Adventist Midwest Health: 2013 Community Health Needs Assessment

Transcription

Joint Community Health Needs
Assessment
2013
Adventist Midwest Health
Adventist Bolingbrook Hospital
Adventist GlenOaks Hospital
Adventist Hinsdale Hospital
Adventist La Grange Memorial
Hospital
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Table of Contents
Project Goals ..................................................................................................................................... 3
Expected Outcomes ........................................................................................................................... 4
Executive Summary............................................................................................................................ 5
Mission, Vision, Values....................................................................................................................... 9
A Message from Adventist Midwest Health President and CEO; David L. Crane .................................. 11
About Adventist Midwest Health Hospitals....................................................................................... 12
CHNA Components .......................................................................................................................... 16
CHNA Report ................................................................................................................................... 17
The Adventist Midwest Health Community........................................................................................ 17
Adventist Midwest Health Community Benefit Assets ....................................................................... 25
CHNA Methodology ............................................................................................................................ 30
Community and Public Health Input ................................................................................................... 35
Prioritized Health Needs ..................................................................................................................... 37
Measures and Resources to Address Identified Health Needs .......................................................... 44
CHNA Contact .................................................................................................................................. 46
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Project Goals
Simply put, a Community Health Needs Assessment is the ongoing process of evaluating the health
needs and assets of a community. It is systematic and it is data-driven. Assessment outcomes are
analyzed to understand the health status, behaviors and needs of residents in the community.
Identified health needs are prioritized so that effective plans may be put in place to address the most
critical health needs.
The process is perpetual. Community needs change. Well-implemented plans lead to opportunities to
address other, more salient needs. One must assess needs, prioritize needs, implement a plan, assess
plan effectiveness, modify the plan if indicated, and again assess the needs. Each cycle of this process,
each “turn of the wheel,” allows an organization to drill down to a deeper understanding of how it can
position itself to be the best community health asset possible.
Assess Health
Needs
Modify the
Plan, as
Indicated
Assess Plan
Effectiveness
Prioritize Needs
Implement a
Plan to Address
Needs
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Expected Outcomes
Community Health Needs Assessments must ultimately result in Community Benefit. It is the
expectation of Adventist Midwest Health that our continued systematic approach to study Community
need will continue to result in benefit to the Community.
The Catholic Health Association, in A Guide for Planning and Reporting Community Benefit ISBN 087125-282-1, defines community benefit as programs or activities that provide treatment or promote
health and healing as a response to identified community needs and meet at least one of the four
objectives below. Accordingly, and in response to the force of our Mission and our commitment to the
needs of our Community, our Community will appreciate direct and meaningful benefit from our
hospitals in response to this Community Health Needs Assessment.
Improved Access to
Healthcare Services
Enhance population
health
Advance increased
general knowledge
Reduce the burden of
government to improve
health
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Executive Summary
Adventist Midwest Health is a network of four not-for-profit hospitals in Chicago’s western and
southwestern suburbs.
As a part of the Adventist Health System, Adventist Midwest Health brings a long tradition of health care
to Illinois and Wisconsin. Our national network of 44 campuses in 10 states makes us part of the largest
not-for-profit Protestant hospital system in the country. We take a holistic, “whole-person” approach to
wellness, providing medical and spiritual support for our patients and their families.
Adventist Midwest Health includes four hospitals in Chicago’s western and southwestern suburbs
(Adventist Bolingbrook, Adventist GlenOaks, Adventist Hinsdale, and Adventist La Grange Memorial
Hospitals), with more than 5,100 employees and more than 2,600 physicians on staff. These hospitals,
clinically integrated and tied by common Community, Mission, Vision, and Values, embarked on a
Community Health Needs Assessment to define and ultimately respond to the specific health needs of
the Community they serve.
As a not-for-profit health care organization, the four hospitals in Adventist Midwest Health embrace a
rich tradition of providing benefit to the community, with the ultimate goal of improving community
health and increasing access to care. All of the net income (profit margin) generated by the hospital is
reinvested back into hospital programs and services. This benefits the patients and communities we
serve rather than individual owners or shareholders.
Under new federal regulations that govern charitable hospital organizations, a Joint Community Health
Needs Assessment (“CHNA”) was conducted by the four Chicago-area Adventist Midwest Health
hospitals to assist in identifying the most significant health needs of the community served. The
hospitals are in the same Metropolitan Service Area (“MSA”) and collaborated to conduct a Joint
Community Health Needs Assessment in 2013. The facilities worked together with the state and local
health departments (three) and other partners in the MSA. The Joint Report identifies all of the
collaborating hospital facilities by name on both the cover page and full report, and was approved by
their respective Hospital Boards in December 2013. This CHNA will serve to guide the next phase of the
Community Health Needs Assessment Process: Development of an Implementation Strategy to address
these identified needs.
Adventist Midwest Health Community - Defined
This CHNA assessed needs specific to the four hospitals in the Adventist Midwest Health Community.
Statistically significant samples of residents participated in the CHNA, representing the demographic
makeup of the Community. For the purpose of this Community Health Needs Assessment, the Adventist
Midwest Health Community is defined by the primary and secondary zip codes for patients who receive
“safety net” and general acute care services at our hospitals. Safety net services are those services
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which generate a low or negative margin and would not be provided if the decision were based purely
on financial indicators. Safety net services include psychiatric care, prenatal care, pediatric services,
inpatient rehabilitation and emergency care. As a not-for-profit health care provider, our commitment is
to provide these necessary services to the Community we serve despite the impact on revenue.
Methodology
Data collection, aggregation and analysis were completed with the goal of identifying the top presenting
healthcare needs in the Adventist Midwest Health Community. The hospitals created a Community
Health Needs Assessment Committee (“CHNAC”) that represented the broad community as well as low
income, minority and underserved populations. The CHNAC worked with the hospitals to analyze the
data and prioritize the issues to be addressed by the Adventist Midwest Health hospitals.
1. Data Collection: Many community partners were engaged to promote the collection of
meaningful data. This included a partnership through the Metropolitan Chicago Healthcare
Council leading to use of a third party vendor to conduct primary data collection of Community
residents through telephone survey and focus groups. Adventist Bolingbrook Hospital
participates actively in the Will County MAPP Collaborative, with distribution of written surveys
to a representative sample of residents in the Community in order to obtain primary data
relating to health priorities. Secondary quantitative and qualitative data were collated and
analyzed from county, state, and national sources). Multiple focus groups and forums were held
throughout the Community through the Metropolitan Healthcare Council and the Will County
MAPP Collaborative. Care was taken in all data collection to promote participation by a
representative sample of the community, including medically underserved, low-income and
minority populations.
2. Data Aggregation: Key health indicators identified through both primary and secondary data
collection were collated and presented in an excel spreadsheet so that data comparisons across
sources could be made.
3. Data Analysis: Community Health Needs Assessment Committees inaugurated by Adventist
Midwest Health were presented with the key health indicators (37 in total). The Committees
(including hospital executives, clinical experts, hospital strategic planning and marketing staff,
and community members representing the broader interests of the Community) participated in
a data analysis and formal prioritization process using analysis tools to support decision-making.
The key health indicators that initially fell out as potentially problematic were compared to
additional secondary data sources for additional support.
Input from those Served
The CHNA was conducted under the premise that primary source data was mandatory
(collecting first-hand data directly from the individuals living in our Community). Care was taken
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to assure the individuals sampled for primary source data collection represented the Community
demographics. A statistically significant threshold was met for three of the four hospitals
represented in this CHNA, providing confidence that the results can be generalized to the
community. For the remaining hospital, additional data collection was sought from those racial
groups that were underrepresented during initial primary data collection.
