Community Health Improvement Plan 2019 - 2021 First Hill and Cherry Hill (Seattle) Campus - Swedish Medical Center
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S W E D I S H H E A LT H S E R V I C E S
First Hill and Cherry Hill
(Seattle) Campus
Community Health
Improvement Plan
2019 – 2021
TABLE OF CONTENTS
CEO LETTER 1 Summary of Community Health
Improvement Planning Process 10
EXECUTIVE SUMMARY 2
Addressing the needs of
MISSION, VISION, AND VALUES 3 the Community:
• Mental Health 10
INTRODUCTION 4 • Drug Addiction 12
Who We Are 4 • Obesity and Diabetes 13
Our Commitment to Community 4 • Homelessness 15
• D iabetes and Obesity –
OUR COMMUNITY 6 Prediabetes Screening 16
Definition of Community Served 6 • H omelessness – Medical Care
Age 6 in Homeless Encampments 17
Ethnicity 6 • M ental Health – Depression
Median Income 7 Screening and Mental Health
First Aid 18
Poverty 7
Other Community Benefit Programs
COMMUNITY NEEDS AND ASSETS and Evaluation Plan 19
ASSESSMENT PROCESS AND RESULTS 8
PLAN APPROVAL 20
COMMUNITY HEALTH
IMPROVEMENT PLAN 10 APPENDIX 21
A 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 First Hill and Cherry Hill 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 First Hill
communities of health, and others are required by federal and Cherry Hill Community Health Needs Assessment
law, state mandates, or agency policy to conduct (CHNA) and through a prioritization process aligned
community health needs assessment every three to five with our mission, resources and hospital strategic
years. This process involves reviewing community plan, Swedish First Hill and Cherry Hill will focus on
health data, identifying and prioritizing community health the following areas for its 2019-2021 Community
needs, and developing a community health improvement Benefit efforts:
plan. Historically, community health needs assessments
have been planned and conducted independently, but • Mental Health
for the first time, stakeholders in King and Snohomish • Drug Addiction
Counties have aligned planning and assessment cycles
• Obesity
to leverage resources and improve collaboration for
collective impact. • Homelessness
• Diabetes and Obesity (campus specific)
Goal of the Community Health Needs Assessment
• Homelessness (campus specific)
In April 2018, community members selected three to
• Mental Health (campus specific)
five priority areas of focus through a county-wide,
coordinated community health needs assessment
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 First Hill and Cherry Hill 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 transformation
person we serve. and innovation, we strive to improve the health
and quality of life in our communities. We commit
Our Vision to compassionate and reliable practices for the
Health for a Better World 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
people, our resources, and our earth. We stand and 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 First Hill and Cherry Hill 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 im-
value. Our mission is to improve the health and prove the health and quality of life for the communities
well-being of each person we serve. Swedish is the it 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
origins of the hospitals’ inpatients. The Primary Service
Who We Are
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
• Swedish Edmonds is located at 21601 76th Ave. W.,
includes: Providence Health & Services, St. Joseph
Edmonds, WA 98026. The PSA consists of 5 cities
Health; Covenant Health in West Texas; Facey Medical
and 9 zip codes. The SSA consists of 6 cities and 9
Foundation in Los Angeles; Hoag Memorial Presbyterian
ZIP Codes.
in Orange County, California; Kadlec in Southeast
Washington; and Pacific Medical Centers in Seattle. • Swedish First Hill is located at 747 Broadway, Seattle,
WA 98122 and Swedish Cherry Hill is located at 500
Bringing these organizations together increases access
17th Avenue, Seattle, WA 98122. These hospitals
to health care and brings quality, compassionate care to
share the same service area. The PSA consists of
those we serve, with a focus on those most in need.
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 First Hill and Cherry Hill 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 First Hill and Cherry Hill 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/ Income Poverty
Ballard Edmonds Issaquah
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 First Hill and Cherry Hill 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 Seattle (First Hill/Cherry Hill) CHNA. The
availability of the data. priority health needs were: Mental Health, Homelessness,
Primary Data: Stakeholder surveys and listening Drug Addiction, 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 First Hill and Cherry Hill will focus on the following
areas for its 2019-2021 Community Health Improvement
conducted surveys to gather data and opinions
Plan (CHIP):
from community residents, and hospital leaders
• Mental Health
and staff who interact with patients and families in
• Drug Addiction
the ED and specialty clinics.
