The Heart of New Ulm: Population Health Takes a Village Rebecca Lindberg, MPH, RDN Karen Moritz, RN, BSN, PHN Cindy Winters March 21, 2018
Housekeeping Items All attendees are currently muted. Use the “raise hand” icon to raise your hand. We can unmute you for the Q&A. The slides are available for download in the “Handouts” section on your control panel . Use the “Questions” panel to ask questions and submit comments throughout the presentation.
… PHF Mission : We improve public health and population health practice to support healthier communities www.phf.org Experts in Quality Improvement, Performance Management, and Workforce Development
Public Health Foundation Improving public health and population health practice to support healthier communities Get Involved with the Council on Linkages See the Latest Tools for Using the Core Competencies for Public Health Professionals Learn about and Join the Academic Health Department Learning Community Provide feedback on the draft Population Health Competencies http://www.phf.org/resourcestools/Pages/Population_Health_Competencies.aspx Visit PHF’s Resources on Performance Improvement Solving Population Health Problems through Collaboration www.phf.org/populationhealthbook Performance Management Toolkit www.phf.org/PMToolkit Public Health Quality Improvement Encyclopedia www.phf.org/qiencyclopedia Public Health Improvement Resource Center Subscribe: www.phf.org/improvement www.phf.org/newsletters
Public Health Foundation Improving public health and population health practice to support healthier communities Increase Your Skills with Quality Training on TRAIN Training Plans of Vetted Courses are on TRAIN www.phf.org/trainingplans Access On-site Assistance from PHF Experts Technical Assistance and Training www.phf.org/piservices
Poll #1 Tell Us About Your Organization
Poll #2 Tell Us About Your Partnerships
Today’s Webinar Presenters Rebecca Lindberg, Rebecca Lindberg, MPH, RDN , RDN Director, Population Health & Professional Education Minneapolis Heart Institute Foundation Cindy Cindy Winter inters Manager, Heart of New Ulm Project Minneapolis Heart Institute Foundation Kar aren M en Moritz, oritz, RN RN, , BS BSN PHN PHN Director, Brown County Public Health
Objectives Understand how to Identify strategies Summarize a drive a community for leveraging data sustainable transformation to target and framework for agenda to propel engage those most community health as a shared at risk and sharing transformation value across data for community guided by the social community engagement and determinants of partnerships impact health
“A healthy person over a given decade will spend about two hours with their doctor. The idea that that two hours will determine their health for that decade is pretty unreasonable.”
Initial Partnerships Established
Primary Objectives Improve the proportion of 56073 zip code residents (age 40-79 years; active Allina health record) with controlled modifiable heart disease risk factors over 5 years. * 1. Elevated blood lipids (i.e., total/LDL/HDL cholesterol, triglycerides) 2. High blood pressure 3. Uncontrolled glucose (i.e., type 2 diabetes, pre-diabetes) 4. Obesity 5. Tobacco use 6. Physical inactivity 7. Low fruit/vegetable consumption 8. Uncontrolled stress 9. Medication underutilization/non-adherence
2009 Community Diagnosis | New Ulm 41% 35% 38% 17% Obese Overweight Metabolic Consumed 5 syndrome fruits and vegetables a day
Electronic Health Record & Community Surveillance Over 90% of New Ulm’s population has an active EHR Photo Credit : https://www.eclinicalworks.com/products-services/eclinicalworks-v10-ehr-suite/
Data Collection Strategy Electronic health Environmental assessments record Screening • data Risk factors • Physical environment • MI • • Nutrition environment Behavioral • Demographics • • Policy and environmental Health-related data assessment National/ Community Needs State/Local Data • MI • Resident • Police surveys Data Integration Plan • • Public health Focus groups • CNA for assessment, monitoring and communication Desired Impact
5 Year Changes in Risk Factors 2008/09 2012/13 n = 6082 n = 6388 193.4 ± 0.5 187.8 ± 0.5 Total Cholesterol (mg/dL) Cholesterol at Goal (< 200 mg/dL) 58.3 65.1 140.4 ± 1.1 132.4 ± 1.2 Triglycerides (mg/dL) Triglycerides at Goal (<150 mg/dL) 66.4 70.1 22.9 31.8 Lipid medication * Continuous outcomes are reported as mean ± standard error, and categorical outcomes are reported as percent. ** Residents age 40-79, adjusted for age and gender
Behavior Changes Among Screening Participants age 40-79 Measure 2009 2011 2014/15 (n = 3,123) (n = 1,976) (n = 1,008) Smoking 7.9 7.4 5.5 Physical Activity 63.9 73.1 76.2 (at least 150 minutes per week) Fruit and Vegetables 16.3 26.6 30.2 (5 or more servings per day) Screening analysis is age and gender adjusted to account for differential age and gender distributions in each screening time period.
