Fairview Ridges Hospital - Fairview Health Services

Fairview Ridges Hospital
Community Health Needs Assessment (CHNA) Implementation Plan
Fairview Ridges Hospital in Burnsville is a 150-bed, Level III Trauma Care facility that offers the most
advanced emergency services, orthopedics, pediatrics, cancer, surgery and cardiology available in the
Twin Cities south of the Minnesota River. In 2012, the hospital was recognized as high-performing in
five specialties by U.S. News & World Report.
This implementation plan summarizes the process to-date and priorities established for Fairview Ridges
to sustain and develop community benefit programs that 1) address prioritized needs from the 2012
Community Health Needs Assessment (CHNA) conducted by the Fairview Ridges Community Health
Needs Assessment Steering Committee with assistance from the Fairview Health Services Community
Health Department and 2) respond to additional identified community health needs.
Target Areas and Populations
Fairview Health Services identified the community and assessment area as the population within the zip
codes that comprise the Primary Service Area for Fairview Ridges. The entire population within this area
is included in the assessment; we did not limit our assessment to only Fairview patients. See appendix A
for a map of the assessment area.
How the Implementation Strategy was Developed
The Fairview Ridges implementation strategy was developed based on the findings and priorities
established by the Fairview Ridges CHNA Steering Committee.
Fairview Ridges along with Fairview Community Health provided leadership for the 2012 Fairview
Ridges community health needs assessment. Fairview Ridges reached out to members of the community
in the fourth quarter of 2011, asking a diverse group of community leaders to represent the community by
becoming a member of the CHNA Steering Committee. The following are members of that Steering
Committee:
Bonnie Brueshoff, Dakota County Public Health
Jennifer Deschaine, Scott County Public Health
Doug Dirks, Fairview Ridges Board Member, community member
Ann Ellison, Director, Fairview Community Health
Beth Krehbeil, President, Fairview Ridges Hospital
Charles Li, M.D.
Rev. Jeff Marian, Pastor, Prince of Peace Lutheran Church, community member
Janet Mohr, Fairview Ridges Board Member; Associate Professor, Minnesota State University
Moorhead, community member
Stacy Montgomery, Fairview Ridges Community Health, community member
Shari Prest, Fairview Ridges Board Member, community member
Murt Sherek, Fairview Ridges Board Member, retired R.N., community member
Peter Toensing, M.D., Fairview Ridges Hospital Chief of Staff
Major Needs and How Priorities Were Established
Both qualitative and quantitative data were gathered in the assessment process. The qualitative data
included:
Focus groups of three populations (mothers, seniors, vulnerable)
Web surveys
Key stakeholder interviews with elected officials, community leaders, physicians and members of
community-based agencies.
1
Quantitative data included:
Mortality data
Hospital utilization data
Emergency room data
Community Need Index (CNI) scores which are based on underlying socio-economic indicators
of health. Causation has been shown between high CNI scores and inappropriate emergency
room admission for ambulatory sensitive conditions. See appendix B for a map of CNI scores for
the assessment area.
The assessment resulted in a number of themes. The themes identify specifically what Fairview Ridges
community members need to maintain or improve their health and/or specific medical conditions that
require attention. The six themes that emerged are:
Obesity
Diabetes
Mental health
Education and information
Access to dental care
Access to Care/Working Moms
These six themes were discussed by the Steering Committee members and then prioritized using a Need
Prioritization Worksheet and criteria, see appendix C. The prioritization, by the Steering Committee,
resulted in the following top health needs for the community:
1. Mental health
2. Obesity/diabetes
A review of current community benefit programs found that the hospital is meeting existing community
needs through provision of charity care, Medicaid services, health professional education programs,
participation in several community based education efforts such as Lakeville Heart Restart—aimed at
improving the survival rate of people in sudden cardiac arrest—a partnership with Burnsville Fire
Department to distribute bike helmets and educate about bike safety, and SAFE—a support and education
program for victims of sexual assault. These activities were determined to be additional priorities for the
hospital’s implementation strategy.
Description of What Fairview Ridges Will Do to Address Community Needs
Fairview Ridges CHNA Steering Team has identified specific initiatives to address these top community
health needs.
