Transcript Beyond the Status Quo: Building Effective Coalitions

Beyond the Status Quo:
Building Effective Coalitions
Mimi Baugh, MSN
Angelo State CareGiver Research Institute
Crystal Conner, MA
Shannon Medical Center
Population 110,224
 13.9% population 65 years
old or older
 57% White, non-Hispanic
36.3% Hispanic
6.7 % Other
 24.3% Uninsured
 75.7% Insured
 20.4% Medicaid
 13.6% Medicare
Source: US Census, 2010, Small Area Health Insurance Estimates; Department of State Health Services, County
Health Facts; Texas HHSC Medicaid Enrollment by County, November 2012.
Population 110,224
 From 2006-2011, adult
residents (18+) of Tom
Green County received
$214,677,910 in charges
for hospitalizations that
were potentially
preventable.
Source: US Census, 2010; Department
of State Health Services
Preventable Hospitalizations
 Hospitalizations for the conditions selected are called
“potentially preventable,” because if the individual
had access to and cooperated with appropriate
outpatient healthcare, the hospitalization would likely
not have occurred.
Source: Center for Health Statistics, Texas Department of State Health Services
Selected Conditions
Condition
Definition
Bacterial Pneumonia
A serious inflammation of the lungs caused by an
infection. Bacterial pneumonia primarily impacts older
adults.
Urinary Tract Infection (UTI)
Usually caused when bacteria enter the bladder and
cause inflammation and infection. It is a common
condition, with older adults at highest risk. In most
cases, an uncomplicated UTI can be treated with proper
antibiotics.
Chronic Obstructive
Pulmonary Disease (COPD)
Characterized by decreased flow in the airways of the
lungs. It consists of three related diseases: asthma,
chronic bronchitis and emphysema. Because existing
medications cannot change the progressive decline in
lung function, the goal of medications is to lessen
symptoms and/or decrease complications.
Source: Center for Health Statistics, Texas Department of State Health Services
Financial Impact 2005-2010
Potentially
Preventable
Hospitalizations for
Adult Residents of
Tom Green County,
Texas
Number of
Average Total
Hospitalizations Hospital Hospital
2005-2010.
Charge Charges
Hospital Charges
Divided by 2010
Adult County
Population
Bacterial Pneumonia
2,666
$21,876
$58,322,558
$692
Urinary Tract Infections
1,445
$15,182
$21,938,091
$260
Chronic Obstructive
Pulmonary Disease
1,396
$21,226
$29,631,897
$352
Source: Center for Health Statistics, Texas Department of State Health Services
• Administrative agency for
County Indigent Program,
serving approx. 1,400 clients
• Provides case management
• Agreement with local
providers for indigent health
services
• Fiscal agent for Preventable
Hospitalizations project
•
•
•
•
•
Full Continuum of Care—Independent
Living, Memory Care, Long Term Care,
Skilled Nursing, Home Health, Hospice,
Peace of Mind Program, Rotary House
of Hope, and Outpatient Therapy
Unique concept of Continuum of Care
found nowhere else in this area
100 acres, 600 residents, 300+
employees
Has served the Concho Valley area
since 1951
A leader in innovation with many
different options in various Senior
Living areas
• 171-bed acute care hospital
• Designated Level III Trauma Center
• Concho Valley's only accredited
Chest Pain Center
• Concho Valley’s only accredited
Congestive Heart Failure facility
• Comprehensive Heart and Vascular
program, including open heart
surgery
• Robotic-assisted surgery
• Level III-A Neonatal Intensive Care
Unit
• The leader and advocate in
facilitating supportive services and
opportunities that enable older
citizens to be able to live more
independently and productive
• One of 28 Area Agencies in Texas
• The region covers over 16,000
miles and approximately 112,000
citizens
• Locally sponsored by the Concho
Valley Council of Governments
•
•
•
•
•
•
409-bed safety net hospital
Over 225 providers
Locally owned non-for profit
medical center and clinic
With more than 20 locations,
Shannon provides a range of
services for Tom Green and 18
surrounding counties
The lead Level III Trauma Center and
Air Med 1 air ambulance serving a
200-mile radius
The primary stroke center for the
region
•
•
•
Serves older adults, frail elders, caregivers,
and all people providing care to others
The main focus is helping those providing
care to others and education of nurses
specifically taking care of the elderly or
working in long-term care settings
The mission of CRI is to ensure that we
have caregivers, both formal and informal,
who are well-equipped to care for this
distinctive group. CRI draws from many
campus resources, and a variety of nursing
specialties, to help caregivers and nurses
provide exceptional care to older adults
Teach a man to fish.
Assets
Resilience
Sustainability
Partnering Organizations






