Fairview Southdale Hospital - Fairview Health Services

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Fairview Southdale Hospital Community Health Needs Assessment (CHNA) Implementation Plan

Fairview Southdale Hospital offers care to people living and working in the southwest Twin Cities metro

area. We offer high quality care for all health problems. Our doctors and staff work to provide personal

care using the latest technology. In its 390-bed licensed facility, Fairview Southdale Hospital offers

convenient access to more than 40 specialty services including cardiology, orthopedics, oncology,

obstetrics, primary care, neurosciences, critical care, vascular and emergency services. Physician partners

from Fairview, Fairview Physician Associates, University of Minnesota Physicians and independent

physicians throughout the southwest metro and beyond combine their talents to balance innovative

technologies and treatments with the art of medicine.

This implementation plan summarizes the process to date and priorities established for Fairview

Southdale Hospital to sustain and develop community benefit programs that 1) address prioritized needs

from the 2012 Community Health Needs Assessment (CHNA) conducted by the Fairview Southdale

Hospital CHNA 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 Southdale Hospital. The entire population

within this area is included in the assessment, not only Fairview patients. See appendix A for a map of

the assessment area.

How the Implementation Strategy was Developed The Fairview Southdale implementation strategy was developed based on the findings and priorities

established by the Fairview Southdale Hospital CHNA Steering Committee.

Fairview Southdale, along with Fairview Community Health, provided leadership for the 2012 Fairview

Southdale Hospital CHNA. Fairview Southdale Hospital reached out to members of our 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:

Brad Beard, President, Fairview Southdale Hospital

Steve Devich, Manager, City of Richfield

Ann Ellison, Director, Fairview Community Health

Robb Gruman, Vice President, Facilities and Support Services, Fairview Southdale Hospital

Amy Gumestad, Director, Admissions and Marketing, Minnesota Life College

David Holm, retired Pastor, Fairview Southdale Hospital Board Member

Martin Kirsch, former Mayor of Richfield, Fairview Southdale Hospital Board Member

BJ Larson, Director of Spiritual Health, Fairview Southdale and Ridges Hospitals

Alissa LeRoux Smith, Manager, Community Health and Volunteer Services, Fairview Southdale

Hospital

Richard Sturgeon, M.D., Interim Vice President of Medical Affairs, Fairview Southdale Hospital

Lori Syverson, President, Edina Chamber of Commerce

Cathy Utne, Director, Patient and Guest Services, Fairview Southdale Hospital

Raymond Yu, Principal, Oakgrove Elementary School

Karen Zeleznak, Public Health Administrator, Bloomington Health Division

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Major Needs and How Priorities Were Established Both qualitative and quantitative data was 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.

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 Southdale

community members need to maintain or improve their health. The five themes that emerged are:

Access to affordable health care

Transportation across city boundaries

Health care information and education

Access to dental care

Cultural competency in treatment/interactions

These five themes were discussed by the Steering Committee members and then prioritized using a Need

Prioritization Worksheet and Criteria, see appendix C. As a result of the discussion, the group reclassified

“healthcare information and education” to be used as a strategy, and added healthy lifestyles and social

and emotional well-being as two more themes based on the qualitative and quantitative data specific to

our population. The prioritization, by the Steering Committee, resulted in the following top health needs

for the community:

1. Healthy lifestyles

2. Social and emotional well-being

A review of current community benefit programs found that the hospital is meeting existing community

needs through provision of charity care, Medicaid services, on-the-job training programs, community

health fairs, Telecare (a telephone check-in program), funding for transportation for low-income

individuals, financial support for programs at Normandale Center for Healing and Wholeness and

educational programs. These activities were determined to be valuable priorities for the hospital’s

implementation strategy.

Description of What Fairview Southdale Hospital Will Do to Address Community Needs Fairview Southdale Hospital CHNA Steering Team has identified six initiatives to address these top

community health needs: funding and implementing community vegetable gardens, providing health

education and information, increasing participation in and support of local health events, expanding

clientele of a telephone wellness check-in program, and offering volunteer and job opportunities along

with work-readiness training to vulnerable young adults.