Mental Health Action Plan
Fairview Ridges Hospital currently supports and participates in Youth Grief Services, which provides
grief support, education, and resources to assist children and the adults in their lives in grieving the death
of a loved one. The program offers a free comprehensive seven-session grief support program for families
with children ages 4 through 18. Youth Grief Services is strongly committed to educating the community
about the unique aspects of childhood grief. This can include (but is not limited to): parents, school staff,
children and youth (as to how they can best support their grieving friends), therapists, faith communities,
and college communities. Fairview Ridges will continue to support this program and will work to further
develop and expand the program.
2
In addition, Fairview Ridges will work with mental health providers, internally through University of
Minnesota Physicians and Fairview Medical Group, and externally through the Cobblestone Clinic and
other community based providers to identify opportunities to partner and strengthen the mental health
services and network available to the community.
Obesity /Diabetes Action Plan
Fairview Ridges is a founding partner in the Metro Alliance for Healthy Families, an early intervention
program for high risk families and their infants. Through this home visiting program education will be
provided on healthy eating, nutrition and obesity prevention.
Fairview Ridges will identify opportunities to partner with local county public health departments
(Dakota and Scott counties) to support initiatives focused on obesity and diabetes prevention.
Other Community Needs
In addition, Fairview Ridges will support the following top community need:
Access to Dental Care – Fairview Ridges Hospital will work with community-based dental providers to
provide education to the community about available services. Prince of Peace Lutheran Church, located
within a mile of the hospital has a strong Mission Outpost and serves many community members in need.
Fairview Ridges will explore with Prince of Peace the development of dental services in that Mission
Outpost.
The hospital will continue to meet other community needs by providing charity care, Medicaid services,
Lakeville Heart Restart, bike helmet safety education and the SAFE program. It also will continue to
provide community education and information events as needed or requested.
Next Steps for Priorities
For each of the priority areas listed above, Fairview Ridges will work with the Community Health
Assessment Steering Committee and community partners to:
Identify any related activities being conducted by others in the community that could be built
upon.
Develop measurable goals and objectives in order to evaluate the effectiveness of the
interventions.
Build support within the community for the identified initiatives.
Develop detailed work plans.
Priority Needs Not Being Addressed and the Reasons
While not identified as one of the community’s top three health needs, health information and education
is something that Fairview Ridges sees as a priority. The CHNA data related to health information and
education will be communicated across the organization. Efforts will be made to increase and improve all
aspects of health information and education that is provided broadly to the community.
After further consideration, it was felt that the issue of Access to care/working moms was related more to
access to care for families in the primary care clinic. For this reason, the issue was brought to the
attention of Fairview Medical Group which is developing action steps to expand services hours in this
community. To further address this need, Fairview Ridges will continue to be a funding partner to Portico
Healthnet, a local community nonprofit that helps uninsured community members access affordable
health coverage and care.
3
Resources
Fairview Ridges Hospital s prepared to commit our ongoing FTE’s and other resources to our current
partnerships and activities listed in the implementation plan, e.g., SAFE, Youth Grief Services, Metro
Alliance for Health Families and various other community educational events.
Approval
Each year at the December meeting, the Fairview Ridges Board of Directors will review the prior fiscal
year’s Community Benefit Report and approve the Community Benefit Implementation Strategy for
addressing priorities identified in the most recent Community Assessment and other plans for community
benefit.
This report was prepared for the Nov. 13, 2012 meeting of the Fairview Ridges Board of Directors and
was approved by the Board at that meeting.
4
Appendices
A. Primary Service Area Map
B. Community Need Index (CNI) Score Map
C. Need Prioritization Worksheet and Criteria
D. Definition of Community – Zip Codes by Hospital PSA
E. Qualitative Data Tools and Questions
F. Top Ten Health Conditions by Population and Hospital
Appendix A: Primary Service Area Map
Fairview Ridges Hospital
Primary Service Area
Appendix B: Community Need Index (CNI) Score Map
Fairview Ridges Hospital
CNI Scores
Appendix C
Need Prioritization Worksheet
Criterion and Considerations Guide
Criteria #1: Is the need health related?
Considerations:
 To what degree is the need health related?
Criteria #2: Is the need tied to Community Need Index (CNI) scores or similar measure of vulnerability?
Considerations:
 To what degree is the need tied to CNI scores or other measure such as the percentage of school Free and
Reduced Lunch (FRL) participants (e.g. A community may have a low CNI score, but a school within that
community may have a high percentage of students who qualify for FRL).
