Community Health Improvement Plan 2019 - 2021 Edmonds Campus - Swedish ...
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S W E D I S H H E A LT H S E R V I C E S
Edmonds Campus
Community Health
Improvement Plan
2019 – 2021
Edmonds
TABLE OF CONTENTS
CEO LETTER 1 COMMUNITY HEALTH IMPROVEMENT PLAN
EXECUTIVE SUMMARY 2 Summary of Community Health
Improvement Planning Process 10
MISSION, VISION, AND VALUES 3 Addressing the needs of
the Community:
INTRODUCTION 4
• Mental Health 10
Who We Are 4
• Obesity and Diabetes 12
Our Commitment to Community 4
• Homelessness 14
OUR COMMUNITY 6 • Drug Addiction 14
• J oint and Back Pain 15
Definition of Community Served 6
• M ental Health —
Age 6
Inpatient Ligature Reduction 16
Ethnicity 6
• O besity — Nutrition Services 17
Median Income 7
• O besity — Hospital Food Environment 18
Poverty 7
ther Community Benefit Programs
O
COMMUNITY NEEDS AND ASSETS and Evaluation Plan 18
ASSESSMENT PROCESS AND RESULTS 8
PLAN APPROVAL 20
APPENDIX 21A MESSAGE FROM OUR CEO
To Our Communities:
As outlined in our 2018 Community Health Needs Assessment, the following social determinants of
health emerged across the communities of all Swedish locations during the assessment process:
mental health, drug addiction, homelessness, obesity and diabetes, and joint or back pain.
We have completed the development of a Community Health Improvement Plan (CHIP) to specifically
address many of these barriers, including strategies and measures, towards making our community
a healthier place. The CHIP outlines the process of strengthening our existing programs across the
Swedish system along with identifying new programs and resources to support those, and build
and sustain our partnerships with key organizations to collaborate on solutions.
The next phase will involve broad implementation of the action plans details included in this
2019- 2022 CHIP, and monitoring and evaluating its short-term and long-term outcomes.
As CEO, I am proud to lead Swedish in creating health for a better world.
R. Guy Hudson, M.D., MBA
Chief Executive Officer
Swedish Health Services
1 | CHIP Edmonds Campus — 2019-2021EXECUTIVE SUMMARY
About the Community Health Needs 2019 - 2021 Community Health Improvement
Assessment Process Plan Priorities
Nonprofit hospitals, public health agencies, accountable As a result of the findings of our 2018 Swedish Edmonds
communities of health, and others are required by Community Health Needs Assessment (CHNA) and
federal law, state mandates, or agency policy to through a prioritization process aligned with our
conduct community health needs assessment every mission, resources and hospital strategic plan,
three to five years. This process involves reviewing Swedish Edmonds will focus on the following areas
community health data, identifying and prioritizing for its 2019-2021 Community Benefit efforts:
community health needs, and developing a community • Mental Health
health improvement plan. Historically, community health
needs assessments have been planned and conducted • Obesity and Diabetes
independently, but for the first time, stakeholders in King • Homelessness
and Snohomish Counties have aligned planning and
• Drug Addiction (campus specific)
assessment cycles to leverage resources and improve
collaboration for collective impact. • Joint and Back Pain (campus specific)
• Mental Health – Inpatient Ligature Reduction
Goal of the Community Health Needs Assessment (campus specific)
In April 2018, community members selected three to • Obesity—Nutrition Services (campus specific)
five priority areas of focus through a county-wide,
• Obesity—Hospital Food Environment
coordinated community health needs assessment
(campus specific)
process. This process provides us with the opportunity
to collaborate, identify community needs, and move in
the same direction as other organizations. By aligning
our resources with and leveraging the expertise of
community partners, our collective impacts in King
and Snohomish Counties is even greater. Additionally,
partners are well-positioned to align timelines and
coordinate future improvement cycles.
2 | CHIP Edmonds Campus — 2019-2021MISSION, VISION, AND VALUES
Our Mission EXCELLENCE: We set the highest standards for
Improve the health and well-being of each ourselves and our services. Through transfor-
person we serve. mation and innovation, we strive to improve the
health and quality of life in our communities. We
Our Vision commit to compassionate and reliable practices
Health for a Better World for the care of all.
Our Values DIGNITY: We value, encourage and celebrate
COMPASSION: We reach out to those in need. the gifts in one another. We respect the inherent
We nurture the spiritual, emotional, and physical dignity and worth of every individual. We recognize
well-being of one another and those we serve. each interaction as a sacred encounter.
Through our healing presence, we accompany INTEGRITY: We hold ourselves accountable to
those who suffer. do the right thing for the right reasons. We speak
JUSTICE: We foster a culture that promotes unity truthfully and courageously with respect and
and reconciliation. We strive to care wisely for our generosity. We seek authenticity with humility and
people, our resources, and our earth. We stand simplicity.
in solidarity with the most vulnerable, working to SAFETY: Safety is at the core of every thought
remove the causes of oppression and promoting and decision. We embrace transparency and
justice for all. challenge our beliefs in our relentless drive for
continuous learning and improvement.