• Obesity
The full report and results of the 2018 Swedish
• Homelessness
(Seattle) Cherry Hill/First Hill Community Health
• Diabetes and Obesity (campus specific)
Needs Assessment can be accessed at: https://
• Homelessness (campus specific)
www.swedish.org/~/media/Files/Providence%20
Swedish/PDFs/Mission/2018/CHNASeattle21419.pdf • Mental Health (campus specific)
Continued on the next page...
8 | CHIP First Hill and Cherry Hill 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 No hospital facility can address all the health needs
current community health program expertise, and present in the community. We are committed to
other non-profits in the community are providing our mission through Swedish Community Benefits
robust services. However, we see the interconnected- granting program and partnering with like-minded
ness of health, housing, education, and income. If we organizations in service to our community.
can improve the health of our workforce, they will be
better caregivers and more able to contribute to the
economic vitality of our service area.
9 | CHIP First Hill and Cherry Hill Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN
Summary of Community Health Improvement Planning Process
Swedish Medical Center, First Hill and Cherry Hill 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 creating a much needed workforce to support integrated
by Hoag Hospital Newport Beach ED in partnership behavioral health (BH) care.
with the National Alliance on Mental Health (NAMI). To Scope (Target Population): People in the Seattle
accomplish this goal and implement a pilot project, community
Swedish will explore 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 N/A (new
2 clinics 2-4 Clinics
behavioral 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-wide 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 BH services (and have space expect 800-1000
(2020-2021)
much needed workforce 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 First Hill and Cherry Hill 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 First Hill and Cherry Hill Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
2. INITIATIVE/COMMUNITY NEED ADDRESSED: SUBSTANCE ABUSE AND OPIOID USE DISORDER
Goal (Anticipated Impact): Initiate a pilot program at patients presenting with OUD with evidence-based
the Ballard Emergency Department (ED) to transition guidelines for withdrawal management.
patients with opioid use disorder (OUD) to a Suboxone Scope (Target Population): Initially, Ballard ED patients
clinic for treatment. This pilot will be modeled off of the who present with OUD. After the Swedish-system rollout,
Swedish Edmonds Suboxone program, which began patients who present in any Swedish ED with OUD. Re-
in January 2019. The goal is to address the identified ferral to a network of suboxone Medicaid waivered clinics
community need through enhanced treatment of (both Swedish and partners) will be offered to our patients.
OUTCOME MEASURE BASELINE FY19 TARGET FY21 TARGET
Percent of patients that follow up from the ED
0% 50%* 80%*
to a Suboxone clinic
*Targets modeled off of Swedish Edmond’s Suboxone program goals, although subject to change.
STRATEGY(IES) STRATEGY MEASURE BASELINE FY19 TARGET FY21 TARGET
Ballard pilot of best-practice
Continued full
OUD screening, treatment, Full implementation of Full implementation
N/A implementation
and referral from the ED to a Ballard pilot at Ballard
at Ballard
Suboxone clinic
Seven EDs all with
Swedish-wide implementation One additional Suboxone pathway
Number of campuses campus: Ballard
of best-practice OUD screening, One ED - for OUD (Edmonds
with implemented
treatment, and referral from the Edmonds Plan full Swedish- / Ballard / First Hill /
best-practices
ED to a Suboxone clinic wide roll out Cherry Hill / Red-
mond / Mill Creek)
Full participation in
Couple work with
Align with Community both North Sound TBD based on ACH
Accountable Communities of N/A
partners related to OUD and Healthier Here partnership
Health (ACH)
ED related OUD work
Evidence Based Sources Resource Commitment
Multiple guidelines including the WA Bree Collaborative Ballard Operations sponsored by Kasia Konieczny
Opioid Guidelines (Chief Operating Officer—Swedish Ballard), Quality
http://www.breecollaborative.org/topic-areas/cur- Division resources, Nursing and Social Work resources,
rent-topics/opioid/ Addiction Recovery team, Swedish Family Practice
Clinic at Ballard, and Clinical Transformation and
Key Community Partners Simulation Services.
