The Power of Collaboration- When Competitors Become Collaborators Community Indicators Consortium Conference
"A group becomes a team when each member is sure enough of himself and his contribution to praise the skills of others." Norman Shidle
It’s in our DNA… BayCare’s 2018 Community Benefit contribution was $462 million totaling 11% of annual operating revenue! Medicaid/Income-based Programs - $311 million Underinsured – Patients with some insurance but not enough to cover medical bills. Charity Care - $117 million Patients will have their medical bills waived if they fall under the criteria set in BayCare’s Financial Assistance Policy Unbilled Community Services - $34 million Health professional education, community health services, cash and contributions to community groups, and other services. All 3 of these are measured in un-reimbursed costs.
What is a Community Health Needs Assessment? ✓ Comprehensive analysis of health priorities ▪ Rigorous review of available data ▪ Focus on the voices of our community CHNA completed ✓ Develop Implementation Plan every 3 years ▪ Evidence based data driven interventions ▪ Impactful and measurable outcomes to improve health
Our New Vision New survey design Shared Implementation Strategy • County focus • Literacy Review • Validated Questions • Increased impact • Focus on emerging trends • Strong support from hospital leadership • Adverse Childhood Events and Boards • Food Insecurity • Housing instability • Opiate use • Social Isolation Boots on the ground
Leaning Into Collaboration Across the System Shared resources, Establish common regular and deliverables Identify and consistent address communication organizational Creating a needs shared vision
Does Strong Vision Ensure Success? Integrity We challenged the local industry norms Consistency Commitment • Never worked together Trust • Competing brands • Established a new standard for collaboration and accountability Listen Values Truth
Challenges Turn to Wins: Survey Methodology Representative sample- raising the bar • Weekly data review Shared contact lists to expand survey reach Internal alignment and support Deeper insight into community
Demographic Breakdown
Outreach • Faith Community Nurses • Community Health Team • Free Clinics •FQHC’s • Libraries • Local community events • Housing Authority • Barbershops • City/County connections • Tax Collectors Office
Improvement: Survey Numbers 19,534 Survey responses across our footprint 3,038 5,304 3,920 6,494 Balm!!!
Joint Prioritization Meetings
EXERCISE, NUTRITION & WEIGHT Childhood Risk Factors for Obesity Parent survey respondents who answered “NO” to the following: Do children living in your home… 29.4% of survey respondents who self-reported food insecurity Question Hillsborough Pasco Pinellas Polk Eat at least 3 servings of fruits and 25.1% 34.6% 27.9% 25.6% vegetables every day? 32.7% Hillsborough Exercise at least 60 minutes every day? 32.1% 38.0% 31.2% 32.7% 32.0% Pasco OVERWEIGHT OR OBESE RATES 2016 26.7% Pinellas Footprint Florida 27.4% Polk 64.7% 63.2% 31.0% 30.3% 30.5% 27.6% FOOD INSECURE INDIVIDUALS BY AGE (N = 4,597) Middle School Students High School Students Adults 1,004 981 968 902 453 230 59 18-24 25-34 35-44 45-54 55-64 65-74 75 or older 11,161 ED Visits including a 8,413 ED Visits for diagnosis of Congestive Uncontrolled Diabetes Heart Failure In the last 12 months, did you or anyone living in your home ever get emergency food from a church, a food pantry, or a food bank, or eat in a soup kitchen? Zip codes with the highest number of ED visits across the system 13.0% responded ‘yes’ Top Zip Codes Winter Haven 33881 SURVEY RESPONDENTS WITH CHILDREN IN THE HOME WHO Winter Haven 33880 SELF-REPORTED FOOD INSECURITY (N = 2,019) Bartow 33830 39.4% (N = 714) 38.5% (N = 353) 33.5% (N = 488) 33.0% (N = 464) Plant City 33563 Clearwater 33756 Dunedin 34698 Hillsborough County Pasco County Pinellas County Polk County
2019 Top Health Priorities 1 2 3 Exercise, Behavioral Access to Nutrition & Health Healthcare Weight
Social Determinants to Health: Food Insecurity In the last 12 months, did you or anyone 29.4% of respondents living in your home ever get emergency food from a church, a food pantry, or a self-reported food insecure food bank, or eat in a soup kitchen? 13.0% responded ‘yes’ Food Insecure Individuals by Age 1,200 1,000 800 600 400 200 0 18-24 25-34 35-44 45-54 55-64 65-74 75 or older
Social Determinants to Health: Unstable Housing Has there been any time in the past 2 Are you worried or concerned that in years when you were living on the street, the next 2 months you may not have in a car, or in a temporary shelter? stable housing that you own, rent, or stay in as part of a household? 5.1% responded ‘yes’ 10.2% responded ‘yes’ Hillsborough and Pinellas: 6.0% Hillsborough: 12.1%
Social Determinants to Health: Social Isolation Social Isolation Questions % Disagreed "I am happy with my friendships and 8.2% relationships” “I have enough people I can ask for help 15.8% at any time” "My relationships are as satisfying as I 16.3% would want them to be"
Adverse Childhood Experiences Percentage of survey respondents reporting four or more Adverse Childhood Experiences: 28.2% OR 4,208 Respondents
Self Harm Over the past 12 months, how often have you had thoughts that you would be better off dead or of hurting yourself in some way? 11.6% OR 1,814 Respondents Indicated they had these thoughts several days, more than half of the days or nearly every day over the last 12 months.
BayCare Health System ED Utilization Mental Health and Substance Abuse 2018 Mental Health and Substance Abuse ED Utilization: Repeat Visits 9000 8417 2018: 78,715 ED Encounters 8000 7000 Number of Individuals 6000 5000 4318 4000 Repeat Visits: 3000 2250 2000 2,250 individuals with 5+ visits 1000 0 2 Visits 3-4 Visits 5 or More Visits
Heat Maps: ED Utilization for Uncontrolled Diabetes
Every Voice Matters
“If you are working on something exciting that you really care about, you don’t have to be pushed . The vision pulls you .”
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