legal action for nonpayment unless it has first examined
the patient's eligibility for other assistance or charity care.
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COMMUNITY HEALTH NEEDS ASSESSMENT
2A
COMMUNITY
2A I
DEFINITION OF COMMUNITY SERVED BY THE HOSPITAL
To ensure alignment with publicly available Colorado Department of Public Health and Environment (CDPHE)
data, Centura Health leaders decided that Colorado counties would comprise the geographic area for the
2012 Community Health Needs Assessment (CHNA). Individual Centura hospital facilities then examined their
primary market areas and identified Colorado counties where at least 10% of their patient population resided.
The counties identified by each facility comprise the “Primary Service Area” used in the data reports. The
Primary Service Area for Avista Adventist Hospital includes Boulder, Broomfield, and Adams Counties.
Avista Adventist Hospital Service Area Map
The map above shows Avista’s primary service area, which includes zip codes that the hospital reaches out to
in order to communicate the services and programs available to the community. The hospital serves the
counties of Boulder, Broomfield, and Adams and the zip codes include the following: 80020, 80021, 80023,
80026, 80027, 80030, 80031, 80221, 80229, 80233, 80234, 80241, 80260, 80301, 80302, 80303, 80304,
80305, 80306, 80307, 80308, 80309, 80516, 80602. While this data is representative of the entire Avista
service area, Avista will target a more narrowly focused demographic area for this Community Health Needs
Assessment; concentrating on the areas of Boulder and Broomfield Counties which demonstrate the greatest
healthcare needs.
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2A II
DEMOGRAPHICS OF THE COMMUNITY
The population of Boulder County is 294,567 and consists of 117,222 households. The median age is 35 and
the county is home to the University of Colorado. The racial/ethnic makeup is as follows: 87% White
(including Latino), 4% Asian, 1% African American, .4% Native American, 3% two or more races, 5% some
other race. 17% of the population speaks a language other than English at home. 94% of the population are
high school graduates, 58% have earned a bachelor’s degree or higher, and 26% have a graduate degree. The
median family income as of 2008 was $85,602 while 14% of individuals, 8% of families, and 13% of children
were living below the poverty level.
The population of Broomfield County is 55,880 and consists of 22,646 households. The county is experiencing
vast growth in family population and much of the demographics represent these growing families. The
racial/ethnic is as follows: 89% White (including Latino), 6.1% Asian, 1.5% African American, .9% Native
American, and 2.4% two or more races. 12.2% of the population speaks a language other than English at
home. 95.4% of the population are high school graduates and 41.9% have earned a bachelor’s degree or
higher. The median family income as of 2010 was $75,590, while 5.5% of Broomfield County lives below the
poverty level.
Population by age, HSR 16 and Colorado, 2010 and 2020
2010
HSR 16
Age 0-18 years
Age 19-64 years
Age 65 years and older
All ages
Colorado
Age 0-18 years
Age 19-64 years
Age 65 years and older
All ages
2020
Percent change
Average annual
growth rate
85,772
244,083
31,341
361,196
102,433
250,636
63,429
416,498
19.4%
2.7%
102.4%
15.3%
1.8%
0.3%
7.3%
1.4%
1,334,223
3,284,580
541,386
5,160,189
1,587,802
3,656,925
927,003
6,171,730
19.0%
11.3%
71.2%
19.6%
1.8%
1.1%
5.5%
1.8%
HSR 16 includes: Boulder and Broomfield Counties
SOURCE: Colorado Health Institute using data from the Colorado Demography Office
Unemployment rates, HSR 16 and Colorado, 2009-10
Oct-Dec
2009
HSR 16
Colorado
5.9%
7.1%
Jan-Mar
2010
April-June 2010
7.7%
9.5%
7.1%
8.8%
July-Sept
2010
7.1%
8.6%
Oct - Dec 2010
7.0%
8.8%
Median household income and percent of population at or below 100% and 200% of the federal poverty
level (FPL), HSR 16 and Colorado, 2008-09
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Median
household
income
HSR 16
Colorado
% of population at or
below 100% of FPL, all
ages
$47,285
$38,399
below 200% of FPL,
ages 0-18
17.4%
18.6%
39.4%
45.8%
below 200% of FPL,
ages 19-64
37.7%
37.0%
Health insurance status, HSR 16 and Colorado, 2008-09
SOURCE: 2008-09 Colorado Household Survey, HCPF, analyzed by the Colorado Health Institute.