3 | CHIP Edmonds Campus — 2019-2021INTRODUCTION
Since 1910, Swedish has been the region’s standard- Our Commitment to Community
bearer for the highest-quality health care at the best Swedish Health Services dedicates resources to improve
value. Our mission is to improve the health and the health and quality of life for the communities it
well-being of each person we serve. Swedish is the serves, with special emphasis on the needs of the
largest nonprofit health care provider in the greater economically poor and vulnerable. In the last five years,
Swedish spent more than $900 million in community
Seattle area with five hospital campuses: First Hill,
benefit. We are making investments that go beyond
Cherry Hill, Ballard, Edmonds and Issaquah. We also just the need for free and discounted care by improving
have ambulatory care centers in Redmond and Mill access to care and developing new ways to help people
Creek, and a network of more than 118 primary care stay healthy. In 2017, we spent almost $200 million on
and specialty clinics throughout the greater Puget community benefit programs, including $23.9 million
Sound area. on free and discounted care. The communities served
by Swedish hospitals are defined by the geographic
Who We Are origins of the hospitals’ inpatients. The Primary Service
Area (PSA) was determined by identifying the ZIP Codes
Swedish Health Services is an affiliate of the Providence for 70% of the hospitals’ patient discharges (excluding
St. Joseph Health. Providence St. Joseph Health is a normal newborns). The Secondary Service Area (SSA)
new organization created by the association between was determined by identifying the ZIP Codes for 71%
Providence Health & Services and St. Joseph Health to 85% of the hospitals’’ patient discharges. The service
with the goal of improving the health of the communities areas for all Swedish campuses focus on King County
it serves, especially those who are poor and vulnerable. and Snohomish County.
Together, our 111,000 caregivers (all employees) serve • Swedish Ballard is located at 5300 Tallman Avenue,
in 50 hospitals, 829 clinics and comprehensive range NW, Seattle, WA 98107. The PSA consists of 8 cities
of services across Alaska, California, Montana, New and 36 ZIP Codes. The SSA consists of 18 cities
Mexico, Oregon, Texas and Washington. In addition and 33 ZIP Codes.
to Swedish, the Providence St. Joseph Health family
includes: Providence Health & Services, St. Joseph • Swedish Edmonds is located at 21601 76th Ave. W.,
Health; Covenant Health in West Texas; Facey Medical Edmonds, WA 98026. The PSA consists of 5 cities
Foundation in Los Angeles; Hoag Memorial Presbyterian and 9 zip codes. The SSA consists of 6 cities and 9
in Orange County, California; Kadlec in Southeast ZIP Codes.
Washington; and Pacific Medical Centers in Seattle. • Swedish First Hill is located at 747 Broadway, Seattle,
Bringing these organizations together increases access WA 98122 and Swedish Cherry Hill is located at 500
to health care and brings quality, compassionate care to 17th Avenue, Seattle, WA 98122. These hospitals
those we serve, with a focus on those most in need. share the same service area. The PSA consists of
13 cities and 53 ZIP Codes. The SSA consists of 23
cities and 35 ZIP Codes.
• Swedish Issaquah is located at 751 NE Blakely
Drive, Issaquah, WA 98029. The PSA consists of
12 cities and 19 ZIP Codes. The SSA consists of
16 cities and 28 ZIP Codes.
Continued on the next page...
4 | CHIP Edmonds Campus — 2019-2021INTRODUCTION CONTINUED
Planning for the Uninsured and Underinsured One way Swedish Health Services informs the public
of FAP is by posting notices in high volume inpatient
Our aim is to provide quality care to all our patients,
and outpatient service areas. Notices are also posted
regardless of ability to pay. We believe that no one should
at location where a patient may pay their bill. Notices
delay seeking needed medical care because they lack
include contact information on how a patient can obtain
health insurance. That is why Swedish Health Services
more information on financial assistance, as well as
has a Patient Financial Assistance Program (FAP) that
where to apply for assistance. These notices are posted
provides free or discounted services to eligible patients.
in English and Spanish and any other languages that
Our charity care program provides a 100 percent are representative of 5% or greater of patients in the
discount to individuals and families between hospital’s service area. All patients who demonstrate
0-300 percent of the federal poverty level (formerly lack of financial coverage by third party insurers are
0-200 percent.) offered an opportunity to complete the Patient Financial
• For example, a family of four with a household income Assistance application and are offered information,
of approximately $75,000 or less would qualify. assistance, and referral as appropriate to government
sponsored programs for which they may be eligible.
In addition, for individuals and families between 301-400
percent of the federal poverty level, Swedish provides a
discount of at least 75 percent.
•F
or example, a family of four with a household
income of approximately $75,000 - $100,000
would qualify
5 | CHIP Edmonds Campus — 2019-2021OUR COMMUNITY
Definition of Community Served Among the Swedish campuses, the Edmonds service
area has the highest percentage of residents who are
Population for Total Service Area, 2017
non-Latino White (65.2%) and Hispanic or Latino (9.6%).
First Hill/ The Issaquah service area has the highest percentage
Ballard Edmonds Issaquah
Cherry Hill of Asians/Pacific Islanders (20.3%), and the Ballard
service area has the highest percentage of Blacks/African
Population 2,373,420 651,452 2,846,268 1,451,299
Americans (7.4%).
Source: Intellimed, ESRI, 2017
Among Swedish campus service areas, Issaquah has the Race/Ethnicity*
highest percentage of children (22.5%). Edmonds and
Issaquah service areas include percentages of children First Hill/
Ballard Edmonds Issaquah
higher than that of the county (21.1%). Edmonds has the Cherry Hill
highest percentage of seniors (14.1%) among Swedish
Non-Latino
hospital campuses, which exceeds the percentage of 61.6% 65.2% 61.4% 59.7%
White
21.1+16.6+21.82613.6
seniors in the county (13.6%).
Asian/Pacific
17.2% 16.4% 18.1% 20.3%
2017 Population by Age, King and Snohomish Counties Islander
Hispanic or
9.4% 9.6% 9.1% 8.4%
Latino
13.6%
21.1% 0-17 years Black/African
7.4% 5.4% 7.0% 6.8%
American
18-29 years
Two or more
26.9% 30-44 years 6.0% 5.9% 5.8% 5.3%
races
16.6%
45-64 years Other races/
3.6% 3.3% 3.5% 3.2%
ethnicities
21.8% 65 and older
Source: U.S. Census Bureau, American Community Survey, 2016; DP05
*Percentages total more than 100% as some persons selected more than one
race or ethnicity category.