Metrics for these activities will be established using the Healthy People 2020 guidelines and others.

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Healthy Lifestyles Action Plan

Fairview Southdale Hospital will address healthy lifestyles through a variety of initiatives that focus on

diet, food choices, and fruit and vegetable consumption in relation to obesity, cardiovascular and vascular

health. These initiatives will be implemented at our areas of highest need. One of these target areas is the

Church of the Assumption in Richfield, which has a high membership percentage of low-income Latino

families. Of the Church’s congregation, 65 percent are pre-diabetic and 75 percent obtain food support at

the local food pantry. Another area of focus is Oakgrove Elementary School in Bloomington, where more

than 60 percent of students qualify for free or reduced lunch.

Fairview Southdale Hospital will partner with Assumption Church and Oakgrove Elementary

School to fund and implement the building or expansion of vegetable gardens. The gardens will

be used as a source of healthy food and as a forum for education on healthy eating.

Fairview Southdale Hospital will also partner with Edina Parks and Recreation to support their

construction of an “edible playground” in Lewis Park, which is adjacent to an apartment complex

with an increasing percentage of low income, racial and ethnic minority families. Children from

the apartments will be recruited to partake in the Lewis Park summer garden program that will

focus on healthy eating and physical activity.

Fairview Southdale dietitians, chefs and other staff will provide education and demonstrations on

nutrition, healthy food choices and cooking for our community partners.

We will increase our participation in and contributions to health fairs and events in our service

area, providing free blood pressure and BMI screenings as well as resources and information on

weight management and healthy eating.

Social and Emotional Wellbeing Action Plan

Fairview Southdale Hospital aims to address issues of depression, anxiety and social isolation for

vulnerable populations including seniors, adults with disabilities and low-income young adults.

Fairview Southdale Hospital will increase the clientele of its longstanding Telecare program, a

free telephone check-in service for adults and elders who live alone, by creating a new marketing

brochure and advertising through our community partners.

We will offer hospital volunteer positions that include on-the-job training for students of the

Minnesota Life College, a program for adults on the autism spectrum.

We will support the STEP-UP Achieve Jobs Program for disadvantaged youth by providing a

paid summer internship and work-readiness training at Fairview Southdale.

Other Community Needs

In addition, Fairview Southdale will support the following top community needs:

Transportation

Fairview Southdale will double its annual contributions to VEAP (Volunteers Enlisted to Assist

People), a program that provides a free ride service for low-income adults, which will cover 100

percent of rides to Fairview Southdale Hospital and Fairview Clinics in geographic area in 2013.

Cultural Competency in Treatment Interactions

Fairview Southdale Hospital will build its relationship with the Latino population through

engaging hospital staff in the community health activities held at Church of the Assumption.

Access to Affordable Health Care

Fairview Southdale will continue to be a funding partner to Portico Healthnet, a local community

non-profit that helps uninsured community members access affordable health coverage and care.

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We will partner with Hennepin County Human Services Department to provide community

education on “Assured Access” programs for medical, dental and mental health needs.

Next Steps for Priorities For each of the priority areas listed above, Fairview Southdale Hospital will work with the CHNA

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 Access to dental care was identified as a top community need; however, the Steering Committee

determined that dental care was beyond the scope of Fairview Southdale Hospital’s expertise at this time.

While not identified as one of the communities top two health needs, health information and education is

something that Fairview Southdale 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.

Resources The work of the action plans will be supported by a .7 FTE community health manager.

Approval On an annual basis, the Fairview Southdale Hospital 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. 20, 2012 meeting of the Fairview Southdale Board of Directors and

was approved by the Board at that meeting.

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 Southdale Hospital

Primary Service Area

Appendix B: Community Need Index (CNI) Score Map

Fairview Southdale Hospital

CNI Scores

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.