Multiple focus groups were held to gather community perception of health needs. Composition
of focus groups, with intent, included leaders and community members who could speak
directly to the needs of the medically underserved, those with low income and minority
populations.
Prioritization
Top identified needs (those needs where Hospital, County, and State outcomes were markedly
lower than Healthy People 2020 goals) were the following:
Access to Healthcare [lack of insurance]: Consequences of loss of health insurance
include delayed diagnosis, decreased opportunities for effective treatment options at a
later stage of diagnosis, greater likelihood of spread of communicable disease and
health apathy. As healthcare reform unfolds, Adventist Midwest Health will be in a
unique position to contribute to timely acquisition of health insurance for those with
the most substantive healthcare and financial needs through partnership with the
Centers for Medicare and Medicaid Services.
Access to Healthcare [lack of awareness of services – Adventist Bolingbrook Hospital]:
Primary data collected in the Bolingbrook zip codes indicate that respondents with
significant health needs are not aware of the resources in the community that are
available to meet those needs. Adventist Bolingbrook Hospital’s participation in the
MAPP Initiative will promote community education and enhance the ability of public
and private Community advocates to work collaboratively to bring services to those with
the most substantive needs: the medically underserved, low-income, and minority
populations.
Influenza Vaccination [18-64 years]: In Illinois and Adventist Midwest Health
Communities the adult population under 65 falls substantively below the Healthy People
2020 goal for receipt of the influenza vaccination. Those individuals with financial need
or who lack access to care are less likely to receive the vaccine. The CDC reports that
although younger adults typically experience a less severe influenza and there is less
frequent hospitalization than very young and very old people, a study of 18-49 year olds
(through one reported economic modeling analysis) revealed that the influenza caused
five million illnesses, 2.4 million outpatient visits, thirty-two thousand hospitalizations,
and 680 deaths. Impact on the individual, the Community, the healthcare system, and
the Government (for those individuals receiving government funded care) is high.
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Pneumococcus Vaccine [65 years and older]: According to the CDC, invasive disease
from pneumococcus is a major cause of illness and death in the United States, with an
estimated 43,500 cases and 5,000 deaths among persons of all ages in 2009. Eighty-four
percent of those who are infected and nearly all deaths occurred in adults. Individuals
with financial need and decreased access to care are less likely than the insured to be
vaccinated. Efforts to raise awareness and provide vaccination to those in need leads to
potential for preserved health status and decreased risk for pneumonia-related
hospitalization or death. A single vaccine in an underprivileged adult who would have
otherwise developed pneumonia can save a life and relieve the Government of
preventable and costly medical care.
Hypertension [over 18 y/o): Heart disease and stroke, both caused by high blood
pressure, are the first and third leading causes of death in the U.S. Twenty-eight
percent of adults in Illinois have high blood pressure. Primary data collection in the
Adventist Midwest Health Community reveals even higher self-reports of hypertension
(up to 42% surrounding Adventist GlenOaks Hospital). The poor and those with
decreased access to care are less likely to be diagnosed than those with the financial
means to receive regular health checkups. The outcome for those left unchecked is
escalation of disease, further damaging organ systems that results in decreased quality
of life, as well as increased burden on the Government to pay for care that could have
been avoided with appropriate screening.
Measures and Resources
The Adventist Midwest Health hospitals will develop a Community Health Plan
(implementation strategy) based on the health priorities noted above. Measures of success
for each identified health need priority will be developed by the Community Health Needs
Assessment Committee following a full review and discussion of related implications.
The Chicago Metropolitan area is home to 119 hospitals. Duplication of service and
availability of like resources to meet community need is evident. Key to successfully
meeting health needs identified in this CHNA is leveraging these services and resources in a
manner that has the highest impact on community health with appropriate preservation of
resources. To that end, Adventist Midwest Health will work collaboratively with Community
Partners to implement improvement strategies in a meaningful way. Mechanisms of
partnership include active participation in Metropolitan Chicago Healthcare Council efforts
to unite providers across the Chicago Metro area to align benefit activities. Additionally,
work through the County Health Departments’ MAPP Initiatives provides both resources
and informational guidance to promote benefit to the Community for selected measures.
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Our Vision
Adventist Midwest Health is an integrated health care system of outstanding quality. We work as a
partner with patients, families, and healers to achieve optimal health for our patients and the
communities we serve. We provide unsurpassed value by using practices based on the most up-todate evidence and by coordinating comprehensive care for every patient in a highly personal
environment.
Our Mission
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Our Values
Excellence:
For quality care
and service with
optimal
outcomes that
seek to exceed
patient
expectatation
Christian Service
Motivation:
Offering
compassion,
respect, and the
belief that every
life has value.
Stewardship:
Integrity:
Enhancing staff
development,
nurturing the
environment,
conserving
resources, and
offering value
for services
That generates
trust, and offers
consistency in
decision-making.
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Our Community; Our Commitment
By David L. Crane, President/Chief Executive Officer, Adventist Midwest Health
“Every live man with a gift must divide it with others, or pay the penalty of
having it shrink away and finally shrivel up altogether … it is what we give
away that we really keep.”
Dr. David Paulson; Founder – Adventist Hinsdale Hospital (1904)
Within Adventist Midwest Health hospitals, there is a special effort in place to create memorable
experiences for our patients and for our community. We want those we serve to feel God’s compassion,
grace and truth through our hands, giving them hope and healing.
We call this effort Transforming Care ~ Transforming Lives. But what does this really mean? When Jesus
healed, he focused on transforming the lives of those he touched. This is our commitment to our
patients and our community. We want to transform lives through the care, compassion and expertise
provided by our employees, nurses and physicians. Each day, these care providers apply the gifts they
bring to make a positive change in peoples’ lives.
This is such an important assignment. It’s not one I take lightly. In order to fulfill our mission of
extending the healing ministry of Christ, we work as partners to achieve optimal health for our patients
and the community we serve. We do this in the midst of a changing healthcare environment.
Reimbursement changes and reform are creating a highly competitive healthcare market demanding
that hospitals reduce costs and improve quality and safety. Hospitals that don’t change to meet new
industry demands will not survive. We have a once in a lifetime chance to re-create our organization so
we can survive in this radically new healthcare environment and continue our commitment to our
patients and to community.
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About our Hospitals:
Adventist Bolingbrook Hospital
Bolingbrook, IL
Rick Mace, CEO/President
Adventist Bolingbrook Hospital opened in 2008 as the first new hospital to be built in Illinois in more
than 25 years. This state-of-the-art facility has 138 beds (all private rooms) and specializes in cardiac
care, interventional radiology, orthopedics, surgery, oncology and women’s care. The Emergency
Department is among the top 5 percent in the nation according to HealthGrades, placing the hospital in
an exclusive group of high-performing hospitals; providing confidence to individuals in the Community
with emergent medical needs that quality care is readily available, regardless of their ability to pay.
Recent designation as a Chest Pain Center augments the available emergency services. The hospital
opened its new wound care center in 2013 and has also established an agreement with VNA Health
Care to offer a Federally Qualified Health Center on the hospital campus to provide care for the
uninsured and underinsured.
2012 Statistics:



138 beds
Inpatient Admissions: 5,419
Outpatient Visits: 46,741
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Adventist GlenOaks Hospital
Glendale Heights, IL
Bruce C. Christian, CEO/President
Adventist GlenOaks Hospital has served Chicago’s western suburbs for more than 30 years in Glendale
Heights. The 146-bed hospital offers a full range of services including emergency care, surgery,
cardiology, oncology, obstetrics, behavioral health, interventional radiology, orthopedics and more. The
Therapeutic Day School provides an environment for students in third grade through high school that
blends academic education with therapies that nurture each student’s emotional growth and
independence. The hospital is an accredited Chest Pain Center and certified Primary Stroke Center. As
the only Disproportionate Share Hospital in DuPage County, the hospital is a safety net for the most
vulnerable and underserved populations – providing care many patients cannot access elsewhere.