Initial community partner for the pilot include Swedish
Ballard ED, Swedish Addiction Recovery Clinic at Ballard,
and Swedish Ballard Family Practice Clinic. After the
Swedish-wide roll out, partners will include multiple
agencies such as Federally Qualified Health Centers,
Behavioral Health Organizations, and others.
12 | CHIP First Hill and Cherry Hill Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
3. INITIATIVE/COMMUNITY NEED ADDRESSED: OBESITY AND DIABETES
Goal (Anticipated Impact): 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 low
• Reduce the prevalence of childhood obesity and 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 commu- At least one
screening at events where Swedish at three events nity event for three community
community events participates by administering in 2018 Swedish campuses event for all
prediabetes screenings and/ Prediabetes during quarters three five Swedish
or glucose testing. Events screening and four community campuses
will include community in 2018 outreach events 2019 during quarters
outreach events and health 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...
13 | CHIP First Hill and Cherry Hill 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
14 | CHIP First Hill and Cherry Hill Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
4. INITIATIVE/COMMUNITY NEED BEING ADDRESSED: HOMELESSNESS
Goal (Anticipated Impact): Develop ongoing partnerships Additionally, this consortium will work to address up-
with community-based organizations and city and county stream health needs, such as behavioral health, and
entities whose focus is homelessness and providing social determinants 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 in King and Snohomish Counties.
reduce homelessness and provide supportive housing.
OUTCOME MEASURE BASELINE FY19 TARGET FY21 TARGET
Develop collaborative 782 family households (2,624 individuals) experiencing
strategies focused on homelessness in King County (2018)1 House 10%
moving a percent of House 10% + of
21 family households (60 individuals) experiencing of homeless
the homeless families homeless families
chronic homelessness in Snohomish County (2018)2 families
to stable housing
Initial conversations with community partners
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 0 targets in TBD
to transition families to stable housing 6 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
15 | CHIP First Hill and Cherry Hill Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
5. INITIATIVE/COMMUNITY NEED ADDRESSED: DIABETES AND OBESITY—
PREDIABETES SCREENING
Goal (Anticipated Impact): Increase awareness of See system wide goal for obesity and diabetes for
individuals who are at risk for developing prediabetes system outcomes.
including screening (X) number of people. Identify Scope (Target Population): King County residents -
and acknowledge additional avenues for improving % of those identified with prediabetes (compare with
knowledge to reduce and prevent the risk of developing WA State)
type 2 diabetes.
FY19 FY21
OUTCOME MEASURE BASELINE
TARGET TARGET
# of people tracked and referred to Swedish diabetes education classes, 0 (new
TBD TBD
YMCA and Diabetes Prevention Programs (DPPs) measure)
0 (new
# of community health fair tabling events TBD TBD
measure)
STRATEGY FY19 FY21
STRATEGY(IES) BASELINE
MEASURE TARGET TARGET
# of people who attend
Employ American Diabetes Association
events (measure TBD
prediabetes screening tool digitally or on paper
depending on ability 0 TBD TBD
questionnaires to people at Swedish sponsored
to track completion of
events and health fairs
screening tool)
# of people connected
Engagement results for referral to providers,
to providers, education, 50 TBD TBD
education, and resources
and resources
Evidence Based Sources Resource Commitment: Diabetes educators and
Centers for Disease Control and Prevention: staff; Registered Dietitians; Swedish Bariatric, Metabolic,
https://nccd.cdc.gov/DDT_DPRP/Registry.aspx Endocrine Center staff
American Diabetes Association: http://diabetes.org/are-
you-at-risk/diabetes-risk-test/
Key Community Partners
American Diabetes Association, YMCA, Public Health—
Seattle & King County (CHNA Report)
16 | CHIP First Hill and Cherry Hill Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
6. INITIATIVE/COMMUNITY NEED ADDRESSED: COMMUNITY EDUCATION: HOMELESSNESS
Goal (Anticipated Impact): • Partner with Operation Night Watch/Point in
•R
educe the volume of patients currently taking Time Program to address the health concerns of
time in the Emergency Department (ED) that do individuals experiencing homelessness by providing
not have acute needs, and help direct them to medical triage in an identified sanctioned homeless
appropriate settings. encampment in partnership with community based
organizations.
•P
roactively support members in our community who
have health care needs, increase access to preventive Scope (Target Population): Partner with agencies/orga-
care resources and address their health concerns in nizations currently present in the community who have
real time to decrease avoidable ED visits. contact with individuals experiencing homelessness, and
evaluate opportunities to provide clinic support at health
fairs in partnership with those agencies’ interventions.