 The Community Need Index (CNI) Scores were developed by Catholic Healthcare West and Thompson Reuters.
Their underlying data is used to create an objective measure of socio-economic barriers to health care access
among populations and their effect on hospital admissions. CNI Scores range from a 5 (highest health
disparity/highest community need) to a 1 (lowest health disparity/lowest community need). CNI Scores provide a
high-level measure of community need and allow for comprehensive comparative analysis to be made on many
levels ranging from individual zip code comparison to regional or multi-state comparisons.
Criteria #3: Is the need tied to assessment or otherwise documented?
Considerations:
 To what degree is the need tied to assessment (i.e. where did the need fall on your list of priorities)?
 Are there contributing factors that may indicate the need for more immediate intervention (i.e. the need may fall
lower on the assessment, but there are additional considerations that make it a higher priority)?
Criteria #4: What is the magnitude of the need?
Considerations:
 How many persons does the need affect, either actually or potentially?
Criteria #5: What is the seriousness of the consequences?
Considerations:
 What degree of disability or premature death occurs?
 What are the potential burdens to your community such as economic or social burdens?
 What happens if we don’t respond?
Criteria #6: What is the feasibility of addressing?
Considerations:
 Is it amenable to intervention? Is the problem preventable?
 Are there scientifically feasible (evidence-based) interventions available?
 Is intervention acceptable to the community (i.e. are there economic, social, cultural or political issues that may
influence the communities ability to address the health need)?
 Does intervention have the potential to produce measurable outcomes?
 Are there adequate technology, knowledge, human and financlal resources to effect change?
Criteria #7: Does the need tie to Fairview Strategy?
Considerations:
 Fairview Strategy is defined as prevention, awareness and treatment of conditions related to cardiovascular,
orthopedics, oncology, mothers/children and behavioral health.
Appendix D: Definition of Community – Zip Codes by Hospital Primary Service Area, 2012
Fairview Lakes Medical Center
Zip Code
Community
55012
Center City
55013
Chisago City
55014
Lino Lakes
55025
Forest Lake
55032
Harris
55038
Hugo
55045
Lindstrom
55056
North Branch
55063
Pine City
55067
Rock Creek
55069
Rush City
55073
Scandia
55074
Shafer
55079
Stacy
55084
Taylors Falls
55092
Wyoming
Fairview Northland Med Ctr.
Zip Code
Community
55017
Dalbo
55309
Big Lake
55330
Elk River
55371
Princeton
55398
Zimmerman
56313
Bock
56329
Foley
56330
Foreston
56353
Milaca
56357
Oak Park
56358
Ogilvie
56363
Pease
Fairview Range Regional
Health Services
Zip Code
Community
55703
Angora
55709
Bovey
55710
Britt
55719
Chisolm
55723
Cook
55738
Forbes
55742
Goodland
55746
Hibbing
55751
Iron
55765
Elmer
55768
Mountain Iron
55769
Nashwauk
55775
Pengilly
55781
Side Lake
Fairview Ridges Hospital
Zip Code
Community
55020
Elko
55024
Farmington
55044
Lakeville
55054
New Market
55068
Rosemount
55121
Eagan
55122
Eagan
55123
Eagan
55124
Apple Valley
55306
Burnsville
55337
Burnsville
55372
Prior Lake
55378
Savage
Fairview Southdale Hospital
Zip Code
Community
55035
Hopkins
55317
Chanhassen
55318
Chaska
55331
Excelsior
55343
Hopkins
55344
Eden Prairie
55345
Minnetonka
55346
Eden Prairie
55347
Eden Prairie
55386
Victoria
55391
Wayzata
55409
Mlps – Harriet
55410
Mlps – Linden Hills
55416
St. Louis Park
55417
Mpls – Nokomis
55419
Mpls – SW
55420
55423
55424
55425
55426
55431
55435
55436
55437
55438
55439
East Bloomington
Richfield
Edina
Bloomington
St. Louis Park
Bloomington
Edina
Edina
Bloomington
Bloomington
Edina
University of Minnesota
Medical Center, Fairview/
Amplatz Children’s Hospital
Zip Code
Community
55102
St. Paul Downtown
55104
Midway
55105
MacGroveland
55108
Falcon Heights
55112
New Brighton
55113
Roseville
55114
Como/Hwy 280
55116
Highland Park
55401
Mpls – North Loop
55402
Mpls – Downtown
55403
Mpls – Loring
55404
Mpls – Franklin
55405
Mpls – Cedar
55406
Mpls – East Lake
55407
Mpls – Phillips
55408
Mpls – LynLake
55409
Mpls – Harriet
55410
Mpls – Linden Hills
55411
Mpls – Near North
55412
Mpls – Camden
55413
Mpls – Central NE
55414
Mpls – SE
55415
Mpls – Downtown
55416
St. Louis Park
55417
Mpls – Nokomis
55418
Mpls – Northeast
55419
Mpls – SW
55421
Columbia Heights
55423
Richfield
55432
Fridley
55454
Cedar Riverside
55455
University
Appendix E: Qualitative Data Tools & Questions
Focus Group Notes—Fairview Health Services 2012 CHNA
Fairview Health Services
Community Health Needs Assessment Focus Group Summary
Hospital:
Name of Group:
Date Held:
Summary by:
Questions:
1. What current health issues trouble you and your family?
2. What is the number one health issue for you or (your clients) your family?
3. What roadblocks do you experience when you are working to maintain your health?
4. Now tell us what roadblocks you experience when seeking healthcare from a professional?
5. To whom do you turn or where do you go when you need help with a health issue?
6. What is needed in our community to help you maintain or improve your health?
7. What is the role of the hospital to help you or others maintain or improve your health?
8. What do you see as your role in maintaining or improving your health?
Appendix E: Qualitative Data Tools & Questions
Stakeholder Interview Summary—Fairview Health Services 2012 CHNA
Fairview Community Health Needs Assessment 2012
Fairview Health Services
Community Health Needs Assessment Stakeholder Interview Summary
Hospital:
Name of Individual:
Date Held:
Summary by:
Background:
1. What do you believe to be the number one health issue in our community?
2. What are the difficulties, challenges and roadblocks faced by community members when they
seek healthcare from a professional?
3. When community members seek help about a health issue, where do you think they go for help?
4. What do you think is needed in your community to help individuals like yourself maintain or
improve your health?
5. What do you see as the health systems/hospitals role?
6. What do you see as your role in these improvements?
Appendix F: Top 10 Health Conditions by Population and Hospital
Fairview Ridges Hospital Primary Service Area—All Population
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Top 10 Reasons for Hospitalization, All Population
With Birth Data
Without Birth Data
Birth, vaginal
^ 1. Pneumonia (nos)
Birth, cesarean
^ 2. Osteoarthritis, lower leg (nos)
Birth, previous cesarean (nos)
3. Hardening of heart arteries
Pneumonia (nos)
4. Appendicitis (nos)
Birth, second degree laceration
5. Osteoarthritis, lower leg (nos)
Overdue pregnancy
6. Irregular heart beat
Osteoarthritis, lower leg (nos)
^ 7. Lumbar disc displacement
Hardening of heart arteries
8. First heart attack
Appendicitis (nos)
9. Chest pain (nec)
Osteoarthritis, lower leg (nos)
10. Severe depression, recurrent episodes
Source: Minnesota Hospital Association, 2008-2010
^ designates a 0.5% or higher percentage of difference between hospital and state of MN
nos = not otherwise specified (unspecified diagnosis)
nec = not elsewhere classified (diagnosis does not fit into a different category)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Top 10 Reasons for ER Visits Not Resulting in
Hospitalization, All Population
Abdominal pain (nos)
^
Chest pain (nos)
^
Headache
Head injury (nos)
^
Fever (nos)
Middle ear infection (nos)
Chest pain (nec)
Upper respiratory infection (nos)
Urinary tract infection (nos)
Lower back pain
Source: Minnesota Hospital Association, 2008-2010
^ designates a 0.5% or higher percentage of difference between hospital and state of MN
nos = not otherwise specified (unspecified diagnosis)
nec = not elsewhere classified (diagnosis does not fit into a different category)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Top 10 Causes of Death, All Population
Cancer
Heart diseases
Mental disorders
Stroke
Chronic obstructive pulmonary disease
Diseases of nervous system/sense organs
Alzheimer’s disease
Diabetes
Suicide
Kidney diseases
^
^
Source: Minnesota Department of Health, 2008-2010
^ designates a 0.5% or higher percentage of difference between hospital and state of MN
^
^
Appendix F: Top 10 Health Conditions by Population and Hospital
Fairview Ridges Hospital Primary Service Area—Children
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Top 10 Reasons for Hospitalization, Children Ages 18 and under
With Birth Data
Without Birth Data