First Hill/
Ballard Edmonds Issaquah Income Poverty
Cherry Hill
In the Swedish campus service areas, the median
Children,
20.5% 21.8% 21.0% 22.5% household income ranges from $69,153 in the Edmonds
ages 0-17
service area to $93,153 in the Issaquah service area. This
Adults, disparity in income might influence health outcomes.
65.9% 64.1% 65.5% 64.6%
ages 18-64
Continued on the next page...
Seniors,
13.6% 14.1% 13.5% 12.9%
65+
Source: US Census Bureau American Community Survey, B01003, 2016
6 | CHIP Edmonds Campus — 2019-2021OUR COMMUNITY CONTINUED
Median Household Income and Unemployment Rate Personal/Households Living at or Below Poverty Level
(COMMUNITY NEEDS AND ASSETS
ASSESSMENT PROCESS AND RESULTS
Summary of Community Needs Assessment Identification and Selection of Significant
Process and Results Health Needs
Secondary Data: Secondary data was collected Significant health needs were identified from the
from a variety of local, county, and state sources. Community Health Needs Assessment process.
Swedish then identified priorities for the Community
Data analyses were conducted at the most local level
Health Improvement Plan associated with the 2018
possible for the hospitals’ service areas, given the Swedish Edmonds CHNA. The priority health needs
availability of the data. were: Mental Health, Homelessness, Drug Addiction,
Primary Data: Stakeholder surveys and listening Obesity, and Diabetes.
sessions were used to gather data and information
Community Health Needs Prioritized
from persons who represent the broad interests of
the community served by the hospitals. Swedish Swedish Edmonds will focus on the following areas for its
2019-2021 Community Health Improvement Plan (CHIP):
conducted surveys to gather data and opinions from
community residents, and hospital leaders and staff • Mental Health
who interact with patients and families in the ED and • Obesity
specialty clinics. • Homelessness
• Drug Addiction (campus specific)
A full report and results of the 2018 Swedish • Joint and Back Pain (campus specific)
Edmonds Community Health Needs Assessment
• Mental Health – Inpatient Ligature Reduction
can be accessed at: https://www.swedish.org/~/ (campus specific)
media/Files/Providence%20Swedish/PDFs/Mis- • Obesity—Nutrition Services (campus specific)
sion/2018/CHNAEdmonds21419.pdf
• Obesity—Hospital Food Environment
(campus specific)
Continued on the next page...
8 | CHIP Edmonds Campus — 2019-2021COMMUNITY NEEDS AND ASSETS ASSESSMENT PROCESS AND RESULTS CONTINUED
Needs Beyond the Hospital’s Service Program
The following community health needs identified in the 2018 Swedish CHNA campus reports may not be addressed
as part of the current CHIP. An explanation is provided below:
BALLARD EDMONDS FIRST HILL/CHERRY HILL ISSAQUAH
Alcohol overuse Alcohol overuse Joint or back pain Homelessness
High blood pressure High blood pressure High blood pressure Cancer
Joint or Back Pain Joint or back pain Cancer Age-related diseases
Cancer Cancer Alcohol overuse Texting while driving
Smoking Stroke Age-related diseases Alcohol overuse
Age-related diseases Smoking Teeth/oral health issues High blood pressure
Stroke Asthma Smoking Environmental factors
Alzheimer’s disease/
Environmental factors Environmental factors Environmental factors
dementia
Texting while driving Texting while driving Stroke Teeth/oral health issues
Asthma Heart disease Asthma Asthma
Lack of access to
Teeth or oral issues Teeth/oral health issues Heart disease
needed medications
Crime Age-related diseases Texting while driving Stroke
Alzheimer’s disease/
Heart disease Crime Child abuse and neglect
dementia
Alzheimer’s disease/ Lack of access to Lack of access to Lack of access to
dementia medical providers healthy food medical providers
Lack of access to Alzheimer’s disease/
Crime Smoking
needed medications dementia
Lack of access to Lack of access to
Child abuse and neglect Heart disease
medical providers medical providers
Lack of access to Sexually transmitted
Child abuse and neglect Domestic violence
needed medications infections
Lack of access to a Lack of access to
Child abuse and neglect Domestic Violence
grocery store needed medications
Sexually transmitted Lack of access to
Domestic violence
infections needed medications
Sexually transmitted
Domestic violence
infections
Some of these areas are out of our scope of our address medical needs in housing situations, people
current community health program expertise, and may be able to stay housed longer.
other non-profits in the community are providing No hospital facility can address all the health needs
robust services. However, we see the interconnect- present in the community. We are committed to
edness of health, housing, education, and income. our mission through Swedish Community Benefits
If we can improve the health of our workforce, they granting program and partnering with like-minded
will be better caregivers and more able to contribute organizations in service to our community.
to the economic vitality of our service area. If we can
9 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN
Summary of Community Health Improvement Planning Process
Swedish Medical Center, Edmonds participated in the King County Hospitals for a Healthier Community
(HHC) as part of a countywide Community Health Needs Assessment. HHC is a collaborative of hospitals
and/or health systems in King County and Public Health-Seattle & King County.
1. INITIATIVE/COMMUNITY NEED ADDRESSED: MENTAL HEALTH AND WELLNESS
Goal (Anticipated Impact): Implement a new program Develop a psychology postdoctoral fellow training
that provides mental health peer support in Swedish program that provides mental health care in the Swedish
emergency departments (ED). This program will be community irrespective of patient’s ability to pay, while
adapted from the ED Connect program implemented by creating a much needed workforce to support integrated
Hoag Hospital Newport Beach ED in partnership with the behavioral health (BH) care.