FY19 FY21
OUTCOME MEASURE BASELINE
TARGET TARGET
# of people treated at health fairs 0 TBD TBD
Impact volume of ED visits by providing minor medical outreach efforts in identified
TBD TBD TBD
locations supporting individuals experiencing homelessness
STRATEGY FY19 FY21
STRATEGY(IES) BASELINE
MEASURE TARGET TARGET
Partner with Operation Night Watch/Point in
Time and Swedish providers. Hold a health fair
twice a month and conduct health screens, # of people who are treated 0 TBD TBD
wound care, minor treatment of ailments such
as headaches, colds, coughs, etc.
Elevate awareness and advocate option of # of people who receive
using the Swedish County Doctor After-Hours information about the After-
Zero TBD TBD
Clinic at Cherry Hill and other Federally Hours Clinic or other Federally
Qualified Health Centers Qualified Health Centers
Evidence Based Sources Resource Commitment
Public Health—Seattle & King County CHNA, First Hill Family practice residents and providers, nurses, certified
and Cherry Hill data analytics - Tableau nursing assistants, ED techs, medical assistants, case
managers or social workers
Key Community Partners
Operation Night Watch/Point in Time, Public Health—
Seattle & King County
17 | CHIP First Hill and Cherry Hill Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
7. INITIATIVE/COMMUNITY NEED ADDRESSED: MENTAL HEALTH—DEPRESSION SCREENING
AND MENTAL HEALTH FIRST AID
Goal (Anticipated Impact): Improve depression screening Scope (Target Population): Swedish patients, caregivers,
efforts using the Patient Health Questionnaire-2 (PHQ-2) and community stakeholders
and Patient Health Questionnaire-9 (PHQ-9). Increase
number of Swedish caregivers and stakeholders who
are trained in Mental Health First Aid.
FY19 FY21
OUTCOME MEASURE BASELINE
TARGET TARGET
# of Caregivers and community stakeholders 25 people 200 # of Caregivers and community stakeholders
trained in Mental Health First Aid by 4/19 trained in Mental Health First Aid
Improve % of patients who are screened 51.46% 54.46% Improve % of patients who are screened for
for depression at primary care clinics using depression at primary care clinics using the
the PHQ-2 or PHQ-9 screenings: PHQ-2 or PHQ-9 screenings:
lign with current CEI Depression
A Align with current CEI Depression
screening measure: Achieve 75% screening measure: Achieve 75%
percentile (63.4%) by 2022 percentile (63.4%) by 2022
rimary care clinics include Central,
P Primary care clinics include Central,
Cherry Hill Family Medicine, Downtown, Cherry Hill Family Medicine, Downtown,
First Hill Family Medicine, First Hill First Hill Family Medicine, First Hill
# of Caregivers and community stakeholders 25 people # of Caregivers and community stakeholders
200
trained in Mental Health First Aid by 4/19 trained in Mental Health First Aid
STRATEGY FY19 FY21
STRATEGY(IES) BASELINE
MEASURE TARGET TARGET
Roll out plan to schedule # of people who
caregivers to attend Mental attend Offer a monthly class with the goal
Health First Aid Training 25 people
John Bruels of engaging 200 Swedish caregivers
scheduled TBD
Promote Mental Health First (Mental Health (clinical or non-clinical) to provide
on 4/19
Aid training to our community First Aid trainer) more mental health knowledge
partners/“train the trainers” offers classes of 10
595 referrals. As the Behavioral
335 referrals to
# of referrals Health resource site is established
Quartet Health
Connect people to for psychiatry, it is anticipated that we will add 260
and various
psychiatry, medication medication more referrals per year because we
outside provid- TBD
management, and management, also will have more resources to give
ers for ongoing
community resources and community those who “cold call” for referrals and
psychiatric care
resources cannot see our providers. Estimate is
and counseling
5 people a week X 52 weeks.
Heighten participation in
National Alliance on Mental
Illness (NAMI) Walk (mental # of
40 50-80 100+
health awareness) to generate participants
access to and awareness of
mental health services.