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Appendix C

Appendix D: Definition of Community – Zip Codes by Hospital Primary Service Area, 2012 Fairview Lakes Medical Center Fairview Ridges Hospital University of Minnesota

Medical Center, Fairview/ Amplatz Children’s Hospital

Zip Code Community Zip Code Community Zip Code Community

55012 Center City 55020 Elko 55102 St. Paul Downtown

55013 Chisago City 55024 Farmington 55104 Midway

55014 Lino Lakes 55044 Lakeville 55105 MacGroveland

55025 Forest Lake 55054 New Market 55108 Falcon Heights

55032 Harris 55068 Rosemount 55112 New Brighton

55038 Hugo 55121 Eagan 55113 Roseville

55045 Lindstrom 55122 Eagan 55114 Como/Hwy 280

55056 North Branch 55123 Eagan 55116 Highland Park

55063 Pine City 55124 Apple Valley 55401 Mpls – North Loop

55067 Rock Creek 55306 Burnsville 55402 Mpls – Downtown

55069 Rush City 55337 Burnsville 55403 Mpls – Loring

55073 Scandia 55372 Prior Lake 55404 Mpls – Franklin

55074 Shafer 55378 Savage 55405 Mpls – Cedar

55079 Stacy Fairview Southdale Hospital 55406 Mpls – East Lake

55084 Taylors Falls Zip Code Community 55407 Mpls – Phillips

55092 Wyoming 55035 Hopkins 55408 Mpls – LynLake

Fairview Northland Med Ctr. 55317 Chanhassen 55409 Mpls – Harriet

Zip Code Community 55318 Chaska 55410 Mpls – Linden Hills

55017 Dalbo 55331 Excelsior 55411 Mpls – Near North

55309 Big Lake 55343 Hopkins 55412 Mpls – Camden

55330 Elk River 55344 Eden Prairie 55413 Mpls – Central NE

55371 Princeton 55345 Minnetonka 55414 Mpls – SE

55398 Zimmerman 55346 Eden Prairie 55415 Mpls – Downtown

56313 Bock 55347 Eden Prairie 55416 St. Louis Park

56329 Foley 55386 Victoria 55417 Mpls – Nokomis

56330 Foreston 55391 Wayzata 55418 Mpls – Northeast

56353 Milaca 55409 Mlps – Harriet 55419 Mpls – SW

56357 Oak Park 55410 Mlps – Linden Hills 55421 Columbia Heights

56358 Ogilvie 55416 St. Louis Park 55423 Richfield

56363 Pease 55417 Mpls – Nokomis 55432 Fridley

Fairview Range Regional Health Services

55419 Mpls – SW 55454 Cedar Riverside

Zip Code Community 55420 East Bloomington 55455 University

55703 Angora 55423 Richfield

55709 Bovey 55424 Edina

55710 Britt 55425 Bloomington

55719 Chisolm 55426 St. Louis Park

55723 Cook 55431 Bloomington

55738 Forbes 55435 Edina

55742 Goodland 55436 Edina

55746 Hibbing 55437 Bloomington

55751 Iron 55438 Bloomington

55765 Elmer 55439 Edina

55768 Mountain Iron

55769 Nashwauk

55775 Pengilly

55781 Side Lake

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 Southdale Hospital Primary Service Area—All Population

Top 10 Reasons for Hospitalization, All Population

With Birth Data Without Birth Data

1. Birth, vaginal 1. Pneumonia (nos)

2. Birth, cesarean 2. Blood poisoning (nos)

3. Pneumonia (nos) 3. Irregular heart beat

4. Birth, second degree laceration 4. Osteoarthritis, lower leg (nos)

5. Blood poisoning (nos) 5. Hardening heart arteries

6. Irregular heart beat 6. Osteoarthritis, lower leg (nos) ^

7. Osteoarthritis, lower leg (nos) 7. Rehabilitation (nec)

8. Birth, previous cesarean 8. First heart attack

9. Hardening of heart arteries 9. Kidney failure (nos)

10. Osteoarthritis, lower leg (nos) ^ 10. Urinary tract infection (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, All Population