2A III
UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS
92.7% of White, non-Hispanic/Latino adults in the service area indicated that they had some sort of health
care coverage compared to 61.8% of White, Hispanic/Latino adults, and 94.8% of Asian American/Pacific
Islander adults. 5.8% of White, non-Hispanic/Latino adults reported that their general health was fair or poor
compared to 20.8% of White, Hispanic/Latino adults and 4.4% of Asian American/Pacific Islander. The ageadjusted incidence rate of all cancers per 100,000 population was 451.3 for White, non-Hispanic/Latinos;
350.8 for White Hispanic/Latinos; 285.9 for Black/African Americans; and 254.7 for Asian American/Pacific
Islanders. The age-adjusted incidence rate of mortality due to heart disease per 100,000 population was
155.7 for White, non-Hispanic/Latino; 128.7 for White, Hispanic/Latino; 117.9 for Black/African American;
70.0 for Asian American/Pacific Islander; and 187.1 for American Indian/Native Alaskan. The age-adjusted
incidence rate of mortality due to cancer per 100,000 population was 153.4 for White, non-Hispanic/Latino;
114.1 for White, Hispanic/Latino; 48.7 for Black/African American; 85.6 for Asian American/Pacific Islander;
and 124.0 for American Indian/Native Alaskan. In the late summer of 2012 Avista hopes to have additional
information from the Boulder County Public Health dashboard, which will include disparities data on Boulder
County level indicators.
Health Disparities Profile for Region 16
Region 16 includes: Boulder and Broomfield Counties
Population Characteristics
Region16
Colorado
measure
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Total Population:
343,953
4,861,515
White, non-Hispanic/Latino
278,830
3,508,736
White, Hispanic/Latino
42,122
909,833
Black/African American
4,930
228,718
Asian American/Pacific Islander
15,196
150,112
American Indian/Native Alaskan
2,875
64,116
Source: CDC/NCHS 2007-based, bridged-race population estimates, 2007.
Adult Health
Region16
Colorado
measure
Health Care Coverage
% of adults who reported they had any kind of health care coverage
92.7
89.2
61.8
57.3
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82.5
94.8
84.4
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68.1
General Health Status
% of adults who reported that their general health was 'fair' or 'poor'
5.8
9.3
20.8
24.3
*
15.0
4.4
7.7
*
24.6
Source: Behavioral Risk Factor Surveillance System (BRFSS) Survey, Health Statistics Section, CDPHE, 2003-2007.
* Indicates fewer than 50 respondents in subgroup.
Mortality
Region16
Colorado
measure
Heart Disease
Age-adjusted incidence rate of mortality due to heart disease per 100,000 in population
155.7
160.7
128.7
141.0
117.9
179.7
70.0
70.4
187.1
103.2
Malignant Neoplasms
Age-adjusted incidence rate of mortality due to cancer per 100,000 in population
153.4
160.4
114.1
145.7
48.7
185.5
85.6
113.7
124.0
91.8
Source: Vital Statistics Unit, Health Statistics Section, CDPHE, 2005-2007.
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*Indicates fewer than three events in category.
2B
DATA COLLECTION
2B I
PROCESS USED TO GATHER DATA
The Center for Health Administration at the University of Colorado Denver was retained to conduct the data
collection for the Centura Health system and its respective hospital facilities.
Additionally, Avista gathered data from Boulder County Public Health Department’s (BCPH) 2011 Public
Health Improvement Process (PHIP).
PUBLIC HEALTH DATA
Data for the Community Health Needs Assessment (CHNA) was predominantly collected from the Colorado
Department of Public Health and Environment (CDPHE). The CDPHE’s Colorado Behavioral Risk Factor
Surveillance System Survey (2003-2010) was used to determine information about adult behaviors that
impact health, such as substance abuse, eating and exercise habits, and smoking. The national Youth Risk
Behavior Survey (2003-2010) was queried to determine behaviors that impact the health of students from 9th
through 12th grades. The CDPHE’s database was also probed for information on mortality rates for a variety
of health indicators.
