sharp mcdonald center community health needs assessment implementation strategy … ·...

Sharp McDonald Center Community Health Needs Assessment – Implementation Strategy

Fiscal Years 2019-2022

Current as of 9/24/2018 of 12

Identified Community

Health Need: Behavioral

Health including Substance Use

Objectives/Anticipated Impact

Strategy/Action Items Responsible

Party/ies

Themes in 2016 CHNA

Findings

Evaluation Methods, Measurable Targets, and Other Comments

1. Expand access to chemical dependency services and resources for both the general San Diego community and high-risk populations, specifically community members impacted by the opioid epidemic.

a. Develop a program, treatment and support protocol for San Diego community members impacted by opioid use.

Director of Outpatient

Services, Sharp Mesa Vista

Hospital (SMV)/ Sharp McDonald

Center (SMC)

Manager, SMC

Behavioral Health Chemical

Dependency Access to Care

Military Stigma

Education Collaboration

SMC created a MAT (Medications in combination with psychosocial therapy) program, which provides FDA-approved medication to specifically treat opioid use disorder and alcohol use disorder. The MAT program addition creates a comprehensive continuum of care that spans inpatient care to MAT outpatient. The program will support monitoring patients post-discharge, improve retention of patients within the SMV/SMC continuum, and contribute to reducing the impact that the opioid use disorder epidemic has created in the community. The program is 9 to 11 hours a week and the length of stay is 8 to 10 weeks on average. Once a patient graduates, he or she will have lifetime access to SMC’s aftercare programming. Background: Low utilization of MAT for opioid use disorder is influencing high rates of hospitalizations and opioid overdose deaths across the nation. Many addiction treatment facilities are not able to provide this life-saving therapy due to insufficient program capacity available to patients that need to receive life-saving follow-up care.









Party/ies

Themes in 2016 CHNA

Findings


SMC will continue to support the community and high-risk populations through a general awareness campaign that has a greater focus on SMC programs.

2. Improve outcomes for community members with chemical dependency issues through support and follow-up after discharge.

a. Continue to provide SMC Aftercare and Lifetime Support meetings free to former patients.


Services, SMV/SMC

Manager, SMC



Support Care Management

In September 2016, SMC implemented Measurement-Based Care principles to improve upon the manner in which patient outcomes are gathered and utilized to inform on-going improvement. All patients are provided the Brief Addiction Monitor, an evidence-based multi-dimensional assessment tool at admission and weekly through treatment. This date is utilized to continually update the patient's individualized treatment plan and to monitor progress throughout treatment. Aggregated data at a population level is utilized quarterly to inform performance improvement and program development efforts. Data shows that the 95% of patients who remain in treatment for 4 or more weeks in either an inpatient or outpatient setting at SMC demonstrate resiliency in their Recovery and possess greater protective factors than risk factors with their sobriety.









Party/ies

Themes in 2016 CHNA

Findings


In March of 2018, aggregated data showed significant improvement in patient outcomes across various clinical symptom domains compared to the year prior after multiple important best practices across the clinical program were implemented. SMC continues to track Aftercare participation and these Aftercare sessions continue to have over 100 members in attendance each week. Likewise, follow-up aftercare contacts are made with discharged patients at 30 days, 6 months, and 1 year to continue to track on-going abstinence rates. These abstinence rates continue to be far above national benchmarks.

b. Provide support to families of patients with chemical dependency issues post-discharge through the substance abuse family program.


Services, SMV/SMC

Manager, SMC



Support Care Management

The SMC Substance Abuse Family Program offer support through the transition to an alcohol- or drug-free home. Participants address early recovery issues, examine significant relationship dysfunctions and develop support networks for the entire family.

The SMC Family Program was enhanced in 2017 to integrate evidence-based practices and develop a comprehensive eight-week Psychoeducation and Multi-family support group series. This eight-week program is available for family members and care partners of current









Party/ies

Themes in 2016 CHNA

Findings


and aftercare patients. Services are provided by all members of the interdisciplinary clinical team- psychologists, nurses, marriage and family therapists, and chemical dependency counselors.

3. Increase access to chemical dependency screenings and referral sources to the San Diego community.

a. Explore and evaluate opportunities for drug and alcohol screening in primary care settings.