2012 Statistics:



146 beds
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Adventist Hinsdale Hospital
Hinsdale, IL
Michael J. Goebel, CEO/President
For more than a century, Adventist Hinsdale Hospital has provided superior health care with Christian
compassion. The hospital’s new $75 million patient pavilion, which opened in 2012, features private
suites and an environment that promotes comfort and healing. The 276-bed hospital is an accredited
Chest Pain Center and certified Primary Stroke Center, and a comprehensive Breast Care Center. The
hospital offers highly-specialized services and technologies to treat a variety of serious health concerns
such as heart disease, cancer, stroke, neurological issues, orthopedic problems and pediatric conditions.
The hospital has a Level III Neonatal Intensive Care Unit and the da Vinci Robotic surgical system. It is
the only teaching hospital in DuPage County.
2012 Statistics:



276 beds
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Adventist La Grange Memorial Hospital
La Grange, IL
Lary Davis, CEO/President
Since its opening in 1955, Adventist La Grange Memorial Hospital has maintained a high level of medical
excellence in the community. The 205-bed hospital is a leader in comprehensive oncology services,
advanced cardiac care, women’s health and maternity care, emergency and geriatrics. The hospital is an
accredited Chest Pain Center, a certified Primary Stroke Center and a comprehensive Breast Care
Center. The hospital has been named a Top Performer on Key Quality Measures by the Joint Commission
for exemplary performance in the areas of heart attack, heart failure, pneumonia and surgical care. The
hospital offers the da Vinci® Robotic surgical system, physicial rehabilitation services and is a family
medicine teaching hospital.
2012 Statistics:



205 beds
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Assessment Report Components
This Community Health Needs Assessment Report documents steps taken by the four Adventist
Midwest Health hospitals to capture representative, reliable, and comprehensive information on the
health needs and assets of our Communities.
The Report, in total, provides readers with a comprehensive view of presenting health needs and
Adventist Midwest Health’s identified priorities for taking action. It also serves as an organizational tool
for developing a plan to address identified needs and ultimately effectively guiding benefit to most
appropriately impact our Community’s health. Report components are below.
Community Health Needs
Assessment
AMH Community
Defined
Current Community
Benefit Assets
Assessment
Methodology
Community Input
Obtained
Prioritized Health
Needs
Existing Resources to
Meet Needs
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The Adventist Midwest Health Community
“Bear one another’s burdens, and so fulfill the law of Christ.”
Galatians 6:2
Our Community - Defined
For the purpose of this Community Health Needs Assessment, the Adventist Midwest Health Community
is defined by the primary and secondary zip codes for patients who receive “safety net” and general
acute care services at our hospitals. Safety net services are those services which generate a low or
negative margin and would not be provided if the decision was based purely on financial indicators.
Safety net services include psychiatric care, prenatal care, pediatric services, inpatient rehabilitation and
emergency care. As a not-for-profit health care provider, our commitment is to provide these necessary
services to the Community we serve despite the fact that revenue is not appreciated.
80% of the patients receiving care at Adventist Midwest Health live within our Primary and Secondary
service areas.
Primary Service Area:
The primary service area is based on the first sixty percent (60%) of our patients’ origin.
Secondary Service Area
The secondary service area represents the next twenty percent (20%) of our patients’ origin.
The four AMH hospitals are located in Cook, DuPage and Will Counties. The zip codes are noted in the
chart below.
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Adventist Midwest Health Primary and Secondary Zip Codes
60101
ADDISON
PRIMARY
60558
WESTERN SPRINGS
PRIMARY
60108
BLOOMINGDALE
PRIMARY
60559
WESTMONT
PRIMARY
60139
GLENDALE HEIGHTS
PRIMARY
60561
DARIEN
SECONDARY
60154
WESTCHESTER
PRIMARY
60126
ELMHURST
SECONDARY
60188
CAROL STREAM
PRIMARY
60133
HANOVER PARK
SECONDARY
60439
LEMONT
PRIMARY
60137
GLEN ELLYN
SECONDARY
60440
BOLINGBROOK
PRIMARY
60148
LOMBARD
SECONDARY
60446
ROMEOVILLE
PRIMARY
60162
HILLSIDE
SECONDARY
60458
JUSTICE
PRIMARY
60172
ROSELLE
SECONDARY
60480
WILLOW SPRINGS
PRIMARY
60181
VILLA PARK
SECONDARY
60490
BOLINGBROOK2
PRIMARY
60185
WEST CHICAGO
SECONDARY
60501
SUMMIT ARGO
PRIMARY
60187
WHEATON
SECONDARY
60513
BROOKFIELD
PRIMARY
60402
BERWYN
SECONDARY
60514
CLARENDON HILLS
PRIMARY
60435
JOLIET
SECONDARY
60515
DOWNERS GROVE
PRIMARY
60441
LOCKPORT
SECONDARY
60516
DOWNERS GROVE2
PRIMARY
60455
BRIDGEVIEW
SECONDARY
60517
WOODRIDGE
PRIMARY
60457
HICKORY HILLS
SECONDARY
60521
HINSDALE
PRIMARY
60532
LISLE
SECONDARY
60523
OAK BROOK
PRIMARY
60546
RIVERSIDE
SECONDARY
60525
LA GRANGE
PRIMARY
60563
NAPERVILLE
SECONDARY
60526
LA GRANGE PARK
PRIMARY
60564
NAPERVILLE2
SECONDARY
60527
WILLOWBROOK
PRIMARY
60565
NAPERVILLE3
SECONDARY
60534
LYONS
PRIMARY
60585
PLAINFIELD2
SECONDARY
60544
PLAINFIELD
PRIMARY
60586
PLAINFIELD3
SECONDARY
60638
CHICAGO
SECONDARY
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Adventist Midwest Health Primary and Secondary Service Areas
Adventist Midwest Health lies within a highly-populated suburban area beginning just west of the third
largest city in the United States (Chicago, IL). Healthcare service providers in the Primary and Secondary
Service Areas are, accordingly, many and varied, with 9 hospitals in our service area [see below].
Primary Service Area
AMH Facilities
Secondary Service Area
Non-AMH
Hospitals/Facilities
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The Greater Chicago Healthcare Market
Expanding beyond the Primary and Secondary Service Areas (see below), the Chicago Metropolitan area
is home to 119 Hospitals, each with an obligation to serve the Communities they serve. Shared
ownership of community wellness through planned partnerships promotes health outcomes in an
effective and efficient manner.
Population Growth
2000-200
More than 30%
20% - 30%
10% - 20%
0% - 10%
Less than 0%
+
+
Academic Medical Centers
Advocate
1
Alexian Brothers (Ascension)
2
Loyola (Trinity)
RHC - Provena
Centegra
CDH – Delnor
Vanguard
Other
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Our Community Residents
HOSPITAL
Primary Service Area
Primary Inpatient
Age [Projected Growth
by 2016]
Race/Ethnicity
[Projected Growth
by 2016]
0-17 years [5.7%]
Hispanic [30%]
Service Lines
Adventist
Bolingbrook
Adventist
GlenOaks
Bolingbrook, Woodridge, Lemont,
Romeoville, and Plainfield.
Glendale Heights, Bloomingdale,
Addison, and Carol Stream.
