About Us - Act 53 Hospital Community Report - Community Needs Assessment

Click here for a complete PDF of the 2006 Community Needs Update report

Methodology
In 2001, Copley Hospital conducted a comprehensive Community Health Needs Assessment, with the mission to work collaboratively to create “a community with wellness at its core and clear access to a comprehensive continuum of high quality care.”

Three years later, in 2004, Copley Hospital convened a Community Health Needs Assessment Committee, under Act 53, to conduct a Community Health Needs Assessment to achieve its mission: “Copley envisions a community with wellness at its core and clear access to a comprehensive continuum of quality care.” The 2004 Community Health Needs Assessment was conduced in six (6) phases:

Phase 1: Initial meeting of Community Health Needs Assessment Committee
Phase 2: 5 community and provider focus groups
Phase 3: Chronic Disease Community Forum (in collaboration with VDH)
Phase 4: Vermont Department of Health data analysis
Phase 5: Prioritizing meeting
Phase 6: Annual Public Meeting

Service Area
The service area studied for the Copley Hospital Community Health Needs Assessment was defined by the Vermont Department of Health, in consultation with the Vermont Department of Banking, Insurance, Securities and Health Care Administration (BISHCA), based on a percentage of inpatient discharges from the Hospital. Both qualitative and quantitative data for this Assessment were derived from this service area (see map on cover page). However, the service area for this Assessment does not reflect the Hospital’s self-defined service area, which was utilized in the 2001 Assessment.

Factors Contributing to Community Health
It should be noted that although this 2004 Assessment, as required by Act 53, was an ambitious task conducted in a very short time frame, it does not encompass all factors that impact community health (e.g., education, affordable housing, crime, environment, socio-economics, household composition, etc.). Community demographic factors that are most likely to impact lifestyle behaviors account for an estimated 50% of a community's health status. Thus, since only a small proportion of individual and community health status is influenced by access to medical care (estimated by some experts at about 10%), it is suggested that a broader Assessment be conducted the next time, to determine how to best improve the health of our community. Also, to better understand the disease and illness patterns in our community, data for each hospital service area should include service area resident patient utilization data that is trended over time (5 years), age-adjusted and significance-tested for differences from the aggregate of all Vermont residents. Finally, additional key health status and outcome data should be included in the next Assessment (e.g., infant and neonatal death rates, childhood lead poisoning, etc.).

5 Community and Provider Focus Groups
The Copley Hospital Community Health Needs Assessment Committee invited twenty- five (25) community organizations, thirty (30) healthcare providers, sixteen (16) government officials, twenty-six (26) business leaders and over four hundred and fifty (450+) members of the Copley Hospital staff to participate in a focus group discussion to identify community health needs. The introductory letter utilized to invite people to participate in one of the five (5) focus groups is located in Appendix B.

In total, ninety (90) members of the community and healthcare professionals participated in five (5) Community Health Needs Assessment focus groups: four (4) representatives from community organizations, fifteen (15) healthcare providers, eight (8) government officials, ten (10) business leaders and fifty- three (53) Copley Hospital staff and physicians. This represents significant participation levels in the Copley Hospital Community Health Needs Assessment process. (See Acknowledgements)

On Wednesday evening, October 13, 2004 a Copley Hospital staff focus group was held at Hilary’s Restaurant with fifty- three (53) individuals participating (47 in the session and an additional 6 people sent in written comments). On Thursday morning and at noon, October 14, 2004 focus groups among government officials and community organizations were held at Hilary’s Restaurant with eight (8) and four (4) individuals participating, respectively. Deborah J. White, Senior Consultant and Principal of Helms & Company in Concord, New Hampshire facilitated these sessions.

On Monday evening, October 18, 2004 a healthcare provider focus group was held at Hilary’s Restaurant with fifteen (15) people participating. A business leaders focus group was held at Hilary’s on Tuesday morning, October 19 and attended by ten (10) individuals representing nine (9) local businesses/organizations. Jeffrey G. White, FACHE, Senior Consultant and Principal of Helms & Company in Concord, New Hampshire facilitated these sessions.