The BCPH’s PHIP included conducting an assessment of community health status and the capacity of the
broader public health system to address health needs. They prepared a county public health plan on the basis
of their assessments, including setting priorities for providing services. BCPH contracted with Primetime
Research and Evaluation to lead a formal prioritization and capacity assessment based on the National Public
Health Performance Standards Program (NPHPSP) process. From March through June 2011, Primetime
Research and Evaluation developed methods to prioritize BCPH activities and measure its capacity to provide
public health services according to Ten Essential Services developed by the NPHPSP. The outcomes of the
process identified Obesity, Mental Health, and Substance Abuse as the three prioritized health needs.
Response strategies for obesity include measuring BMI, increasing access to healthy foods, monitoring
prevalence rates of vigorous activity, and track commuting patterns. Mental health issues will be addressed
by monitoring suicide rates and attempted suicide rates, evaluating early childhood social and emotional
development, and prevention efforts around post-partum depression. The efforts to prevent substance
abuse include metrics such as binge drinking, age when alcohol is introduced, parental monitoring initiatives,
marijuana use, and prescription drug use. Avista is committed to its relationship with BCPH and other
community partners and will explore new methods to support and advance their efforts.
COMMUNITY LEADER INTERVIEWS
Rather than repeat a duplicative community engagement with the same stakeholders, Avista chose to utilize
the community feedback obtained through BCPH’s PHIP. Primetime Research and Evaluation conducted
interviews with the BCPH PHIP Core Team, as well as selected BCPH employees and a variety of community
stakeholders. The interviews consisted of a review of a list of 30+ health outcomes and were followed by a
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discussion of what the interviewee felt were the most important health outcomes to prioritize over the next
five years.
Primetime Research and Evaluation also completed the formal health system capacity assessment in Boulder
County, which was conducted through a series of ten 3‐hour meetings held during the month of May 2011.
Each meeting focused on one of the Ten Essential Public Health Services. These meetings were conducted
through facilitated focus groups consisting of 6‐10 invited participants. These participants’ tasks were 1) to
review the evaluation measures developed by the NPHPSP for that session’s essential service, 2) participate in
the group discussion about the health system’s capacity and performance of that public health function, 3)
come to a consensus on a rating score of the current capacity, and 4) to express concerns and provide
recommendations for improvement. Participants selected for each meeting were chosen based on area of
expertise or interest and relationship to the essential service to be discussed. Invitations were sent to a broad
range of key partners from the local public health agency, state service agencies, community based
organizations, academic institutions, hospitals, school systems, foundations, law enforcement agencies, and
non‐profit organizations. Additionally, invitations were sent to people in local governmental or
quasi‐governmental entities including first responders, elected officials, social service providers,
administrators, diversity advocates, and others. Invitations were also extended to individuals in the business
community, media, and judicial institutions. Approximately 70 key participants (6‐10 per meeting) responded
to the request to participate in the assessment sessions.
Organizations that were represented included:
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20 Judicial District
Board of County Commissioners
Boulder Community Hospital
Boulder County Aging Services
Boulder County Attorney
Boulder County Community Services
Boulder County Emergency Operations Center
Boulder County Healthy Kids
Boulder County Housing and Human Services
Boulder County Judicial System
Boulder County Kid Connects
Boulder County Land Use
Boulder County Medical Society
Boulder County Public Health
Boulder County Sheriff
Boulder Valley School District
Boulder Valley Women’s Health Center
Carriage House
City of Boulder
City of Longmont
Civic Forum
Clinica Family Health Services
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Colorado Department of Public Health and Environment
Colorado School of Public Health
Colorado Statewide Parent Coalition
Community Action Program
Community Foundation
Early Childhood Council of Boulder County
Emergency Family Assistance Association
Environmental Defense
Environmental Protection Agency
Exempla
Foothills United Way
Head Start
Healthy Youth Alliance
Imagine!