General Medicine
[28.4%]
18-44 years [1.8%]
Asian [23%]
Cardiac Services
[26.4%]
45-64 years [14.5%]
Multiracial [18%]
Obstetrics [23.8%]
65+ YEARS [21.6%]
Black [13%]
General Medicine
[14.7%]
0-17 years [-3.5%]
Pacific Islander
[22%]
18-44 years [-4.9%]
Cardiac Services
[16.7%]
45-64 years [-4.8%]
Native American
[21%]
Obstetrics [22.6%]
65+ YEARS [21.6%]
Black [16%]
Hispanic [14%]
Adventist
Hinsdale
Hinsdale, Oak Brook,
Westchester, La Grange Park,
Brookfield, La Grange,
Willowbrook, Darien, Clarendon
Hills, Westmont, Woodridge and
Downers Grove.
La Grange, La Grange Park,
Adventist La
Grange Memorial Westchester, Brookfield, Lyons,
Summit/Argo, Justice, Willow
Springs, Willowbrook and
Western Springs.
General Medicine
[22.7%]
0-17 years [-2.7%]
Asian [20%]
18-44 years [-2.5%]
Native American
[16%]
Cardiac Services
[22.3%]
45-64 years [-2.15]
Obstetrics [32.9%]
65+ YEARS [11.7%]
General Medicine
[38.8%]
0-17 years [.6%]
Hispanic [13%]
Black [13%]
18-44 years [-3.2%]
Cardiac Services
[40.8%]
45-64 years [-2.3]
Obstetrics [16.9%]
65+ YEARS [8.2%]
Native American
[12%]
Hispanic [12%]
Multiracial [11%]
Black [7%]
Notable projected trends across the Adventist Midwest Health Community in the next three
years include substantive growth in individuals 65 years and over, limited growth in the
percentage of children, and an increase in racial diversity.
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US Census Data
DuPage County
Median age (years)
38.2
(X)
16 years and over
18 years and over
21 years and over
62 years and over
65 years and over
717,588
689,494
656,171
135,104
106,398
78.3
75.2
71.6
14.7
11.6
RACE
Total population
One Race
White
Black or African American
American Indian and Alaska Native
Asian
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian [1]
Native Hawaiian and Other Pacific Islander
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander [2]
Some Other Race
Number
916,924
896,528
714,140
42,346
2,415
92,304
42,233
13,092
15,254
1,369
4,758
3,747
11,851
217
50
47
28
92
45,106
Percent
100.0
97.8
77.9
4.6
0.3
10.1
4.6
1.4
1.7
0.1
0.5
0.4
1.3
0.0
0.0
0.0
0.0
0.0
4.9
INCOME and BENEFITS (IN 2011 INFLATION-ADJUSTED DOLLARS)
Total households
Less than $10,000
$10,000 to $14,999
$15,000 to $24,999
$25,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 to $199,999
$200,000 or more
Median household income (dollars)
Mean household income (dollars)
Number
335,651
10,554
8,192
20,974
25,263
37,669
59,441
49,399
62,355
29,651
32,153
77,598
103,296
Percent
335,651
3.1%
2.4%
6.2%
7.5%
11.2%
17.7%
14.7%
18.6%
8.8%
9.6%
(X)
(X
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US Census Data
Cook County
Median age (years)
35.3
16 years and over
18 years and over
21 years and over
62 years and over
65 years and over
4,108,936
3,962,395
3,750,384
766,376
620,329
Percent
79.1
76.3
72.2
14.8
11.9
RACE
Total population
One Race
White
Asian
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian [1]
Native Hawaiian
Samoan
Some Other Race
Number
5,194,675
5,062,905
2,877,212
1,287,767
21,559
322,672
93,730
62,392
64,349
11,446
37,008
13,522
40,225
1,724
430
542
202
550
551,971
Percent
100.0
97.5
55.4
24.8
0.4
6.2
1.8
1.2
1.2
0.2
0.7
0.3
0.8
0.0
0.0
0.0
0.0
0.0
10.6
INCOME AND BENEFITS (IN 2011 INFLATION-ADJUSTED DOLLARS)
Total households
Less than $10,000
$10,000 to $14,999
$15,000 to $24,999
$25,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 to $199,999
$200,000 or more
Number
335,651
10,554
8,192
20,974
25,263
37,669
59,441
49,399
62,355
29,651
32,153
77,598
103,296
Percent
335,651
3.1%
2.4%
6.2%
7.5%
11.2%
17.7%
14.7%
18.6%
8.8%
9.6%
(X)
(X)
23 | P a g e
US Census Data
Will County
Median age (years)
35.4
(X)
16 years and over
18 years and over
21 years and over
62 years and over
65 years and over
503,512
480,606
454,661
80,601
62,814
74.3
70.9
67.1
11.9
9.3
RACE
Total population
One Race
White
Asian
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian [1]
Native Hawaiian
Samoan
Some Other Race
INFLATION-ADJUSTED DOLLARS)
Total households
Less than $10,000
$10,000 to $14,999
$15,000 to $24,999
$25,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 to $199,999
$200,000 or more
Number
677,560
662,104
514,664
75,743
1,703
30,833
11,100
3,729
8,191
342
1,824
1,086
4,561
136
36
30
14
56
39,025
Number
335,651
10,554
8,192
20,974
25,263
37,669
59,441
49,399
62,355
29,651
32,153
77,598
103,296
Percent
100.0
97.7
76.0
11.2
0.3
4.6
1.6
0.6
1.2
0.1
0.3
0.2
0.7
0.0
0.0
0.0
0.0
0.0
5.8
Percent
335,651
3.1%
2.4%
6.2%
7.5%
11.2%
17.7%
14.7%
18.6%
8.8%
9.6%
(X)
(X)
24 | P a g e
Community Benefit Assets
“Seek the peace and prosperity of the city to which I have carried you … because if it prospers,
you too will prosper.”
Jeremiah 29:7
Adventist Midwest Health Community Health Commitment
Adventist Midwest Health has a rich tradition of Community giving. We are committed advocates of our
Community’s health.
AMH Community Health
Commitment
Individuals with financial need are prioritized
for healthcare service
As a not-for-profit healthcare provider, we have
a duty to improve community health
The AMH Community Benefit Program is guided
in collaboration with health resources available
in the Community
The AMH Community Benefit Program is
synchronized with strategic initiatives
AMH leaders must be engaged advocates for
the Community Benefit Program
25 | P a g e
Prioritizing Health Service for those in Poverty
Medically Underserved Population: The community of Bolingbrook was designated by the Federal
Government as a “Medically Underserved Population” (“MUP”) in 2003. Medically underserved
populations include populations experiencing health disparities or at risk of not receiving adequate
medical care as a result of being uninsured or underinsured or due to geographic, language, financial or
other barriers. Adventist Bolingbrook Hospital was built in 2008 in response to this designation,
replacing a free-standing emergency department with a hospital that operates a breadth of safety net
services that are now available to these underserved individuals in the community.
Federally-Qualified Healthcare Center: In partnership with the VNA, Adventist Bolingbrook Hospital
opened a Federally-Qualified Healthcare Center (“FQHC”) at the Hospital in 2013. FQHCs provide access
to primary care in areas where primary care resources are constrained.
Family Practice Medicine Programs: Adventist Hinsdale and Adventist La Grange Memorial Hospitals
each operate a Family Medicine Center. These centers are staffed by Resident Program Faculty and up
to fifty Family Practice Residents, serving patients in Western Cook and DuPage Counties with significant
financial need and decreased access to care. A high percentage of Medicaid patients are seen in these
clinics. The Hinsdale Family Medicine Center currently provides more free-of-charge immunizations to
children in DuPage County than any other health care provider.