Focus group discussion guides, developed in accordance with guidelines from the Vermont Association of Hospitals and Health Systems, were sent out to each attendee in advance of the meeting and utilized to guide each focus group discussion. (See Appendix B) To kick off each session, a brief history of Act 53 and the requirement that each Vermont acute care hospital perform a Community Health Needs Assessment every four years beginning in 2004 was presented to respondents by Peter Wright, Director of Planning and Marketing for Copley Health Systems, Inc.

Quantitative Data Review
Vermont Department of Health data reports were reviewed and included in each appropriate section of this report, as required. (See Appendix D)

Disclaimer: The Vermont Department of Health data tables were subject to numerous changes throughout the process of preparing this report, as well as after the report was drafted and disseminated to the public. All attempts were made to include the most recently updated, corrected data tables in this report. However, since it was required that data be analyzed at a specific point and time, in order to meet the required deadlines for public input and submission to the state, certain data tables corrected after the printing of this report may not be included in this report.

Copley Chronic Disease Community Forum
The Copley Chronic Disease Community Forum, sponsored by the Vermont Department of Health, was held on November 3, 2004. Nine (9) participants attended the Forum and seven (7) completed a survey, which was tabulated by VDH, to evaluate the quality and effectiveness of chronic disease care in the Copley Hospital service area. Results of this survey are included in the Chronic Disease section of this report.

Prioritizing Meeting
Findings were synthesized from five (5) community focus groups, analysis of data from the Vermont Department of Health, and the Copley Chronic Disease Community Forum and were presented at a meeting where sixteen (16) attendees participated in a group process to prioritize the community’s health needs.
 
Annual Public Meeting and Preparation of Final Report
The Annual Public Meeting was held on December 15, 2004 in Morrisville. Subsequently, a final draft report, including comments from the Annual Public Meeting, was prepared for submission to the state, as required.

Plan To Update The Community Needs Assessment Biennially
The biennial update will include a report about: what has happened since the last report; who has used the Community Health Needs Assessment reports/data; a description of the Annual Public Meeting with the community to generate community input; any changes in the community stakeholders; a description of any changes that may have occurred in the community and a description of preliminary plans for the next comprehensive assessment.

Click here for a complete PDF of the 2006 Community Needs Update report
Click here for a complete PDF of the 2004 Community needs Assessment (2mb)

                 EXECUTIVE SUMMARY ASSESSMENT SCHEDULE
The Copley Hospital Community Health Needs Assessment will be conducted on the following
time schedule:
    §  Initial Assessment completed January 1, 2005
    §  Assessment updated January 1, 2007
    §  Next Assessment completed January 1, 2009

PRIORITIES
2001 Priority Health Needs
In 2001, the top ten (10) health needs for all age groups that were most often identified, in order of the most number of mentions, were:
§ Access to mental health/behavioral healthcare
§ Dental care access
§ Preventive care/regular physician visits and screening
§ Substance abuse services, especially child and adolescent
§ Obesity/nutrition
§ Transportation
§ Affordable healthcare/lack of health insurance
§ Information on resources and referrals
§ Specialty care
§ Smoking

2004 Priority Health Needs
In 2004, Copley Hospital convened a prioritizing meeting of Hospital Board members, medical staff and members of the Strategic Planning Committee to select the top health improvement and health resource priorities for the Copley Hospital service area, from a list of priorities identified by community members participating in the Assessment. A total of sixteen (16) participants in the prioritizing meeting selected the following priorities, which are presented in this section by category, from the most to the least number of priority votes received at the meeting. The listing of these priorities by the number of votes received is located in Appendix A.
Although some of the needs identified by this Community Health Needs Assessment do not fall within the scope of Copley Hospital’s mission, the Hospital staff and its Board of Trustees are strongly committed to sharing this information with other organizations in the community so that the identified needs may be addressed.