Intrepid Home Health
Odyssey Hospice
Meals for the Elderly
Myer’s Drug
Disability Connections
Relative Marketing &
Design
 Sam’s Club
 San Angelo Standard
Times
 KIXY radio
 KKCN radio
 KLST/KSAN news
Collective Impact: Rules of Engagement
Framework for Success
Common Agenda
All participants have a shared vision for change
including a common understanding of the problem and
a joint approach to solving it through agreed upon
actions.
Shared Measurement
Collecting data and measuring results consistently
across all participants ensures efforts remain aligned
and participants hold each other accountable.
Mutually Reinforcing Activities
Participant Activities must be differentiated while still
being coordinated through a mutually reinforcing plan
of action.
Continuous Communication
Consistent and open communication is needed across
the many players to build trust, assure mutual
objectives, and create common motivation.
Backbone Support
Creating and managing collective impact requires a
separate organization(s) with staff and a specific set of
skills to serve as the backbone for the entire initiative
and coordinate participating organizations and
agencies.
Common Agenda
 Not a transfer of costs Savings to one
organization is savings to all
 Organizations serve similar populations
Collaboration of efforts
 Support from organizational leaders
Relationships based on shared objectives
 Commitment to improving health in Tom Green
County
Shared Measurement
 DSHS Data brought it to our attention
 DSHS defined the data sets
 Allowed for comparisons among the community
 DSHS defined accountability (interventions are
evidence-based efforts are targeted)
Mutually Reinforcing Activities





Differentiated interventions with coordinated efforts
Public events, provider conferences, immunization clinics
Print Ads
Billboards
Online Media (Website, Facebook, Patient Channel)
Interventions: Events






April 2012 Public Event
October 2012 Provider Event
October 2012 Heloise Public Event
Heart of Texas Conference on Aging
Speakers Bureau
Health Fairs/Events
Education Events
Interventions: Immunization Clinics





Area Agency on Aging
Station 618 Senior Center
Diabetes Update Seminar
Sunset Mall Health Fair
Friday Immunization Clinics
Interventions: Education Materials








Hand Sanitizer
Hydration Cups
Hydration card (urine)
Rack Cards in Spanish & English
Immunization Records (lifetime & adult)
Walking booklet
COPD Consult, Harvard Health Publications
COPD Manuals, UT Tyler
Interventions: Media
 Television, radio, newspaper, classifieds coverage and
print ads
 Stethoscoop & Heartbeat, hospital newsletters
 Health Beat Hospital Magazine
 Direct mail
 www.tgcpartnershipforbetterhealth.org
 Patient Channel, The Wellness Network
 Facebook Page
Continuous Communication
 DSHS Roadmap
 Required monthly meetings; planning and status updates
 Monthly Technical Assistance calls with DSHS and 16
participating counties
 Two face-to-face meetings with 16 Counties in Austin and
DSHS experts/staff
 Sub-committee meetings
 Intervention Ad Hoc group meetings as needed, PRN
Backbone Support
Organization
Support
Valuable Impact
Educational/Clinical
expertise; Educational
Provider/Community
outreach
Perceived neutrality; Public
interest; Health education
expertise
Education/Community
Advocacy; Direct access to
target population
Public interest; Community
Outreach; Local
governmental entity.
Direct access to target
population; Strong
understanding of the issue
Public sector “seal of
approval”; Credibility
Backbone Support
Organization
Support
Valuable Impact
Financial resources;
Educational expertise;
Logistical support; Direct
access to target population.
Represent Private, Forprofit health care
corporation and providers;
Credibility
Financial resources;
Educational expertise;
Logistical support; Direct
access to target population;
Grant coordination
expertise.
Safety-net hospital; Private,
non-profit local provider.
Marketing/media expertise.
Internal communication;
Credibility.
Direct access to target
population; Strong
understanding of the issue;
Start-up funding; Logistical
support
Public sector/ local
governmental entity “seal
of approval”; Credibility;
Perceived neutrality.
Where are we now?





Provider/Public Education
Collateral materials
Website
Mobilized immunization resources
Center of educational expertise and resources
Bacterial Pneumonia Interventions
 5,459 high risk adults vaccinated for Bacterial Pneumonia
 17,228 high risk adults vaccinated for Influenza
 564 high risk adults educated on Bacterial Pneumonia and
ways to possibly avoid it
 12 education opportunities provided
 505 healthcare providers educated
 1,895 smoking cessation services provided
to high risk adults
Urinary Tract Infection (UTI)
Interventions
 305 high risk adults educated on UTI and ways to possibly
avoid it
 12 education opportunities provided to the general
population
 505 healthcare providers educated
Chronic Obstructive Pulmonary
Disease (COPD) Interventions
 1,594 adults diagnosed with COPD vaccinated for Bacterial
Pneumonia
 1,169 adults diagnosed with COPD vaccinated for Influenza
 1,998 adults diagnosed with COPD educated on the condition
and ways to manage it
 2652 adults educated on COPD and ways to manage it
 505 healthcare providers educated
 2,260 diagnosed with or at risk for COPD
provided with smoking cessation services
Success begets MORE success
Sustainability + Assets = Resilience
Resilience = Effectual Change
Effectual Change  Improved
Community Health
Opportunities/Future Efforts
 “Train the Trainer” program for long-term care &
assisted living facilities
 Collaborate with existing events and organizations
 Promote the website and Facebook page
 October 18, 2013: Provider Education
 Look for additional funding/support
The Status is not Quo.
Contact Information
Mimi Baugh, MSN, RN-BC, RAC-CT
Director, Caregiver Research Institute, Angelo State University
325.486.6607 [email protected]
Crystal Conner, MA
Regional Health Coordinator, Shannon Health & Wellness
Shannon Medical Center
325.657.5677 [email protected]