Disproportionate Share Hospital: Adventist GlenOaks Hospital is the only designated Disproportionate
Share Hospital (“DSH”) in DuPage County, serving the healthcare needs of a high percentage of Medicaid
patients requiring inpatient stays.
Community Partnerships
Adventist Midwest Health has engaged in meaningful partnerships with Community providers to best
meet the needs of those served. Integration of cross-organizational strengths provides a complement of
unique services, with depth and breadth to reach specific Community need.
Access DuPage is a collaborative and unique partnership of hospitals, physicians, local government,
human services agencies, and community groups working together locally to address the national health
care crisis. Individuals with limited access to care have healthcare opportunities that would not
otherwise be met. Adventist Hinsdale Hospital supports Access DuPage through subsidies and through
care provision to those in need at no cost (this occurs through inpatient service, outpatient service, and
through the Family Medicine Center). With the advent of the Healthcare Exchange and Medicaid
expansion, there are anticipated changes in this unique and beneficial healthcare collaborative.
Illinois Department of Public Health Breast and Cervical Cancer Screening Program: The Hinsdale
Family Medicine Center participates in cooperation with the Illinois Department of Public Health in a
26 | P a g e
Breast and Cervical Cancer Screening Program. This program provides free cancer screening to
individuals with health need who are financially unable to pay for service.
The Aging Resource Center (“ARC”) Program: ARC is offered through Aging Care Connections and is a
grant-based healthcare program located within Adventist La Grange Memorial Hospital. ARC liaisons
work closely with hospital case managers and discharge planners to provide older adults and their
families with a unique plan for transition to home by linking them to necessary community resources
prior to discharge. This proactive approach, with integrated care from the inpatient care team and the
ARC liaisons, has provided benefit to thousands of patients and their families, with the ultimate goal of
linking patient/family to community support services, better management of chronic disease and
decreased readmissions to the hospital.
Community Nurse Health Association: Community Nurse Health Association serves as a community
healthcare center for residents of the western suburbs of Chicago, focusing on those who have limited
access to care. Adventist La Grange Memorial Hospital collaborates with this organization to provide
healthcare to uninsured patients treated at the center who require acute care services. Additionally,
Adventist La Grange Memorial Hospital Family Practice Residency Program has a 20-year history of
providing clinic services through this clinic.
Open ARMS ― Breast Cancer Outreach Fund
In partnership with Adventist Hinsdale Hospital, the Hinsdale Hospital Foundation Open Arms fund was
established in 2011 to support breast cancer patients and their families by funding programs that bring
hope and healing as they help patients and families navigate the difficult journey through cancer
diagnosis, treatment, and recovery. Donations to the Open Arms Fund make possible the best diagnosis,
technology, and treatment programs to optimize the lives of those individuals in the community who
have been diagnosed with breast cancer. Proceeds from the Open Arms Fund in 2012 were directed to
Adventist Hinsdale Hospital for providing free mammograms to 40 women over the age of 40 who don’t
have health insurance.
Wellness House
The Wellness House is a community-based organization that provides education, support and
empowerment to enrich the physical and emotional lives of individuals with cancer and their families. It
is located in Hinsdale, Illinois, offered at no cost to participants, and is a complement to medical
treatment; treatment received through the comprehensive services of Adventist Midwest Health
providers. Through donations and participation in community events and sponsorships, Adventist
Hinsdale Hospital extends its Mission into the important work of this organization that touches the lives
of so many.
Association of Physicians of Pakistani Decent of North America (APPNA Clinic)
The Pakistani Descent Physician Society IL (PPS), in corporation with Association of Pakistani Descent
Physicians of North America, opened a free health clinic in the Adventist Hinsdale Hospital service area
in 2009. Free primary healthcare services are provided in this clinic to individuals in the community who
have limited access to care. Patients requiring further diagnostic testing are referred to Adventist
27 | P a g e
Hinsdale Hospital, where free diagnostic services are provided based on the financial need of the
patient.
Education
1. Family Practice Residency Programs: Adventist Hinsdale and Adventist La Grange Memorial
Hospitals support the educational needs of nearly 50 Family Practice Residents through two
separate Family Practice Residency Programs. The Hinsdale Program is the only Family Practice
Residency Program in DuPage County. The educational support of Family Practice Physicians is
critical. These family doctors care for the entire span of generations; the minimally ill and the
terminally ill. The number of medical school graduates in the U.S. who choose primary care is
half of what it was in 1999. A recent study published in the Annals of Family Medicine predicts
that due to population growth/aging and insurance expansion, the number of primary care
office visits will increase significantly through 2025 (from 462 million in 2008 to 565 million in
2025). This translates into a 2025 need for an additional 52,000 primary care physicians. (Annals
of Family Medicine; November/December 2012; Volume 10 no. 6 pp. 503-509). According to
The Department of Health and Human Services Strategic Plan, more than 64 million people
currently live in a primary-care health professional shortage area
(http://www.hhs.gov/secretary/about/goal5.html).
2. Clinical Affiliation Experience: The Department of Health and Human Resource identifies the
following critical healthcare shortages: primary care physicians, nurses, behavioral health and
long-term care workers, as well as public health and human service professionals. At the same
time, need for healthcare is increasing as the population ages and as quality of care concerns
become front and center in a pay for performance healthcare model. Adventist Midwest Health
contracts with 96 colleges/universities to provide a site for clinical training of healthcare
professionals at no charge (with over 100,000 hours of training provided to nurses and allied
health professionals in 2012). Physicians, nurses and other allied healthcare providers have the
opportunity to develop clinical skills necessary to enter the workforce at this time when a
shortage of skilled healthcare workers is evident.
Research
Through research the most promising treatments and cures are discovered. Research is an
important “public good” in the health care system; a place where translational knowledge
emerges from scientific research, underpinning the quality of care provided to the community at
large. Adventist Midwest Health supports an active research program, with oversight of nearly
200 clinical trials in 2012.
28 | P a g e
Community Benefit Provided in 2012
Charity Care:
Language Assistance Services:
Government-sponsored Indigent Healthcare:
Subsidized Health Services:
Bad Debt:
$13,192,987
$331,117
$54,735,470
$786,945
$2,517,101
Donations:
$877,647
Volunteer Services:
$486,627
Education:
Research:
$11,285,002
$505,206
Other:
$2,548, 537
Total Community Benefit (2012):
$87,266,639
29 | P a g e
Assessment Methodology
Data Sources
To enrich knowledge of the health status and assets in the Adventist Midwest Health Community, an
eclectic approach to data gathering was sought. This allowed for collecting first-hand data that both
described our Community thoughts about health needs, and quantified those needs using statistically
sound analysis. It also provided a chance to build on the solid research analysis methodology from our
secondary data sources charged with measuring population health. The result is a comprehensive,
integrated picture that provides a base from which to build meaningful benefit.
Quantitative
Data
Numeric
Qualitative
Data
Descriptive
Primary
Data
New;
First-hand
Secondary
Data
Already
Published
Our Community Health Needs Assessment Partners:
Primary Data Sources: Quantitative and Qualitative Data
1. Metropolitan Chicago Healthcare Council: Adventist GlenOaks, Hinsdale and La
Grange Memorial Hospitals partnered with the Metropolitan Chicago
Healthcare Council, and Professional Research Consultants (“PRC”), as a
subcontracted vendor, to promote comprehensive and statistically sound
methods of assessing the needs of the Adventist Midwest Health Community.
The survey instrument used is based on the Centers for Disease Control and
Prevention Behavioral Risk Factor Surveillance System. Other public health
surveys and customized questions were developed by PRC relative to health
promotion and disease prevention (See Appendix A for a list of questions from
the survey instrument).