Kaiser Permanente
LiveWell Longmont
Longmont Police Longmont United Hospital
Mental Health Partners
OUR Center
Parenting Place
Regis University
Saint Benedict
Salud Community Health Center
St. Vrain Valley School District
United Church of Christ
University of Colorado
University of Northern Colorado
Whole Foods
Those involved in Avista Adventist Hospital’s community health needs assessment also include:
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Boulder County Public Health (BCPH)- Represented by Heath Harmon, Director of Health Programs**
Works to protect, promote, and enhance the health and well-being of all people and the
environment in Boulder County. Under the direction of the Boulder County Board of Health,
the department’s 200+ staff and numerous volunteers/interns provide services in several
BCPH divisions housed within six sites to address the diverse public health needs of our
community
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The Boulder County Civic Forum- Represented by Morgan Rogers, Program Director* and Max
Taffet, Program Research Associate*
Promotes healthy decision making that will sustain the environmental quality, economic
vitality and livability of the Boulder County region through information, research, education
and dialogue. Its goals are to articulate a vision for healthy Boulder County communities,
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measure progress toward that vision through a biennial community indicators report and an
updated website, inform and educate the public and decision makers about issues of
interest and concern, identify community assets and opportunities for strategic action,
convene dialogues and partnerships to address key issues through collaboration, advocate
for systemic community change to create lasting solutions, and assess the impact of these
actions.
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Clinica Family Health Services- Represented by Susan Wortman, Development Director**
Clinca has five locations in the local area. They provide a full spectrum of family health care
services including wellness services, health information, immunizations, and comprehensive
pregnancy services. They serve 41,000 patients annually through 200,000 visits to a patient
population that consists of 97% of patients below 200% of the poverty level. Avista
Adventist Hospital has a strong historical relationship with Clinica which includes financial
support, inpatient care, and nationally recognized diabetes care management.
* Person with special knowledge of or expertise in public health
**Representative of medically underserved, low-income, and minority populations
RANKING QUESTIONNAIRE
In April and May 2012 Avista Adventist Hospital distributed their own health issues ranking questionnaire
where participants were asked to rank several health issues using a scale of 1 to 5, with 1 meaning “not a
critical issue” and 5 meaning a “very critical issue.” The questionnaire was distributed to various community
stakeholders, including members of the hospital community benefit steering committee, patients upon their
discharge from the hospital, and individuals visiting Clinica Family Services. Avista collected and analyzed
numerous completed questionnaires for consideration in the prioritization process.
2B II
INFORMATION GAPS
BCPH went through an exhaustive and valid process for identifying community health needs and Avista is
confident that the combination of that process, the hospital’s long-lasting partnership with the Community
Foundation and the Civic Forum, and the recent health needs assessment tool gives Avista accurate insights
into the genuine health needs of the local community. However, as with any research, there are potential
information gaps for minority segments of the population struggling for representation, but the strong
partnership Avista shares with Clinica Family Health Services minimizes that potential representation gap. As
the implementation strategies evolve it will be important to continually evaluate any additional information
obtained specifically around the priority areas of access and diabetes to maximize effectiveness of
interventions. Obtaining more specific data narrowly focused on zip codes and census tracts will also be
valuable.
2C
HEALTH NEEDS OF THE COMMUNITY
2C I
PROCESS TO IDENTIFY AND PRIORITIZE NEEDS
15
Avista formed a Community Benefit Advisory Committee which included the hospital CEO, hospital senior
leadership, a hospital community board member, and strategic community stakeholders representing both
the Boulder County Civic Forum and the Boulder County Health Improvement Collaborative (BCHIC). This
group studied the data and their objectives were to leverage historical successes, renew community
partnerships and validate the current understanding of the community health needs and the strategies that
impact them. Through analysis that took into account quantifiable data from the Colorado Department of
Public Health and Environment (CDPHE) and Boulder County Public Health (BCPH), qualitative information
from the ranking questionnaire, and the historical experience from community stakeholders, the Advisory
Committee identified six needs. The process of prioritization involved ranking the issues based on
quantitative and qualitative needs and the issues with the greatest needs were prioritized highest to lowest.
2C II
1.
2.
3.
4.
5.
6.
2C III
PRIORITIZED LIST AND DESCRIPTION OF COMMUNITY HEALTH NEEDS
Access to Health Services- Access is a critical component of achieving and maintaining good health.
The ability to access health care is influenced significantly by the presence of health insurance. Lack
of health insurance is correlated with a decline in health screening rates, delayed medical
consultation for adverse health conditions, advanced disease progression and higher mortality rates.