National Alliance on Mental Health (NAMI). To accomplish Scope (Target Population): People in the Edmonds
this goal and implement a pilot project, Swedish will ex- community
plore partnering with Navos, one of the largest providers
of community mental health services in Washington State.
OUTCOME MEASURE BASELINE FY19 TARGET FY21 TARGET
Facilitate full implementation of Mental Health peer support 1 selected Swedish-wide
0
program in ED campus roll-out
Integrate program at Swedish recognized clinics without behav- N/A (new
2 clinics 2-4 Clinics
ioral health services (BHS) at a reduced cost measure)
STRATEGY(IES) STRATEGY MEASURE BASELINE FY19 TARGET FY21 TARGET
Construct a Swedish
Complete Swedish ED Plan for Swedish-
NAMI ED Connect 0 1 approved plan
Connect Plan wide roll-out
implementation plan
Swedish ED Connect plan Plan for Swedish-
Explore pilot with Navos 0 1 approved plan
collaborates with Navos wide roll-out
Initiate full
Set up for Swedish-wide Unfold ED Connect to the 1 campus in
0 Swedish-wide
system Swedish system 2019-2020
roll out in 2021
2019- Develop plan and have
In 2019, develop a successful recruitment of 2
psychology postdoctoral post-doctoral candidates to TBD – but
program for primary care provide services in 2020-2021 anticipate if
800-1000
that will serve anyone in Identify Swedish Primary Care program is
patient visits per
the Swedish community clinics in high need communities successful, we
0 postdoctoral
irrespective of their ability that do not currently have access can continue to
fellow per year
to pay, while creating a to behavioral health (BH) services expect 800-1000
(2020-2021)
much needed workforce (and have space for them to practice) patient visits per
to support integrated Visits with postdoctoral fellow fellow per year
BH care will be provided free of charge
for all patients
Continued on the next page...
10 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
STRATEGY(IES) STRATEGY MEASURE BASELINE FY19 TARGET FY21 TARGET
Adapt a workshop series that can
Conduct mental
be offered at hospital campuses 5 workshops per
health workshops in 0 5 workshops
for any individual in the community year per fellow
the community
to attend for free.
Continued
Each year postdoctoral fellows
recruitment of
will be trained in a system that
2 postdoctoral
provides high quality BH care. Recruitment of
Assemble next generation fellows per year
They will be a generalist that is 5 2 postdoctoral
of mental health providers (with hopes of
capable of meeting the needs fellows
accepting more
of all patients with a behaviorally
with adequate
influenced concern.
funding)
Evidence Based Sources Key Community Partners
Pingitore, D. P. (1999). Postdoctoral training in NAMI ED Connect:
primary care health psychology: Duties, observations, • Navos Behavioral Health Consortium
and recommendations. Professional Psychology:
Research and Practice, 30(3), 283-290. http://dx.doi. • HOAG Memorial Hospital Presbyterian
org/10.1037/0735-7028.30.3.283 Postdoctoral Fellow Training: Current relationships exist
Larkin, K. T., Bridges, A. J., Fields, S. A., & Vogel, M. E. between the Primary Care BH team and multiple local
(2016). Acquiring competencies in integrated behavioral universities.
health care in doctoral, internship, and postdoctoral
programs. Training and Education in Professional Resource Commitment
Psychology, 10(1), 14-23. http://dx.doi.org/10.1037/ NAMI ED Connect
tep0000099
• Leader and staff time to research and plan the pilot
Johnstone, B., Frank, R. G., Belar, C., Berk, S.,
Bieliauskas, L. A., Bigler, E. D., . . . Sweet, J. J. (1995). • Time for the peer counselors
Psychology in health care: Future directions. Professional (dependent on pilot plan)
Psychology: Research and Practice, 26(4), 341-365. Postdoctoral Fellow Training: This program would
http://dx.doi.org/10.1037/0735-7028.26.4.341 require at least a 0.5 FTE to adequately provide support,
supervision, leadership, recruitment, and program
Other Sources development. Additional resource commitment would
include clinic space and supplies.
Health Care Blog: https://thehealthcareblog.com/
blog/2019/03/14/healthcare-must-open-more-doors-to-
mental-health-patients/
Hoag and NAMI: https://www.hoag.org/about-hoag/
news-publications/heart-of-hoag/categories/fall-2018/a-
profound-beautiful-alliance-nami-and-hoag/
11 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
2. INITIATIVE/COMMUNITY NEED ADDRESSED: OBESITY AND DIABETES
Goal (Anticipated Impact): and risk of diabetes in diverse communities
• Increase awareness on the importance of healthy Scope (Target Population): Members of the community
eating and exercise contacted at public events, with focused outreach in
• • Reduce the prevalence of childhood obesity low-income communities
OUTCOME MEASURE BASELINE FY19 TARGET FY21 TARGET
Percentage of “at risk” community members (those
who screen positive for diabetes, prediabetes, or
with high glucose levels) who are given information 0% 50% TBD
for appropriate follow-up (Primary provider, Swedish
diabetes center, YMCA, other community clinics)
STRATEGY(IES) STRATEGY MEASURE BASELINE FY19 TARGET FY21 TARGET
Sponsor Urban
Funding: healthy living, well-
Games (See $5,000 in 2018 $20,000 in 2019 TBD
ness programs and outreach
description below)
Diabetes screening Number diabetes screening Hosted 4 tables in Host more than 4 TBD
and health education and health education tables 2018 covering the tables covering the
at Urban Games hosted at Urban Games following topics: following topics:
1. Prediabetes 1. Diabetes resources
screening tool and prediabetes
and education screening
2. Blood pressure 2. Blood pressure
and CPR 3. Ask the Medical
education Doctor or Registered
3. Swedish sports Nurse (brief consult
medicine on site)
4. Swedish Sports
Medicine
5. Expanded outreach
services
Prediabetes Number of community Glucose testing At least one At least one
screening at events where Swedish at three events community event community
community events participates by administering in 2018 for three Swedish event for all
prediabetes screenings and/ Prediabetes campuses during five Swedish
or glucose testing. Events screening quarters three and campuses
will include community in 2018 four community during quarters
outreach events and health outreach events 2019 three and four
fairs, including Swedish community
sponsored events, walks/ outreach events
runs, races, etc.