PRC collected primary research from the AMH-defined community using
random-sampling telephone surveys, which are considered to provide the most
reliable and timely information regarding an individual’s health status and
30 | P a g e
needs. Focus was placed on the individual’s experience and behaviors that are
both geographically and demographically sensitive.
The sample design used consisted of a stratified random sample of individuals
aged 18 years and older in the Adventist GlenOaks, Adventist Hinsdale, and
Adventist La Grange Memorial Hospital service areas. Sample size follows: 224
for Adventist GlenOaks Hospital; 361 for Adventist Hinsdale Hospital; and 202
for Adventist La Grange Memorial Hospital. Following data collection, the
sample was weighted in proportion to the actual population distribution at the
ZIP Code level so that estimates reflect the area as a whole. All administration
of the surveys, data collection and data analysis were conducted by PRC. The
sample design and the quality control procedures used in the data collection
promote a representative sample. Findings of this research may be generalized
to the total population of community members with a high degree of
confidence.
This data was augmented with primary data from focus groups and community
health panels, allowing for a broader reach into the communities. Focus groups
for Cook County (Adventist La Grange Memorial Hospital) and DuPage County
(Adventist GlenOaks and Adventist Hinsdale Hospital) occurred on June 21st,
2012 and June 19th, 2012 respectively. There was added benefit of discussionbased input from a pre-selected list of community stakeholders who, because of
position, have an ability to identify primary health concerns of the related
community. A list of recommended participants to be included in the focus
groups was provided by the Metropolitan Chicago Healthcare Council, with
input from Chicago Metropolitan Hospital constituents. Participants included
representatives of public health, individuals who work with low-income,
minority or other medically underserved populations, and those who work with
persons with chronic disease conditions.
2. Will County Department of Public Health Collaborative: Adventist Bolingbrook
Hospital participated actively in the Will County MAPP Collaborative, providing a
rich base of both primary and secondary data useful in determining health
priorities of the Community. MAPP is a community-wide strategic planning tool
used for improving public health by helping communities prioritize public health
issues, identifying resources for addressing those issues, and taking action. The
Will County Collaborative is a county-wide effort which includes members from
a variety of sectors including public health, medical, behavioral health, social
services, education, business, government, faith based, and law enforcement.
Community Health Needs Assessment was completed through focus groups and
through distribution of written surveys.
31 | P a g e
Focus Groups: Focus groups were conducted with a variety of service
providers; employees of corporations; major donors; and clients of
service provider agencies; community leaders; African American
communities, Hispanic communities, and Faith-based communities.
Two-hundred twenty workers and residents participated, representing
all sectors of the county. A concerted effort was made to include
minorities, the underserved, and those with less than a college
education.
Community Member Surveys: Four primary assessments were
conducted through the Will County MAPP initiative: Community Health
Status Assessment, Forces of Change Assessment, Local Public Health
Systems Assessment, and the Community Themes and Strengths
Assessment. 5000 surveys were sent to a random sample of Will County
residents. Four-hundred sixty-six surveys were returned. Additional
surveys were distributed in the African American and Hispanic
communities. One percent of respondents were under the age of 25.
The racial breakdown of White and Asian respondents closely
represented the demographics of the county, while the African
American and Hispanic individuals were underrepresented.
Secondary Data Sources: A variety of secondary data, both qualitative and quantitative was accessed to
complement the research generated by PRC (for Adventist GlenOaks, Hinsdale and La Grange Memorial
Hospital) and the Will County MAPP initiative, by Adventist Bolingbrook Hospital. Data was collected at
the County level, the State level, the Federal level (through the Centers for Disease Control, the local
health departments, Healthy People 2020, the Behavioral Risk Factor Surveillance System, National
Health and Nutrition Examination Survey, and US Census Data).
1. Local Health Departments:
Public health surveillance provides for ongoing, systematic collection of data for
use in public health action. In order for local health departments in the State of
Illinois to become certified by the Illinois Department of Public Health, they are
required, per 77 IL Administrative Code Section 600.410, to complete an Illinois
Project for Local Assessment of Needs (“IPLAN”) or similar planning process. The
process must involve community participation in order to identify community
health problems, set priorities, and implement a community health plan to
address these priorities.
The planning process used by the three county health departments serving the
Adventist Midwest Health Community (Will, DuPage, and Cook) is called
32 | P a g e
“MAPP” – Mobilizing for Action through Planning and Partnership. MAPP is a
community-wide strategic planning tool used for improving public health by
helping communities prioritize public health issues, identifying resources for
addressing those issues, and taking action. Community-based planning
promotes community ownership, creates an infrastructure of broader support
and looks to the strengths/weaknesses of the local public health system [not
solely the function of the local health department]. Thus, Adventist Midwest
Health has a role in participating in MAPP processes, understanding MAPP
outcomes and participating in local health department recommended actions to
improve community health status. A key component of the MAPP process is to
minimize health disparities within the community served.
Four assessments are completed as part of the MAPP process: (1) The Local
Public Health System Assessment; (2) The Community Themes and Strengths
Assessment; (3) The Forces of Change Assessment; and (4) The Community
Health Status Assessment.
2. Healthy People 2020: Healthy People provides science-based, 10-year national
objectives for improving the health of all Americans. For three decades, Healthy
People has established benchmarks and monitored progress over time in order
to:
A. Encourage collaborations across communities and sectors.
B. Empower individuals toward making informed health decisions.
C. Measure the impact of prevention activities
Measurable objectives and goals are developed through Healthy People 2020,
providing a benchmark for comparing Adventist Midwest Health Community
Health Needs Assessment outcomes and guiding selection of health need
priorities and outcome expectations.
3. Behavioral Risk Factor Surveillance System: In 1984, the Centers for Disease
Control and Prevention (CDC) initiated the state-based Behavioral Risk Factor
Surveillance System (BRFSS)--a cross-sectional telephone survey that state
health departments conduct monthly via phone with a standardized
questionnaire and technical assistance from CDC. BRFSS is used to collect
prevalence data among adult U.S. residents regarding their risk behaviors and
preventive health practices that can affect their health status. Respondent data
are forwarded to CDC to be aggregated for each state, returned with standard
tabulations, and published at year's end by each state. Over 350,000 adults are
interviewed each year.
33 | P a g e
4. National Health and Nutrition Examination Survey: This survey is designed to
assess the health and nutritional status of adults and children in the United
States. The survey combines interviews and physical exams, providing
information on undiagnosed diabetes, caloric intake, elevated blood levels, etc.
5. US Census Bureau: US Census online tool was used to access quantitative data
defining the counties in which Adventist Midwest Health hospitals reside.
34 | P a g e
Community and Public Health Input
Community and Public Health input is imperative in any Community Health Needs Assessment process.
Perceived and demonstrated needs necessarily guide more focused assessments, prioritization of needs,
and implementation plans. Input should be representative, assuring the broad interests of the
community are addressed.
Persons with Special Knowledge of or Expertise in Public Health:
Public Health input was obtained in the following ways:
1. Adventist Bolingbrook Hospital full integration into the MAPP Planning Process through the Will
County Department of Public Health. As noted above focus groups, including 220 individuals,
were conducted with a variety of service providers, employees of corporations, major donors
and clients of service provider agencies, community leaders, African American, Hispanic and
Faith-based communities.
2. Key Informant Focus Groups: As part of the Community Health Needs Assessment process for
Adventist GlenOaks, Hinsdale and La Grange Memorial Hospitals, four focus groups were held
through Professional Research Consultants. In total, 31 key informants took part, including
physicians, other health professionals, social service providers, and other community leaders.