Services, SMV/SMC

Screenings Care Management

Access to care

SMC is in collaboration with Sharp Rees-Stealy Medical Group to develop a partnership and cross referrals – screenings and substance use disorder resources.

b. Increase access to screenings, services, and resources to the San Diego community.


Services, SMV/SMC

Screenings Care Management

Access to care

In fiscal year (FY) 2017, SMV and SMC provided substance abuse education, nearly 30 Check Your Mood screenings — a brief questionnaire aimed at assessing risk for depression — and led a group-based mindfulness experience as well as offered behavioral health resources to approximately 1,000 attendees at the Sharp Women’s Health Conference in April. SMV and SMC assisted in planning Sharp Chula Vista Medical Center’s Changing Minds — Minds Matter South County Behavioral Health Resource Fair, a free event during which more than 40 community partners gathered to educate South Bay community members about behavioral health challenges and raise awareness of available community services and resources. During the









Party/ies

Themes in 2016 CHNA

Findings


event, SMV and SMC provided workshops on behavioral health and substance use disorders and family impact, as well as Check Your Mood screenings and behavioral health resources to approximately 120 community members. SMC also provided screenings and education at the Point Loma Nazarene Alcohol Awareness event in 2017 and 2018.

4. Raise awareness and reduce stigma through the provision of substance abuse health education for patients, their loved ones, and the community.

a. Participate in Sharp’s partnership with the City of San Diego to provide behavioral health education and resources to employees and residents in the City’s nine districts.


Services, SMV/SMC

Manager, SMC

Behavioral Health Stigma

Education Access to Care

Provide education on behavioral health topics including dual recovery: addiction and substance abuse.

b. Continue to host speaking engagements for community health professionals and community members on

SMV Business Development

Specialist


Dependency Stigma

During FY 2017, SMV and SMC hosted numerous on-site community speaking engagements and workshops to increase awareness of behavioral health and substance use issues. Education addressed a variety of topics,









Party/ies

Themes in 2016 CHNA

Findings


various topics in chemical dependency/substance use.

Manager, SMC

Education Access to Care

including cognitive therapy, chemical dependency, life transitions, domestic violence and child and geriatric psychiatry. SMV and SMC provided continuing education classes, conferences and trainings for behavioral health care professionals in FY 2017, including psychologists, psychiatrists, community physicians, social workers, nurses and other health and human service providers, as well as for the community at large. In October, SMV provided a lecture on suicide prevention to more than 40 health professionals from outpatient behavioral health clinics throughout San Diego County at the HHSA Behavioral Health Services Clinical Standards meeting. At the seventh annual Primary Care and Behavioral Health Integration Summit in December, SMV presented the topic of integrating suicide risk assessment tools into treatment processes. SMV provided behavioral health resources to more than 300 attendees of the annual Early Childhood Mental Health We Can’t Wait Conference in September. In FY 2017, SMV and SMC provided substance abuse education, nearly 30 Check Your Mood screenings, and led a group-based mindfulness experience as well as offered behavioral health resources to approximately









Party/ies

Themes in 2016 CHNA

Findings


1,000 attendees at the Sharp Women’s Health Conference in April. During FY 2017, SMV hosted and participated in the Employee Assistance Professionals Association (EAPA) to increase knowledge and education in the behavioral health professional community. SMV and SMC also hosted educational events for the EAPA, where they provided resources and education regarding current concerns in behavioral health care, evidence-based therapies and emerging treatment models to approximately 50 community members throughout the year. In addition, in FY 2017, SMC spent more than 1,500 hours offering free chemical dependency assessments, educational materials and community referral resources to more than 700 community members. The free assessments were facilitated by a licensed mental health professional, who provided individuals with recommendations for appropriate programs and levels of care.









Party/ies

Themes in 2016 CHNA

Findings


Education and screening programs are evaluated by participants through survey. The goal is to educate and raise awareness for community members and physicians.

c. Continue to provide community educational sessions focused on drug/alcohol addiction of teens and Transitional Age Youth (TAY).