Health Resource Priorities
1. Maintain and/or Expand Copley Hospital’s Existing Services
    § Maintain and Expand Copley Hospital’s 5 Core Services: Women & Children’s Services (Expand Women & Children’s Services), Primary Care (Increase access to primary care), Emergency Care, General Surgery (Expand surgical capacity), Orthopedics (Expand orthopedic capacity)
    § Maintain Specialty Services: Cardiology, Dermatology, ENT, Internal Medicine, Neurology, OB/Gyn, Oncology, Pain Management, Pediatrics, Pediatric Dental, Pulmonology, Rheumatology, Sleep Studies, Urology

§ Maintain Routine Services: Chaplaincy, Home Health, Industrial Medicine, Lab, Occupational Therapy, Palliative Care, Physical Therapy, Radiology & Nuclear Medicine, Respiratory Therapy, Speech Therapy, Wellness & Outreach

2. Improve Copley Hospital Facilities
     §  Expand the Copley Hospital Emergency Department and waiting area
     §  Expand, update and upgrade the Ambulatory Care Unit, Operating Rooms, and OB suite
     §  Expand, update and upgrade patient rooms (private with bath)
     §  Replace the current outdated heating and air conditioning system / infrastructure
     §  Build a new Medical Office Building to replace the existing building, which does not meet code
     §  Build an exercise facility for patients and staff
     §  Expand space to include family consultation and waiting areas
     §  Add a chapel to the Hospital facilities
     §  Expand space to include a community education and conference center
3. Increase Access To Primary Care Physicians for All Residents, Particularly Adults (18 Years And Older), the Underinsured, Uninsured And Medicaid Populations

4. Improve Technology at Copley Hospital
     §  Expand Hospital facility space for implementation of new information technology (IT) programs and services
     §  Implement high speed communication for informatics and upgraded computer systems
     §  Explore implementation of the Electronic Medical Record; develop structured
communication procedures between physicians and patients through Internet, high speed access (e.g., diabetic patient can communicate glucose levels to their PCP)
     §  Develop a telemedicine program to access specialized technology, through interconnectivity among hospitals (e.g., Radiology)
     §  Modernize diagnostic technology in the Hospital including:
            o Updated technology in the OR and ACU
            o Update the CT Scan
            o Fixed MRI
            o OB Ultrasound
            o Prompt Lab and X-ray reports to physicians

5. Improve Access to Mental Health and Substance Abuse Care
     §  Improve mental health screenings in the community through outreach to at risk
populations (e.g., chronically ill patients, adolescents and the elderly), including a
mechanism for follow- up care
     §  Develop mental health and substance abuse early education and prevention programs
     §  Increase access to adult mental health and substance abuse services, including outpatient mental health and psychiatric care, partial hospitalization, intensive outpatient care, and residential care (including low income residents)
     §  Increase access to child and adolescent mental health services, including outpatient therapy, psychiatry and substance abuse services
     §  Explore establishment of an opiate treatment induction center
     §  Educate health providers regarding patient drug seeking behavior for prescription
narcotics; develop methods for providers and pharmacists to share this information
     §  Develop clinical pathways for treatment and referral of suicidal patients

6. Expand Oncology / Cancer Services in the Community (chemotherapy, radiation
therapy, social services, education and support services). Explore mobile/ regional
radiation therapy services.
     §  Increase mammogram screening for breast cancer among area women 40+ years
     §  Develop a local Breast Care Center
     §  Increase colon cancer screening among age appropriate adults
     §  Provide integrative medicine and therapies in cancer treatment

7. Expand Awareness and Resources for Healthy Lifestyles and Behavior
     §  Increase awareness and use of weight control and healthy nutrition programs in the community, through effective communication methods/messages, transportation, etc.
     §  Provide healthy lifestyle programs in schools and workplaces
     §  Increase awareness and use of community physical activity programs, through publicity, increased indoor recreation options, assessments in primary care physician offices and schools, transportation, etc.
     §  Develop an occupational health and Workers Comp program focusing on worksite injury prevention and healthy lifestyles

8. Increase Access to Dental Care for Medicaid and Young Adult Populations

9. Enhance Women’s Health Services
     §  Expand obstetrical and gynecological care (OB/Gyn), with the addition of a female
physician
     §  Create a comprehensive Women’s Health program, including cancer care, menopause, OB/Gyn, domestic violence, etc.
     §  Educate the community about the availability of newborn transport from Copley Hospital to area NICUs

Health Improvement Priorities
1. Mental Health and Substance Abuse
     §  Reduce anxiety, depression and rates of suicide attempts/death among area residents, including adolescents
     §  Reduce substance abuse, including heroin, particularly among area youth

2. Healthy Lifestyles and Behavior
     §  Reduce obesity