1. Chest pain (nos)

2. Abdominal pain (nos)

3. Chest pain (nec) ^

4. Headache

5. Upper respiratory infection (nos)

6. Head injury (nos) ^

7. Fever (nos)

8. Middle ear infection (nos)

9. Abdominal pain (nec)

10. Inflammation, gastrointestinal (nos, 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)

Top 10 Causes of Death, All Population

1. Cancer

2. Heart diseases

3. Mental disorders ^

4. Stroke

5. Chronic obstructive pulmonary disease

6. Symptoms, ill-defined conditions ^

7. Diseases of nervous system/sense organs

8. Accidental falls ^

9. Alzheimer’s disease

10. Kidney diseases Source: Minnesota Department of Health, 2008-2010 ^ designates a 0.5% or higher percentage of difference between hospital and state of MN


Fairview Southdale Hospital Primary Service Area—Children

Top 10 Reasons for Hospitalization, Children Ages 18 and under


1. Birth, vaginal ^ 1. Pneumonia (nos)

2. Birth, cesarean ^ 2. Dehydration

3. Birth, cesarean (twins) ^ 3. Bronchiolitis

4. Pneumonia (nos) 4. Appendicitis (nos)

5. Dehydration 5. Depression (nec)

6. Bronchiolitis 6. Asthma (nos)

7. Depression (nec) 7. Mood disorder (nos)

8. Appendicitis (nos) 8. Pneumonia, bacterial (nos) ^

9. Birth, vaginal (twins) 9. Bronchiolitis (nec)

10. Asthma (nos) 10. Respiratory failure 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, Children 18 and Under

With Birth Data

1. Middle ear infection (nos)

2. Upper respiratory infection (nos)

3. Fever (nos) ^


5. Vomiting

6. Inflammation, gastrointestinal (nos, nec)

7. Croup

8. Asthma (nos) ^

9. Open wound, forehead

10. Abdominal pain (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, Children Ages 18 and Under


1. Perinatal conditions ^ 1. Birth defects ^

2. Birth defects 2. Suicide ^

3. Suicide ^ 3. Residual (other) ^

4. Residual (other) ^ 4. Other accidents (e.g. falls, poison)

5. Other accidents (e.g. falls, poison) 5. SIDS

6. SIDS 6. Motor vehicle accidents

7. Motor vehicle accidents 7. Homicide ^

8. Homicide ^ 8. Diseases of nervous system/sense organs


9. Heart diseases ^

10. Heart diseases ^ 10. Cancer Source: Minnesota Department of Health, 2008-2010 ^ designates a 0.5% or higher percentage of difference between hospital and state of MN


Fairview Southdale Hospital Primary Service Area—Seniors

Top 10 Reasons for Hospitalization, Ages 65 and Over

1. Pneumonia (nos)

2. Blood poisoning (nos) ^

3. Irregular heart beat

4. Osteoarthritis, lower leg (nos)

5. Urinary tract infection (nos)

6. Hardening of the heart arteries

7. Kidney failure (nos)

8. Osteoarthritis, lower leg (nos) ^

9. First heart attack

10. Rehabilitation (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)

Top 10 Reasons for ER Visits Not Resulting in Hospitalization, Ages 65 and Over

1. Chest pain (nos)

2. Chest pain (nec) ^

3. Fainting ^

4. Dizziness and giddiness ^

5. General discomfort, fatigue (nec)

6. Urinary tract infection (nos)

7. Nose bleed


9. Abdominal pain (nos)

10. Limb 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)

Top 10 Causes of Death, Ages 65 and Over

1. Cancer

2. Heart diseases

3. Mental disorders ^

4. Stroke

5. Chronic obstructive pulmonary disease

6. Symptoms, ill-defined conditions ^

7. Alzheimer’s disease

8. Accidental falls ^


10. Kidney diseases Source: Minnesota Department of Health, 2008-2010

^ designates a 0.5% or higher percentage of difference between hospital and state of MN

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