Each county-level group included representatives with expertise in public health.
3. Adventist Hinsdale sub-committee participation on the DuPage County Department of Public
Health MAPP initiative.
Local Health Departments with Current Data Relevant to the Health Needs of the Community Serviced
Full access to and integration of Public Health surveillance and assessment findings was completed to
guide assessment activities, provide comparative data, and assist in prioritization of health needs. Top
health priorities identified by Adventist Midwest Health County Health Departments follow:
Cook County
Chronic Disease Prevention
Sexual Health Improvement Youth
Violence Prevention – Youth
Violence
Access to Healthcare Services
Du Page County
Will County
Overweight/Obesity
Access to Healthcare
Asthma
Mental Health
Mental Health
Infectious Disease
Diabetes
Obesity
Behavioral Health and Substance
Abuse
35 | P a g e
Leaders, Representatives, or Members of Medically Underserved, Low-income, and Minority
Populations, and Populations with Chronic Disease Needs in the Community Served by the Hospital
1. Key informant groups noted above included community leaders and social service providers
representing and serving the medically underserved, minority, and chronic disease
communities. Focus groups for Cook County (Adventist La Grange Memorial Hospital) and
DuPage County (Adventist GlenOaksand Adventist Hinsdale Hospital) occurred on June 21st,
2012 and June 19th, 2012 respectively.
2. Primary data collection was completed through telephone survey, reaching a representative
sample of the Adventist Midwest Health primary and secondary service areas. This includes
members of the community who are medically underserved, low-income, minorities and who
have chronic disease needs.
3. Participation of community representatives on internal hospital operations committee charged
with oversight of the Community Health Needs Assessment process.
36 | P a g e
Prioritized Health Needs
Data Analysis
Assessment findings compiled from primary and secondary data sources were analyzed both in isolation
and through comparison of like measures. A spreadsheet was developed isolating each key health
indicator from across the reported health surveys. A determination was made whether the key
indicator measure was “exact” across the reported health surveys (e.g. the percentage of individuals
between 18 and 64 years of age stating that they lack health insurance coverage) or “relatable” (e.g.
age-adjusted cancer deaths, in which measurement criteria may have differed for the same key indicator
topic across reported health surveys).
The result is a comprehensive spreadsheet of thirty-eight (38) key health indicators comparing Adventist
Midwest Health primary data with the health surveys below (See Appendix B):
Healthy People 2020
Illinois Survey Data
US Survey Data
DuPage County Health Department Data
Cook County Health Department Data
Adventist Bolingbrook Hospital Primary and Secondary Data Collection through the Will County
MAPP Initiative
Adventist GlenOaks Hospital Primary Data Collection
Adventist Hinsdale Hospital Primary Data Collection
Adventist La Grange Memorial Hospital Primary Data Collection
Following comprehensive review of data outcomes, trends were identified and comparative analysis was
initiated by the Community Health Needs Assessment Committee, with keen focus on key indicators
that fell substantively short of Healthy People 2020 goals. Data and information from the County Health
Department MAPP initiatives was collated and related to above surveys, as well as the above-noted
National Surveys (Behavior Risk Factor Surveillance System and National Health and Nutrition
Examination Service). This additional comparative analysis provided a basis for further understanding
needs and recommendations for serving individuals residing within the Counties for each Adventist
Midwest Health Hospital. The data analysis was augmented with integration of internal hospital data
supporting the hospital’s key strategic initiatives, and how these initiatives may tie to opportunities to
benefit the Community (see below).
37 | P a g e
Summary of Comparative Analysis of Key Health Indicators
Primary Data Collection
Secondary Data
Internal Hospital Data
Chronic Disease Prevention
[hypertension, blood cholesterol]
X
X
X
Youth Services
X
X
X
Cancer Treatment
X
Violence Prevention
X
X
Awareness of Services
X
Behavioral Health and Substance Abuse
X
X
X
X
Diabetes
X
Pneumococcus Vaccination
X
Priority Selection
1. Community Health Needs Assessment Committee
Following data collection and initial analysis, Adventist Midwest Health Hospitals formed a
Community Health Needs Assessment Committee (Adventist GlenOaks, Hinsdale, and La Grange
Memorial Hospitals formed a committee representing all three hospitals to review data from
the Metropolitan Chicago Healthcare Council). Adventist Bolingbrook Hospital formed a
committee representing their hospital integration into Will County MAPP initiatives. The
Community Health Needs Assessment Committee includes hospital clinical and administrative
staff, as well as members representing the broader interests of the Community.
Committee Charter:
Review summaries of compiled health data and statistical information and provide input
on opportunities, trends, gap areas, and other conclusions that may be drawn from a
review of primary, secondary, quantitative data, and qualitative data.
Formulate determinations of health priorities that should be addressed in the
Assessment Period taking into account AMH resources and abilities to influence
outcomes with respect to identified priorities;
Consider possible opportunities for collaboration with other organizations, including
related organizations, other hospital organizations, and state and local health agencies;
38 | P a g e
Review and provide feedback on the written Community Health Needs Assessment
Report that will document sources and dates of health data, analytical methods applied
to the data, descriptions of the sources of community input, prioritized descriptions of
all community health needs identified and the process used in prioritizing needs;
Actively participate in development of an Implementation Strategy to address those
community health needs prioritized through the CHNA; and
Provide support and assist Adventist Midwest Health in ongoing cycle of assessing and
addressing Community Health needs and provision of meaningful benefit based on
those needs.
The Community Health Needs Assessment Committees identified Health Priorities from
identified Community Health Needs Assessment outcomes based on the following: (1) Would
the benefit, if provided, generate a low or negative margin; or (2) Does it respond to the needs
of special populations; or (3) Does the benefit supply services that would likely be discontinued
if the decision were made on a purely financial basis.
Top identified needs (those needs where Hospital, County, and State outcomes were markedly
lower than Healthy People 2020 goals) were the following:
Access to Healthcare
 Awareness of Services - Adventist Bolingbrook Hospital
 Access to Primary and Secondary Services – Adventist Bolingbrook Hospital
 Lack of health insurance - Adventist GlenOaks, Hinsdale, and La Grange
Memorial Hospitals
Prevention and Management of Chronic Care Issues
 Heart Disease [blood cholesterol levels]
 Pneumococcus Vaccine [65 years and older]
 Influenza Vaccination [18-64 years]
 Hypertension [over 18 years]
Youth Services [Adventist Bolingbrook Hospital]
The Community Health Needs Assessment teams narrowed the selected priorities using a
prioritization considerations that considered the following: (1) Does Adventist Midwest Health
have the ability to effectively meet the need?; (2) Is this service already offered in a manner that
supports need within or outside of Adventist Midwest Health?; (3) Is this a high-impact
priority—meaning, will it impact community health in a meaningful way?; and (4) Assets: Does
Adventist Midwest Health have the resources necessary to address this priority?
39 | P a g e
2. Tools used to support priority selection:
A Decision Tree Process assisted the Committee in reaching the Final Priority Selections:
YES.
With ACA,
increased
ability to
impact
Identified Need:
E.g., Lack Health
Insurance
What other groups
are working on this
need?
Many
Consider
collaborating with
others
Few
Seriously
consider this
as a Priority
Many
Hospital has
no role
Few
Encourage/support
others who are
meeting this need
Is the hospital able
to effectively meet
this need?
NO.
What other groups
are working on this
need?
An Impact Analysis Matrix whereby Committee Members discussed where on a four-quadrant
matrix a given priority would fall. The Committee was guided away from those priorities that
had lower overall impact on the Community, particularly if the related resource needs were
high.