Offer monthly online # of views of monthly 745 views 1,000+ views TBD: Broaden
cooking classes Facebook Live cooking class (January Increase community community
through Facebook videos which are open to 2019 video) partner outreach and partner outreach
Live, #SwedishEats the community and promote awareness and awareness
healthy eating lifestyles
Continued on the next page...
12 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
Evidence Based Sources Resource Commitment
Centers for Disease Control and Prevention: • Fiscal contribution $5000
https://www.cdc.gov/healthyschools/obesity/facts.htm • Hours to set-up and staff tables at Urban Games
https://www.cdc.gov/prediabetes/takethetest/
https://www.cdc.gov/diabetes/pdfs/data/statistics/na- • Hours to set-up and staff tables at campus
tional-diabetes-statistics-report.pdf community events
American Diabetes Association: https://professional.
diabetes.org/sites/professional.diabetes.org/files/media/
URBAN GAMES INFORMATION
prediabetes.pdf
Urban Games’ vision is a bold community en-
Taking Control of Your Diabetes Conference and Health
gagement initiative that seeks to build community
Fair: https://tcoyd.org/tcoyd-bellevue-2019/
self-advocacy and individual self-agency centered
on health and wellness. Partnering with Youth
Other Sources
Centric, a social purpose organization, Urban
Swedish online cooking class videos (Swedish Eats): Games proposes the following goals and outcomes:
https://www.facebook.com/pg/swedishmedicalcenter/
• Engage 1,000 Urban Games Youth
videos/?ref=page_internal
Ambassadors in year round activities and
programs who are committed healthy living
Key Community Partners
and wellness practices.
• American Diabetes Association
• Develop a data-informed wellness baseline
• Garfield Community Center for each of the Youth Ambassadors
• Seattle Park and Recreation, City of Seattle for monitoring, coaching, and intervention,
as appropriate.
• Austin Foundation
• Track over 10M activity hours (1,000 UG
• Clean Greens and Fresh Bucks Youth Ambassadors x 30 minutes per day
• Seattle Chapter Jack n Jill, Inc. x over 365 days).
• Mary Mahoney Professional Nurses Association • Demonstrate through data analysis how a
• iUrban Teen focused community based effort can improve
health outcomes
• Treehouse
• Black Farmer Collaborative
• Northwest Kidney Center
• Asian Counseling Referral Services (ACRS)
Community Farm
13 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
3. INITIATIVE/COMMUNITY NEED BEING ADDRESSED: HOMELESSNESS
Goal (Anticipated Impact): Develop ongoing partnerships ally, this consortium will work to address upstream health
with community-based organizations and city and county needs, such as behavioral health, and social determinants
entities whose focus is homelessness and providing of health, such as employment.
support for families experiencing homelessness in King Scope (Target Population): Families experiencing
and Snohomish Counties. Build collaborative relationships homelessness or unstably housed (i.e. couch surfing)
to identify and develop strategies and pathways to reduce in King and Snohomish Counties.
homelessness and provide supportive housing. Addition-
OUTCOME MEASURE BASELINE FY19 TARGET FY21 TARGET
Develop collaborative 782 family households (2,624 individuals)
strategies focused on experiencing homelessness in King County (2018)1 House 10%
House 10% + of
moving a percent of 21 family households (60 individuals) experiencing of homeless
homeless families
the homeless families chronic homelessness in Snohomish County (2018)2 families
to stable housing.
STRATEGY
STRATEGY(IES) BASELINE FY19 TARGET FY21 TARGET
MEASURE
# of partners
Meet with housing advocates and 5 community 12 community
within the
community partners in King and partner partner TBD
campus
Snohomish Counties meetings meetings
communities
# of individuals Fully funded housing
in families with strategies align with
Initial
Fully integrated housing children in the Establish housing advocates
conversations
collaborative strategies with a point in time count housing and Swedish
with community
focus on unhoused families. identified as collaborative goals focused on
partners
experiencing families experiencing
homelessness homelessness.
Explore assets to invest in innovative
ways to provide transitional housing
to meet the needs of unhoused TBD TBD TBD TBD
families and partner with Providence
Supportive Housing.