Birth, vaginal
1. Pneumonia (nos)
Birth, cesarean
^ 2. Dehydration
Birth, cesarean (twins)
3. Appendicitis (nos)
Pneumonia (nos)
4. Depression (nec)
Dehydration
5. Asthma (nos)
Appendicitis (nos)
6. Chemotherapy
Depression (nec)
7. Mood disorder (nos)
Asthma (nos)
8. Bronchiolitis
Chemotherapy
9. Bronchiolitis (nec)
Mood disorder (nos)
10. Depression, recurrent episodes
^
^
Source: Minnesota Hospital Association, 2008-2010
^ designates a 0.5% or higher percentage of difference between hospital and state of MN
nos = not otherwise specified (unspecified diagnosis)
nec = not elsewhere classified (diagnosis does not fit into a different category)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Top 10 Reasons for ER Visits Not Resulting in
Hospitalization, Children 18 and Under
With Birth Data
Middle ear infection (nos)
Fever (nos)
^
Upper respiratory infection (nos)
Head injury (nos)
^
Abdominal pain (nos)
^
Vomiting
^
Croup
Inflammation, gastrointestinal (nos, nec)
Open wound, forehead
Flu with other respiratory manifestations (nec)
^
Source: Minnesota Hospital Association, 2008-2010
^ designates a 0.5% or higher percentage of difference between hospital and state of MN
nos = not otherwise specified (unspecified diagnosis)
nec = not elsewhere classified (diagnosis does not fit into a different category)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Top 10 Causes of Death, Children Ages 18 and Under
With Birth Data
Without Birth Data
Perinatal conditions
1. Birth defects
Birth defects
2. Cancer
Cancer
^ 3. Motor vehicle accidents
Other accidents (e.g. falls, poison)
^ 4. Other accidents (e.g. falls, poison)
Motor vehicle accidents
5. Heart diseases
Heart diseases
^ 6. Diseases of nervous system/sense
organs
Diseases of nervous system/sense
^ 7. Suicide
organs
Suicide
8. Residual (other)
Other infectious diseases
^ 9. Other infectious diseases
Residual (other)
10. Stroke
Source: Minnesota Department of Health, 2008-2010
^ designates a 0.5% or higher percentage of difference between hospital and state of MN
^
^
^
^
^
^
Appendix F: Top 10 Health Conditions by Population and Hospital
Fairview Ridges Hospital Primary Service Area—Seniors
Top 10 Reasons for Hospitalization, Ages 65 and Over
1. Pneumonia (nos)
2. Osteoarthritis, lower leg (nos)
3. Urinary tract infection (nos)
4. Hardening of the heart arteries
5. Irregular heart beat
6. First heart attack
7. Osteoarthritis, lower leg (nos)
8. Obstructive chronic bronchitis
9. Blood poisoning (nos)
10. Congestive heart failure (nos)
^
Source: Minnesota Hospital Association, 2008-2010
^ designates a 0.5% or higher percentage of difference between hospital and state of MN
nos = not otherwise specified (unspecified diagnosis)
nec = not elsewhere classified (diagnosis does not fit into a different category)
Top 10 Reasons for ER Visits Not Resulting in Hospitalization,
Ages 65 and Over
1. Chest pain (nos)
^
2. Urinary tract infection (nos)
3. Fainting
^
4. Dizziness and giddiness
5. Chest pain (nec)
6. Abdominal pain (nos)
^
7. General discomfort, fatigue (nec)
8. Nose bleed
9. Head injury (nos)
^
10. Hypertension (nos)
Source: Minnesota Hospital Association, 2008-2010
^ designates a 0.5% or higher percentage of difference between hospital and state of MN
nos = not otherwise specified (unspecified diagnosis)
nec = not elsewhere classified (diagnosis does not fit into a different category)
Top 10 Causes of Death,
Ages 65 and Over
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
^
Cancer
Heart diseases
Mental disorders
Stroke
Chronic obstructive pulmonary disease
Alzheimer’s disease
Kidney diseases
Diseases of the nervous system, sense organs
Symptoms, ill-defined conditions
Accidental falls
Source: Minnesota Department of Health, 2008-2010
designates a 0.5% or higher percentage of difference between hospital and state of MN
^
^
^