High Impact on
Commuinity Low Resource
Need
High Impact on
CommunityHigh Resource
Need
Low Impact on
Community Low Resource
Need
Low Impact on
CommunityHigh Resouce
Need
40 | P a g e
3. Final Priority Selection
The Community Health Needs Assessment Committee chose the following priorities for the four
Adventist Midwest Health Hospitals.
Access to Healthcare [lack of insurance]: Consequences of loss of health insurance
include delayed diagnosis, decreased opportunities for effective treatment options at a
later stage of diagnosis, greater likelihood of spread of communicable disease and
health apathy. It is one of the most pressing health issues in America today, reaching
the needs of those with increased health risks and low resource availability. As
healthcare reform unfolds, Adventist Midwest Health will be in a unique position to
contribute to timely acquisition of health insurance for those with the most substantive
healthcare and financial needs through partnership with the Centers for Medicare and
Medicaid Services.
Access to Healthcare [lack of awareness of services – Adventist Bolingbrook Hospital]:
Primary data collected in the Bolingbrook zip codes indicate that respondents (both in
individual written surveys and in focus groups) are not aware of the resources in the
community that are available to meet their health-related needs. This is of substantive
importance to overall health of the Community. The MAPP Initiative provides a forum
of public and private Community advocates that have an ability to make a high impact
on the Community with relatively low resource efforts related to marketing of available
services to those with the most substantive needs.
Influenza Vaccination [18-64 years]: According to the CDC, routine annual influenza
vaccination is recommended for all persons aged ≥6 months. The risks related to
influenza are highest for those over 65 years of age. However, in Illinois and Adventist
Midwest Health Communities, it is the adult population under 65 that falls substantively
below the Healthy People 2020 goal for receipt of the vaccination. Further, the CDC
reports that although younger adults typically experience a less severe influenza and
there is less frequent hospitalization than very young and very old people, it was
determined in a study of 18-49 year olds (through one reported economic modeling
analysis) to cause five million illnesses, 2.4 million outpatient visits, thirty-two thousand
hospitalizations, and 680 deaths. Impact on the individual, the Community, the
healthcare system, and the Government (for those individuals receiving government
funded care) is high. Further, for those adults aged 18-64 who are not vaccinated, the
potential for infecting more vulnerable populations is higher creating more critical
impact on individuals and the Government.
Pneumococcus Vaccine [65 years and older]: According to the CDC, invasive disease
from pneumococcus is a major cause of illness and death in the United States, with an
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estimated 43,500 cases and 5,000 deaths among persons of all ages in 2009. Rates of
infection do vary, with infants, children and older adults being at highest risk. Eightyfour percent of those who are infected and nearly all deaths occurred in adults. While
studies regarding the effectiveness of the pneumococcus vaccine do vary, most are
consistent relative to positive benefits obtained by older adults. Individuals with
financial need and decreased access to care are less likely than the insured to be
vaccinated. Efforts to raise awareness and provide vaccination to those in need leads to
potential for preserved health status and decreased risk for pneumonia-related
hospitalization or death. A single vaccine in an underprivileged adult who would have
otherwise developed pneumonia can save a life and relieve the Government of
preventable and costly medical care.
Hypertension [over 18 y/o): High blood pressure can lead to damage of blood vessels,
heart, kidneys, and other organs in the body. Heart disease and stroke, both caused by
high blood pressure, are the first and third leading causes of death in the U.S.
Twenty-eight percent of adults in Illinois have high blood pressure, but because it is
“silent” (signs of high blood pressure are often not perceived), there are many more
adults who live life undiagnosed. The poor and those with decreased access to care are
less likely to be diagnosed than those with the financial means to receive regular health
checkups. The outcome for those left unchecked is escalation of disease, further
damaging organ systems that results in decreased quality of life, as well as increased
burden on the Government to pay for care that could have been avoided with
appropriate screening.
4. Measures Not Finally Selected for Priority: The following measures were not finally selected for
priority based on the following:
Access to Healthcare : Access to Primary and Secondary Services – Adventist
Bolingbrook Hospital
Rationale: During this assessment period, Adventist Bolingbrook Hospital, in
conjunction with VNA, opened a Federally Qualified Healthcare Center on the hospital
campus, increasing healthcare access to primary and secondary health services for those
community members with financial need.
Prevention and Management of Chronic Care Issues : Heart Disease [blood cholesterol
levels]
Rationale: While this tested well on the Impact Analysis Matrix, using the Decision Tree,
it was determined that this is a commonly available prevention measure at most
surrounding providers. It is frequently a part of community health fairs and routine
physician visits.
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Rationale: Adventist Midwest Health provides comprehensive inpatient programs for
behavioral health (Adventist GlenOaks Hospital and Adventist Hinsdale Hospital) and
outpatient programs for both behavioral health and substance abuse (Adventist
Hinsdale Hospital). Serving the Adventist Midwest Health Community, the Hospitals
support County initiatives to bring these necessary services to those in need. Prioritizing
Access to Care as one of the selected Health Priorities will assist Adventist Midwest
Health in extending services for those who currently lack such access.
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Measures and Resources for
Implementation
Measures
Measures of success for each identified health need priority will be developed by the Community Health
Needs Assessment Committee following a full review and discussion of related implications. The
Implementation Strategy (Community Health Plan) developed based on the outcomes of this
Community Health Needs Assessment will contain goals, objectives and indicators:
1. Goals: Goals are broad statements describing your anticipated accomplishments (e.g. decrease
incidence of influenza among people 65 years of age and over).
2. Objectives: The objective describes what specific change is expected following implementation
of a strategy. According to the Centers for Disease Control, objectives should be SMART
(Specific, Measurable, Achievable, Realistic, and Time specific).
3. Indicator: The measurement used to determine success in meeting the objective.
Resources
As stated above, the Chicago Metropolitan area is home to 119 hospitals. Duplication of service and
availability of like resources to meet community need is evident. Key to successfully meeting health
needs identified in this Community Health Needs Assessment is leveraging these services and resources
in a manner that has the highest impact on community health with appropriate preservation of
resources.
This may be accomplished through:
1. The benefit of full organizational support through Mission and through Executive Leader active
participation in the Community Health Needs Assessment Process.
2. Careful review of existing Community Partners to identify potential for shared resources to meet
prioritized health needs.
3. Aligning the opportunities and challenges across Adventist Midwest Health Hospitals to best
target healthcare needs of the most medically fragile: those in financial need, and those who
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lack access to service. This may result in pooling of the hospitals’ resources to provide care in
pockets of the service area closest to the hospitals with the highest indigent population.
4. Participation in Metropolitan Chicago Health Care Council’s efforts to grow collaborative efforts
among member hospitals. These planning efforts are in their infancy, with potential for shared
healthcare priorities across the Chicago-land area and/or coordination of effort to reduce waste
in provision of benefit.
5. Participation in County Health Department MAPP initiatives to coordinate implementation of
action plans for improved community health.
6. Redistribution of community benefit spending: Based on the identified health needs in this
assessment, recommendations from the Community Health Needs Assessment Committee will
likely lead to changes in how community benefit dollars are directed at Adventist Midwest
Health.
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CHNA Contacts
The organizational contact for this Community Health Needs Assessment is the Adventist Midwest
Health Compliance and Privacy Officer.
Contact Information:
Anne Herman
Adventist Midwest Health
Corporate Compliance
15 Spinning Wheel Road; Suite 118
Hinsdale, IL 60521
Office: (630) 856-4572
anne.herman@ahss.org
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Adventist Midwest Health: 2013 Community Health Needs Assessment

Transcription

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