CHNAs Drive Hospital Community Health Focus | $name

CHNAs Drive Hospital Community Health Focus

CHNAs Drive Hospital Community Health Focus

Fri, Mar 24, 2017  -  Comments (0)  -   Posted by Kirstin Craciun

The following blog post was written in collaboration with St. Vincent Charity Medical Center's Vice President of Marketing and Communications Wendy Hoke and University Hospital's Director of Community Engagement Danielle Price.

Passage of the Affordable Care Act (ACA), aka Obamacare, really catalyzed hospitals’ involvement in community health assessment and planning. Tucked into the ACA is a provision that requires all nonprofit hospitals to conduct a community health needs assessment (CHNA) and develop an implementation strategy that describes how hospitals will respond to identified health needs at least once every three years. The spirit of the law encourages hospitals to collaborate with others when conducting their CHNAs to ensure the health needs of medically underserved, low-income and/or minority populations are addressed.

The Center for Health Affairs has been working collaboratively with St. Vincent Charity Medical Center and University Hospitals to assess health needs in the communities they serve and develop plans to address priority health concerns. As part of the team charged with helping member hospitals complete their CHNAs and implementation strategies, I’ve learned a lot about the health needs faced by residents in many of our Northeast Ohio communities. 

One thing is clear - we as a community have a lot of work to do and we need to roll up our sleeves and get to it. 

This isn’t to discount the good work that is already happening, of which there is a lot, but our existing efforts simply aren’t doing enough to solve the health needs of our family members, friends, neighbors and fellow Northeast Ohioans. Where there are the greatest health needs, there are also the biggest opportunities to make an impact – and yes, I’m an unfailing optimist about what we can achieve when we work together. Cliché, absolutely, but I believe it.

Take the market area served by St. Vincent Charity Medical Center, for example. While the community served by the hospital has a large footprint, St. Vincent Charity’s leaders recognize that residents living right outside its doors in the Central Neighborhood face some of the greatest health challenges among its patient population.

Interviews with community leaders helped highlight some of the biggest health concerns and opportunities to improve health outcomes among Central Neighborhood residents. While a number of assets exist in the Central Neighborhood, generational poverty – influenced by a lack of available jobs and residents with past felony convictions being unable to obtain jobs – is a pressing concern. Chronic disease, such as diabetes, precipitated by an unhealthy diet is also a key health concern in the neighborhood. Impeding residents’ ability to make healthy food choices are the intertwined factors of hunger, insufficient availability of low-cost healthy options and a lack of awareness about what comprises a healthy diet. Chronic stress – stemming from poverty, illegal activity in the neighborhood, and other stressors – continues to impact the lives of many residents in the Central Neighborhood.

St. Vincent is taking positive steps forward to address the health needs of some of its most vulnerable community members as expressed by Wendy Hoke, Vice President of Marketing and Communications at St. Vincent Charity Medical Center: We’ve known that our immediate neighborhood has many challenges, but this year’s CHNA process illuminated those challenges in a way that focused our response. As a faith-based organization, we have always sought to address unmet needs and now we are going further by crafting solutions with the community, not just for the community. The best ideas in the world are no good if they don’t work for the people they are intended to help. Our focus is not just on health access, but on the quality of health access. We’re exploring ways to alleviate the stress that poverty surfaces not only by providing care, but also by helping to build community. And we’re emphasizing strategies that build on a foundation of trust.

University Hospitals faced the daunting task of conducting multiple CHNAs and assessing the health needs faced by the different and diverse communities served by each of its hospital facilities. They rose to the challenge, and they have been developing plans to address the identified health needs in each community. It won’t come as a surprise that addressing the health needs of individuals living in rural counties often requires a different approach than what is necessary to achieve an impact in urban counties.

Teams at each of UH’s hospitals worked to craft strategies to do just that as described here by Danielle Price, Director of Community Engagement at University Hospitals Health System: Although most of the health priorities are similar in both rural and urban regions across the UH system, issues such as access to care, substance abuse, chronic disease management and mental-health – the specific issues within each broad category, are unique to the locale. For example, access in rural communities very often is related to actual physical access, meaning a lack of adequate transportation or an insufficient number of specialists. In our urban hospitals it usually refers to the cost of care, patients lacking a primary care physician or individuals who unknowingly engage the emergency department for non-emergent issues. At UH Geauga for example, home visiting programs are being piloted to reach patients who live far from the hospital facility or are simply isolated from mainstream information about health-related prevention, treatment or resources. Conversely, at UH Cleveland Medical Center, the Medical Access Clinic was established as an intervention to treat non-emergent patients in a clinical setting after they have been triaged and medially screened in the emergency department. The Clinic is located adjacent to the Emergency department within the hospital for convenience and patients can be connected with primary care physicians and receive information about financial assistance, workshops, screenings and other resources.

Health education and screenings for early detection of disease is a standard intervention across our hospital system. We have learned from our patients and other stakeholders that we are viewed as an authority on health in the community, not just healthcare. As such, we conduct numerous workshops, symposiums, screenings and events to raise awareness of resources, conditions and treatment of disease and disorders.

University Hospitals contributed $275 million in community benefit in 2015 and has contributed over $2.2 billion over the last decade. We are dedicated to continuing our 150 year history of addressing the needs of our patients and community.

Hospitals in the region and throughout the U.S. will continue to develop CHNAs and implement strategies that aim to improve the health of the communities they serve and measure how successful their strategies are. Stay tuned to The Center’s blog posts over the coming year as we profile how efforts at the federal level to repeal and replace the ACA, coupled with state-level population health planning efforts, will impact our community health improvement efforts in Northeast Ohio.

Posted in Population Health
About the Author

Kirstin Craciun

I grew up in Canada where access to healthcare for all citizens is a core principle. I bring that thinking to the work I do as The Center for Health Affairs’ director of community outreach. I spend my days helping Northeast Ohio hospitals assess health needs in the community; develop collab...

See other articles by this author and view full bio »

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