18 | CHIP First Hill and Cherry Hill Campus — 2019-2021COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUED
Evidence Based Sources Resource Commitment
NAMI: namiwalks.org Family practice residents and providers, nurses, certified
Well Being Trust: wellbeingtrust.org nursing assistants, ED techs, health navigators, patient
care coordinator, patient service representatives, care
managers, clinical educators, and behavioral health
Key Community Partners
practitioners.
Mental Health First Aid USA, NAMI
Other Community Benefit Programs and Evaluation Plan
TARGET
INITIATIVE/COMMUNITY
POPULATION
NEED PROGRAM NAME DESCRIPTION
(Low Income or
BEING ADDRESSED
Broader Community)
Family Medicine
Emergency Low Income/
Access Emergency Clothing & Sundries
Clothing Closet/ Homeless
Supply Closet
Education & Workforce Year Up Mentorship Training and Technology Low Income
Clinical Support Care, Triage and
Outreach Clean Sweep Low Income
Provision of Emergency Care Packs
19 | CHIP First Hill and Cherry Hill 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 available1 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
____________________________________________________________________________________________________
Kevin Brooks Date
Chief Operating Officer, First Hill
Swedish Health Services
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 First Hill and Cherry Hill Campus — 2019-2021APPENDIX
Definition of Terms Initiative: An initiative is an umbrella category under
which a campus organizes its key priority efforts.
Community Benefit: An initiative, program or activity
Each effort should be entered as a program in CBISA
that provides treatment or promotes health and
Online (Lyon Software). Please be sure to report on
healing as a response to identified community needs
all your Key Community Benefit initiatives. If a campus
and meets at least one of the following community
reports at the initiative level, the goal (anticipated
benefit objectives:
impact), outcome measure, strategy and strategy
a. Improves access to health services;
measure are reported at the initiative level. Be sure to
b. Enhances public health;
list all the programs that are under the initiative. Note:
c. Advances increased general knowledge; and/or
All Community Benefit initiatives must submit financial
d. Relieves government burden to improve health.
and programmatic data in CBISA Online.
Community benefit includes both services to the poor
and broader community. Program: A program is defined as a program or service
provided to benefit the community (in alignment
To be reported as a community benefit initiative or with guidelines) and entered in CBISA Online (Lyon
program, community need must be demonstrated. Software). Please be sure to report on all community
Community need can be demonstrated through benefit programs. Note: All community benefit
the following: programs, defined as “programs”, are required
a. Community health needs assessment developed to include financial and programmatic data into
by the campus or in partnership with other CBISA Online.
community organizations;
b. D ocumentation that demonstrates community Goal (Anticipated Impact): The goal is the desired
need and/or a request from a public agency or ultimate result for the initiative’s or program’s efforts.
community group was the basis for initiating or This result may take years to achieve and may
continuing the activity or program; or require other interventions as well as this program.
c. The involvement of unrelated, collaborative tax- (E.g. increase immunization rates; reduce obesity
exempt or government organizations as partners prevalence.).
in the community benefit initiative or program. Scope (Target Population): Definition of group being
Health Equity: Healthy People 2020 defines health addressed in this initiative: specific description of
equity as the “attainment of the highest level of health group or population included (or not included, if
for all people. Achieving health equity requires valuing relevant) for whom outcomes will be measured and
everyone equally with focused and ongoing societal work is focused. Identify if this initiative is primarily for
efforts to address avoidable inequalities, historical and persons living in poverty or primarily for the broader
contemporary injustices, and the elimination of health community.
and health care disparities.” Outcome measure: An outcome measure is a
Social Determinants of Health: Powerful, complex quantitative statement of the goal and should answer
relationships exist between health and biology, genetics, the following question: “How will you know if you’re
and individual behavior, and between health and making progress on goal?” It should be quantitative,
health services, socioeconomic status, the physical objective, meaningful, and not yet a “target” level.
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.
21 | CHIP First Hill and Cherry Hill Campus — 2019-2021Cherry Hill
500 17th Ave.
Seattle, WA 98122
T 206-320-2000
First Hill
747 Broadway We do not discriminate on the basis of race, color, national origin, sex, age, or
disability in our health programs and activities.
Seattle, WA 98122
T 206-386-6000
www.swedish.org
© 2019 SWEDISH HEALTH SERVICES. ALL RIGHTS RESERVED. COMM-19-0205-A 5/19You can also read