Administer behavioral health services Establishing
and training and education resources TBD TBD targets in 6 TBD
to transition families to stable housing months
1 http://allhomekc.org/wp-content/uploads/2018/05/FINALDRAFT-COUNTUSIN2018REPORT-5.25.18.pdf
2 https://snohomishcountywa.gov/DocumentCenter/View/54339/2018-Point-In-Time-Report-PDF
Evidence Based Sources Key Community Partners
All Home: http://allhomekc.org/king-county-point-in- Plymouth Housing YWCA
time-pit-count/ Capitol Hill Housing Congregation for
Seattle/King County Coalition on Homelessness: Wellsprings the Homeless
http://homelessinfo.org/ West Seattle Help Link Vision House
Ballard Help Line Solid Ground
City of Seattle: https://www.seattle.gov/humanservices/
Mary’s Place Seattle Chamber of Com-
about-us/initiatives/addressing-homelessness
Seattle King County merce – Housing Connector
Resource Commitment Public Health Providence St. Joseph
City of Seattle Health
Swedish Community Health Investment Division
United Way Others
PSJH Housing Learning Collaborative
14 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
4. INITIATIVE/COMMUNITY NEED ADDRESSED: OPIOID USE DISORDERS, OPIOID WITHDRAWAL,
AND OPIOID OVERDOSE
Goal (Anticipated Impact): Initiate Suboxone therapy in Scope (Target Population): Edmonds ED patients who
the Edmonds Emergency Department (ED) to transition present with OUD, opioid withdrawal, and/or opioid
patients to the Suboxone clinic, Ideal Option, to assist overdose. Treat with evidence based guidelines for brief
in treatment of opioid use disorder (OUD) as outlined in education, intervention, and withdrawal management.
the Opioid Treatment Network Grant contract. Conduct Work with care team to navigate patients to a Suboxone
follow-up phone calls with all patients presenting with clinic for establishing care and maintenance Suboxone
opioid withdrawals or opioid overdose to offer recovery therapy.
supports and resources as outlined in the SURGE Grant.
FY19 FY21
OUTCOME MEASURE BASELINE
TARGET TARGET
Percent of patients that follow up from the emergency department (ED) to a
0% 50% 80%
medication assisted therapy service provider.
STRATEGY FY19 FY21
STRATEGY(IES) BASELINE
MEASURE TARGET TARGET
Begin opioid dependence # of opioid dependence treatments
0 10 20
treatment at Edmonds ED initiated per month at Edmonds ED
Behavioral Health Assessment
% of patients with follow-up appointments
Team (BHAT) schedules
scheduled at Ideal Option (# of patients with
follow-up appointments at 0% 100% 100%
follow-up appointments scheduled/ total # of
Ideal Option for every patient
patients referred for follow-up appointments)
who is induced in the ED
BHAT conducts follow-up
% of follow-up phone calls conducted after
phone calls on all patients who
discharge (# of follow-up phone calls conducted/
presented with opioid with- 0% 100% 100%
total # of patients with opioid withdrawal or
drawal or opioid overdose and
opioid overdose discharged from ED)
are discharged from the ED
Evidence Based Sources Key Community Partners
Substance Abuse and Mental Health Services Initially, Swedish Edmonds, Snohomish Health District,
Administration (SAMHSA): https://store.samhsa.gov/ Health Care Authority of Snohomish County, SAMHSA,
substances/opioids-or-opiates Ideal Option, Consistent Care. Eventually, will add other
Centers for Disease Control and Prevention (CDC): medication assisted therapy service providers.
https://www.cdc.gov/drugoverdose/index.html
Resource Commitment
University of Washington Alcohol & Drug Abuse Institute:
The BHAT and the ED physician group will be doing this
http://adai.uw.edu/confederation/default.htm
work 24/7 – anticipate 0 to 10 hours of work per week.
http://stopoverdose.org/
Ideal Option - 1 hour of work per week.
Washington Recovery Help Line: http://www.warecove-
ryhelpline.org/mat-locator/
The Start with One campaign: https://getthefactsrx.com/
15 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
5. INITIATIVE/COMMUNITY NEED ADDRESSED: JOINT AND BACK PAIN
Goal (Anticipated Impact): The goal is to increase par- seek to learn about effective surgical options for joint
ticipation in hospital sponsored, provider-led educational and back pain from multiple causes. Joint and back
seminars on surgical spine and joint options. pain was one of the top ten problem areas identified
Scope (Target Population): The target population for by Swedish Edmonds stakeholders in the Community
this initiative is residents within the service area who Health Needs Assessment (CHNA) primary data survey.
FY19 FY21
OUTCOME MEASURE BASELINE
TARGET TARGET
# people who attend spine and joint presentations at Swedish Edmonds 2018 - 8 20 TBD
STRATEGY FY19 FY21
STRATEGY(IES) BASELINE
MEASURE TARGET TARGET
Advertise spine and joint presentations # of advertised
at Swedish Edmonds in the local papers/ presentation schedules in 0 2 4
social media sites print and on social media
Communicate Swedish Edmonds spine
and joint presentations at local community # of brochures distributed 0 100 300
events
% of web-based
Explore feasibility of web-based patient
education video pilot 0% 50% 100%
education video pilot
implemented and rolled out
Collaborate with Swedish-wide service line
leaders to explore feasibility of partnering Implementation of collaborative
N/A TBD TBD
with local community organization to estab- functional restoration program
lish a functional restoration program
Evidence Based Sources Key Community Partners
Pre-operative patient education reduces length of stay Swedish Medical Group, Proliance Surgeons, Western
after knee joint arthroplasty: https://www.ncbi.nlm.nih. Washington Medical Group, Verdant Health Com-
gov/pmc/articles/PMC3293278/ mission, City of Lynnwood, City Of Edmonds, City of
The effectiveness of orthopedic patient education in im- Mountlake Terrace, Edmonds Senior Center, Lynnwood
proving patient outcomes: a systematic review protocol: Senior Center, Edmonds Beacon, My Edmonds News
https://www.ncbi.nlm.nih.gov/pubmed/26447013
Resource Commitment
Web-Based Patient Education in Orthopedics: Business Development 40 hours; Swedish Marketing
Systematic Review: https://www.jmir.org/2018/4/e143/ and Communications 20 hours; Provider 12 hours
16 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
6. INITIATIVE/COMMUNITY NEED ADDRESSED: MENTAL HEALTH - INPATIENT LIGATURE
REDUCTION PROJECT
Goal (Anticipated Impact): To create and maintain a Swedish Edmonds has a 25-bed inpatient mental health
ligature-free environment for inpatient psychiatry to unit. Average daily census is 24. In 2018 we admitted
reduce risk of suicide and self-harm. A ligature risk is 550 patients requiring acute mental health treatment.