Co Compa mparison rison of of HO HONU NU C Cha hang nges es to to NH NHANES ANES NHANES NHANES NHANES HONU HONU HONU 2009-10 2011-12 Change 2008-09 2012-13 Change BP at goal 83.1% 82.5% -0.6 79.3% 86.0% +6.7 (<140/90 mmHg) BP medication 35.2% 36.8% +1.6 38.3% 47.6% +9.3 LDL at goal 64.3% 63.7% -0.6 68.0% 72.0% +4.0 (< 130 mg/dL) Cholesterol at goal 47.5% 46.9% -0.6 58.3% 65.1% +6.8 (<200 mg/dL) Not Obese 62.5% 62.3% -0.2 55.9% 55.2% -0.7 (BMI <30) NHANES data selected for participants age 40-79, white non-Hispanic to provide a comparison group similar to New Ulm resident demographics, sample weights applied for analysis
New Ulm versus Comparison Community Managed better: Blood pressure Total cholesterol Triglycerides
10 Year + Project Healthcare Worksite Community
Intervention Strategy Smoking policies, Complete Streets Policy, City Comprehensive Plan Program partnerships, community events, community-wide health challenges, social marketing campaigns Interventions delivered through healthcare, employers, restaurants, grocery stores, convenience stores, and schools Interventions provide social connection opportunities, business leader engagement opportunities, Phone coaching, provider education & training, lipid clinic
Improving community health will require new models of collaboration
Sustainability Strategy From the beginning define: Agenda around common values and goals Partners’ roles and responsibilities Cost sharing responsibilities How interventions/strategies integrate into existing community structure Measureable outcomes Communication strategies Training needs Photo by rawpixel.com on Unsplash
Community Leadership Schools Public Local Grocery Health College Store Chamber Restaurant HONU Community Rep. Vision Health System City Medical Center Large Business Foundation
Sustainable Structure MHIF Allina Associated Allina Health Foundation Board Board NUMC Board NUMC Foundation HONU Action Team Executive Quality Committee Finance Committee Action Committee Team Action Action Action Action Team Team Team Team Action Action Action Action Action Team Team Team Team Team
Capacity Building
National Leadership Academy for the Public’s Health
DO frame your messages DO be teachable DON’T pull the obligation card President Chamber of Commerce
School Superintendent “ It takes all community members and families working together to promote healthy lifestyles. Through MHIF’s Heart of New Ulm Project we’re working on Safe Routes to School, Complete Streets, promoting fitness options, healthier concessions, and much more.”
City Government
Healthcare public health challenge
Systems and Environmental Improvements 2013 2014 2015 2016 2017 Conventional Bike 0 miles 1.5 miles 0 added 0 added 0 added Lanes Shared Lane 0 markings 0 markings 165 blocks 47 blocks of 49 blocks of Markings- approved sharrows sharrows Designated bike painted painted routes Percent of children NA 4% Safe Routes to 4% 4% commuting to School Plan school by bike launched Signage on bike 5 miles 5 miles 11 miles circle route (completed) Enhanced 0 1 0 0 Signage pedestrian added at 2 crossings Complete Streets Adopted Policy October 2016
Systems and Environmental Improvements 2009 2014 2015 2016 2017 Runs offered in 2 8 8 8 8 New Ulm Pieces of 0 pieces 5 pieces in 0 added 9 pieces in three parks 0 outdoor fitness one park equipment • walking & biking routes • Safe Routes to NA Developed Plan 2 Walk to School plan launched mapped and distributed School Days • Pilot testing wayfinding • Program Pop-Up signs to schools Project at 1 school HONU Bike Installed 25 bike racks Racks throughout community Bicycle NA NA Honorable Bronze level Friendly Mention designation Designation
Outdoor fitness equipment in 3 parks Secured snow removal on 2 different trails
Community Communications Strategy
Recommend
More recommend
