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:
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:
Web surveys
community-based agencies.
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
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.
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
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
Fairview Southdale Hospital
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:
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
55723 Cook 55431 Bloomington
55738 Forbes 55435 Edina
55742 Goodland 55436 Edina
55746 Hibbing 55437 Bloomington
55751 Iron 55438 Bloomington
55765 Elmer 55439 Edina
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) ^
6. Head injury (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
6. Symptoms, ill-defined conditions ^
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
Appendix F: Top 10 Health Conditions by Population and Hospital
Fairview Southdale Hospital Primary Service Area—Children
Top 10 Reasons for Hospitalization, Children Ages 18 and under
With Birth Data Without Birth Data
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
3. Fever (nos) ^
7. Croup
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
With Birth Data Without Birth Data
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. 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
Appendix F: Top 10 Health Conditions by Population and Hospital
Fairview…