anything that can be used for the purpose of hanging Patients are admitted on a voluntary basis and an invol-
or strangulation. This initiative will standardize use of the untary basis per court- ordered treatment.
suicide risk assessment tool in the Edmonds Emergency Suicide is a growing concern across the nation, and the
Department (ED) and reduce ligature risk for inpatient Joint Commission, Det Norske Veritas (the hospital
psychiatry patients. accreditation organization used by Swedish), Department
Scope (Target Population): Patient in the ED and of Health, and Centers for Medicare and Medicaid
inpatient psychiatry patients. Mental Health was one Services have mandated hospitals to assure that patient
of the top ten problem areas identified by Swedish care areas are ligature-free to reduce suicide risk.
Edmonds stakeholders in the Community Health Needs
Assessment (CHNA) primary data survey.
FY21
OUTCOME MEASURE BASELINE FY19 TARGET
TARGET
% of identified ligature risks reduced/eliminated 0% TBD TBD
EPIC will have this
Risk for Suicide is assessed
tool built into the
Standardized suicide risk assessment on patients in the ED using
new platform for use TBD
tool in the ED the Columbia Suicide Risk
on the inpatient unit
Screening Tool
starting in June, 2019
STRATEGY FY19 FY21
STRATEGY(IES) BASELINE
MEASURE TARGET TARGET
Conduct initial ligature risk assessment in the % of ligature risk
behavioral health unit assessment in the behavioral 100% N/A N/A
health unit completed
Develop process for periodic follow-up
TBD TBD TBD TBD
assessments at predefined intervals
Risk reduction strategies implemented TBD TBD TBD TBD
Evidence Based Sources Key Community Partners
Centers for Medicare and Medicaid Snohomish County Designated Crisis Responders
Washington Department of Health Compass Health
The Joint Commission on Accreditation Verdant Health
of Health Organizations NBBJ Architects
Det Norske Veritas
Resource Commitment
TBD
Swedish Health Services
17 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
7. INITIATIVE/COMMUNITY NEED ADDRESSED: OBESITY – INTEGRATE NUTRITION SERVICES
INTO SELECT PRIMARY CARE AND SPECIALTY CLINICS
Goal (Anticipated Impact): To integrate specialized Scope (Target Population): The target population for
nutrition services into the offices of select specialty and this initiative are residents within the service area who
primary care providers, providing in-clinic support one require nutrition service referrals. Obesity was one of the
to two times per month, to improve patient access to top ten problem areas identified by Swedish Edmonds
those services, patient compliance with nutrition service stakeholders in the Community Health Needs Assessment
referrals, and care coordination between family physicians, (CHNA) primary data survey.
specialty care physicians and registered dietitians.
FY21 TAR-
OUTCOME MEASURE BASELINE FY19 TARGET
GET
Launch limited scope trial in one specialty clinic N/A Launched trial in one specialty clinic TBD
Analyze trial data to determine effectiveness &
N/A Completed analysis of trial data TBD
feasibility of program expansion
Add additional locations to program, dependent on two
N/A N/A additional
trial data review locations
STRATEGY FY19 FY21 TAR-
STRATEGY(IES) BASELINE
MEASURE TARGET GET
Registered Dietician to work with
nursing staff to develop identification Completion of Completion of criteria
N/A N/A
criteria for patients who would referral criteria by July 1, 2019
benefit from nutrition services
Launch pilot in Wound Healing Number of
Clinic. Provide RD support two patients seen 0 10 TBD
days a month. by RD in clinic
50% of patients seen by RD
Blood glucose in clinic achieved improvement
RD to provide medical nutrition control in HBG A1C
therapy and augment chronic
Wound TBD TBD - The new instance TBD
disease management in the
healing of the electronic health records
outpatient setting
outcomes will allow for tracking of wound
healing outcomes
Evidence Based Sources Key Community Partners
Integrating nutrition services into primary care: https:// Swedish Medical Group
www.ncbi.nlm.nih.gov/pmc/articles/PMC1479497/
What’s Missing from Your Plate? Nutrition Services Resource Commitment
Integration in Primary Care: https://www.nwrpca.org/ RD 16 hours per month
news/339918/Whats-Missing-from-Your-Plate-Nutrition- Manager support 4-6 hours per month
Services-Integration-in-Primary-Care.htm
18 | CHIP Edmonds Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
8. INITIATIVE/COMMUNITY NEED ADDRESSED: OBESITY – IMPROVING HOSPITAL FOOD AND
BEVERAGE ENVIRONMENTS
Goal (Anticipated Impact): The goal of this initiative is Swedish Edmonds will be patients, visitors and Swedish
to create food and beverage environments to ensure Edmonds caregivers. Obesity was one of the top ten
healthy food and beverage options are the routine, easy problem areas identified by Swedish Edmonds stake-
choice for caregivers and visitors. holders in the Community Health Needs Assessment
Scope (Target Population): The target population for (CHNA) primary data survey.