Diabetes- With the recent increases and future projected increases in the incidence of type 2
diabetes mellitus and with the incidence increasing in teenagers and young adults, the already
substantial public health effect of diabetes will become greater in years to come.
Mental Health- Avista doesn’t just recognize the importance of physical health. Treating mental
health is just as important to an individual’s overall wellbeing. Monitoring suicide rates, attempted
suicide rates, evaluating early childhood social and emotional development, and prevention efforts
around post-partum depression are all necessary steps that need to be taken to improve the overall
mental health of the community. According to NIMH, Suicide rates are up from 1999-2007.
Substance Abuse- Education around substance abuse is necessary for a healthier community. The
statistics around the effects of substance abuse are staggering. The National Institute on Drug Abuse
reports that $96 billion in healthcare costs annually are associated to tobacco use, $30 billion to
alcohol and $11 billion to illicit drugs.
Obesity- Obesity has become an epidemic in the United States. According to the CDC, over 1 in every
3 Americans are obese. In fact, medical costs due to obesity were about $147 billion dollars in 2008.
Increasing access to healthy foods, monitoring prevalence rates of vigorous activity, and tracking
commuting patterns ensures a healthier community.
Immunizations- As a healthcare organization it isn’t enough to just treat disease and illness.
Immunizations can prevent an individual from getting sick in the first place, saving resources for less
preventative ailments.
HEALTHCARE RESOURCES AVAILABLE IN THE COMMUNITY TO MEET THE NEEDS
Healthcare Workforce:
Dentists
275
Nurse Practitioners
184
Physicians
1,186
Physician Assistants
168
Psychologists
294
Registered Nurses
3,020
16
Health care utilization profile, HSR 16 and Colorado, 2008-09 HSR 16
Health care utilization1
Visited an emergency room in the past year
Visited a primary care physician in the past year
Deferred medical care due to cost
Insured
Uninsured
Usual source of care2
A doctor's office or private clinic
A community health center or other public clinic
A retail clinic like Wal-Mart
A hospital emergency room
An urgent care center
Certified Nurse Aides
Certified Nurse Midwives
Dental Hygienists
177
Licensed Practical Nurses
410
Pharmacists
307
Physical Therapists
428
1
Psychiatric Technicians for the Developmentally Disabled
0
79.3%
11.0%
0.6%
2.8%
2.3%
76.1%
11.8%
0.2%
4.7%
3.2%
13
Psychiatric Technicians for the Mentally Ill
Social Workers
16.9%
43.7%
172
72
Respiratory Therapists
18.6%
58.3%
10
Optometrists
Podiatrists
24.3%
90.9%
30
477
Occupational Therapists
20.4%
94.5%
1,156
Clinical Social Workers
Nursing Home Administrators
Colorado
106
38
17
Some other place
Does not go to one place most often
3.9%
0.1%
3.5%
0.4%
Within the
main service
area for Avista Adventist Hospital are two other acute care hospital facilities:
Good Samaritan Medical Center: Good Samaritan Medical Center, part of Exempla Healthcare, is a full
service acute care hospital in Boulder County. The medical specialties include emergency and level III
trauma care, cardiology, oncology, orthopedics, surgical services, women’s and children’s services and
neurology. 200 Exempla Circle, Lafayette, Colorado 80026.
Boulder Community Hospital: Boulder Community Hospital is a 159 bed hospital. It offers emergency
services, cardiology, orthopedic, and neurological services. It also operates Foothills Hospital Campus a
60 bed hospital which offers women’s and children’s services. 1100 Balsam Street, Boulder, CO 80304.
Another significant stakeholder and community partner is Clinica Family Health Services with five locations in
the local area. They provide a full spectrum of family health care services including wellness services, health
information, immunizations, and comprehensive pregnancy services. They serve 41,000 patients annually
through 200,000 visits to a patient population that consists of 97% of patients below 200% of the poverty
level. Avista Adventist Hospital has a strong historical relationship with Clinica which includes financial
support, inpatient care, and nationally recognized diabetes care management.
3
CONTACT INFORMATION
100 Health Park Drive
Louisville, CO 80027
303-673-1000
www.avistahospital.org
18

Avista Adventist Hospital

Transcription

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