Outcome Measure Baseline FY19 Target FY21 Target
Modify Café food and beverage environments to expand on fresh, seasonal
ingredients to replace less healthy options: % of total Café food and beverage TBD 20% 50%
offerings that are to be replaced with healthier choices
Modify inpatient food and beverage environments to expand on fresh,
seasonal ingredients to replace less healthy options: % of total inpatient food TBD 20% 50%
and beverage offerings that are to be replaced with healthier choices
FY19 FY21
STRATEGY(IES) STRATEGY MEASURE BASELINE
TARGET TARGET
Number of healthy foods sold
Smart Market Vending Machine (fruits, salad, yogurts) vs. non- TBD TBD TBD
healthy options (chips, candy, soda)
Reducing Café Portion Size Number of calories per serving TBD TBD TBD
100% on
% of fried food eliminated
Eliminate fried food from patient menus 0% May 14, 100%
from patient menus
2019
Evidence Based Sources Key Community Partners
Centers for Disease Control and Prevention: TBD
https://www.cdc.gov/obesity/strategies/hospital_p2p.html
Resource Commitment
TBD
Other Community Benefit Programs and Evaluation Plan
TARGET
INITIATIVE/COMMUNITY NEED POPULATION
PROGRAM NAME DESCRIPTION
BEING ADDRESSED (Low Income or
Broader Community)
Edmonds Food
Access & Food Security Edmonds Food Donations Low Income
Bank Donations
Access & Food Security Meals on Wheels Food Donation Low Income
Cancer Patients SCI Community Support Group Therapy Broader Community
19 | CHIP Edmonds Campus — 2019-20212019 CHIP GOVERNANCE APPROVAL
This community health improvement plan was adopted on May 14, 2019 by the authorized body of the hospital on
May 14, 2019. The final report was made widely available on May 15, 2019.
05/14/2019
____________________________________________________________________________________________________
R. Guy Hudson, M.D., MBA Date
Chief Executive Officer
Swedish Health Services
05/14/2019
____________________________________________________________________________________________________
Kristen Swanson, MSN Date
Chair Board of Trustees
Swedish Health Services
05/14/2019
____________________________________________________________________________________________________
Joel Gilbertson Date
Senior Vice President, Community Partnerships
Providence St. Joseph Health
05/14/2019
____________________________________________________________________________________________________
Sarah Zabel Date
Chief Operating Officer, Swedish Edmonds
CHNA/CHIP CONTACT
Sherry Williams, MPA Request a copy, provide comments or view electronic
Regional Director Community Health Investment copies of current and previous community health needs
Swedish Health Services assessments: https://www.swedish.org/about/overview/
206-386-3407 mission-outreach/community-engagement/communi-
206-386-6000 ty-needs-assessment/assessments-site-list
Sherry.williams@swedish.org
1 Per § 1.501(r)-3 IRS Requirements, posted on hospital website
20 | CHIP Edmonds Campus — 2019-2021APPENDIX
Definition of Terms which a campus organizes its key priority efforts.
Each effort should be entered as a program in CBISA
Community Benefit: An initiative, program or activity
Online (Lyon Software). Please be sure to report on
that provides treatment or promotes health and
all your Key Community Benefit initiatives. If a campus
healing as a response to identified community needs
reports at the initiative level, the goal (anticipated
and meets at least one of the following community
impact), outcome measure, strategy and strategy
benefit objectives:
measure are reported at the initiative level. Be sure to
a. Improves access to health services;
list all the programs that are under the initiative. Note:
b. Enhances public health;
All Community Benefit initiatives must submit financial
c. Advances increased general knowledge; and/or
and programmatic data in CBISA Online.
d. Relieves government burden to improve health.
Community benefit includes both services to the poor Program: A program is defined as a program or service
and broader community. provided to benefit the community (in alignment
with guidelines) and entered in CBISA Online (Lyon
To be reported as a community benefit initiative or Software). Please be sure to report on all community
program, community need must be demonstrated. benefit programs. Note: All community benefit
Community need can be demonstrated through programs, defined as “programs”, are required
the following: to include financial and programmatic data into
a. Community health needs assessment developed CBISA Online.
by the campus or in partnership with other
community organizations; Goal (Anticipated Impact): The goal is the desired
b. D ocumentation that demonstrates community ultimate result for the initiative’s or program’s efforts.
need and/or a request from a public agency or This result may take years to achieve and may
community group was the basis for initiating or require other interventions as well as this program.
continuing the activity or program; or (E.g. increase immunization rates; reduce obesity
c. The involvement of unrelated, collaborative tax- prevalence.).
exempt or government organizations as partners Scope (Target Population): Definition of group being
in the community benefit initiative or program. addressed in this initiative: specific description of
Health Equity: Healthy People 2020 defines health group or population included (or not included, if
equity as the “attainment of the highest level of health relevant) for whom outcomes will be measured and
for all people. Achieving health equity requires valuing work is focused. Identify if this initiative is primarily for
everyone equally with focused and ongoing societal persons living in poverty or primarily for the broader
efforts to address avoidable inequalities, historical and community.
contemporary injustices, and the elimination of health Outcome measure: An outcome measure is a
and health care disparities.” quantitative statement of the goal and should answer
Social Determinants of Health: Powerful, complex the following question: “How will you know if you’re
relationships exist between health and biology, genetics, making progress on goal?” It should be quantitative,
and individual behavior, and between health and objective, meaningful, and not yet a “target” level.
health services, socioeconomic status, the physical
environment, discrimination, racism, literacy levels,
and legislative policies. These factors, which influence
an individual’s or population’s health, are known as
determinants of health. Social determinants of health
are conditions in the environment in which people are
born, live, learn, work, play, worship, and age that
affect a wide range of health, functioning, and quality-
of-life outcomes and risks.
Initiative: An initiative is an umbrella category under
21 | CHIP Edmonds Campus — 2019-2021Edmonds
21601 76th Ave. W. We do not discriminate on the basis of race, color, national origin, sex, age, or
Edmonds, WA 98026
disability in our health programs and activities.
T 425-640-4000
www.swedish.org
© 2019 SWEDISH HEALTH SERVICES. ALL RIGHTS RESERVED. COMM-19-0205-B 5/19You can also read