SMV Sustainable Early Episode Clinic (SEEC)

Clinical Research Team


Dependency Education

Stigma Access to Care

Clinical Programs: As of year to date FY 2018, the SEEC clinic has provided 1,035 contact hours providing psychoeducation for young adults with schizophrenia and schizoaffective disorder and over 300 contact hours providing psychoeducation for families on how to support their young adult children. The impact of the SEEC program on participants’ symptoms and quality of life are evaluated using standardized measures. The SEEC clinic is also measuring participants’ rates of involvement in community activities/work/school and improvements in caregiver burden. Background: SMV opened the SEEC Clinic in January 2017 and began providing services for young adults newly diagnosed with schizophrenia and schizoaffective disorder and their caregivers. All services are provided free of cost and include education sessions about illness and recovery, support groups, community integration, employment and









Party/ies

Themes in 2016 CHNA

Findings


educational support, psychotherapy, peer support services, and medication management. In FY 2016, SMV completed the design of an early episode clinic model (known as SEEC) created to provide services for young adults with schizophrenia or schizoaffective disorder. The SMV Clinical Research Team wrote a grant proposal to fund this project through Janssen research and Development, LLC. Funding was secured and strategic planning for program implementation began with a target date of January 2017. SMC and SMV have collaborated to develop a referral network in order to better assist TAY patients. SMC and SMV physicians have been able to focus on continuity of care, supporting TAY patients throughout the process.

5. Provide support to community members impacted by chemical dependency.

a. Collaborate with SMV and community organizations to host support groups that serve members of the community impacted by chemical dependency issues.


Specialist


Dependency Education Support

Collaboration

Current substance use support groups: SMART Recovery; AL-ANON; Alcoholics Anonymous: 24 Hour Group Mixed; Alcoholics Anonymous: How it is Now Speakers; Alcoholics Anonymous: Resentment and a Coffee Pot; AA Dual Diagnosis; Men’s Recovery Group (AA); Project SMILE 12 Step Recovery; Narcotics Anonymous: Thanks God We’re Clean; Narcotics Anonymous: Tuesday Nite New Beginnings Group; Narcotics Anonymous: New









Party/ies

Themes in 2016 CHNA

Findings


Beginnings; Narcotics Anonymous Family; Women’s Narcotics Anonymous Group; Narcotics Anonymous: Welcome Home Group; Pills Anonymous: Courage to Change; and SMV/SMC Aftercare. No evaluation methods in progress at this time.

6. Strengthen partnerships with community organizations to foster future collaborations and fundraise for behavioral health services.

a. Continue participation in key mental health events and fundraising activities.

CEO, SMV


Specialist


Dependency Education Support

Collaboration

In FY 2017, SMV and SMC sponsored and participated in 10 walks to increase awareness and raise funds for mental health services, including the San Diego County NAMI Walk, San Diego NEDA (National Eating Disorders Association) Walk, American Foundation for Suicide Prevention’s Out of the Darkness Community Walk, Survivors of Suicide Loss’ Save a Life San Diego/San Diego Chapter of Yellow Ribbon Suicide Prevention Program® Community Walk, Alzheimer’s San Diego’s annual Walk4ALZ, McAlister Institute’s Walk for Sobriety, the Heroes in Recovery 6K Run/Walk, the MCCS Camp Pendleton Suicide Prevention Walk, the Travis Manion Foundation’s 9/11 Heroes Run/Walk and the American Heart Association’s 2017 San Diego Heart & Stroke Walk. With the exception of the AHA 2017 San Diego Heart & Stroke Walk, SMV and SMC provided a booth with behavioral health resources during these events. SMC also participated in Strut for Sobriety.









Party/ies

Themes in 2016 CHNA

Findings


At the Walk to End Alzheimer’s, SMV offered education on Alzheimer’s disease, clinical trials and community resources to more than 500 attendees. Partnership with Community Research Foundation (CRF - http://www.comresearch.org/aboutUs.php) to improve collaboration with patients in the community has been in place for over a year now. PERT is also a part of CRF. No evaluation methods in progress at this time.

http://www.comresearch.org/aboutUs.php





Health Needs: Cardiovascular

Disease, Diabetes, Obesity


Strategy/Action Items

Responsible Party/ies

Themes in 2016 CHNA

Findings


Not applicable (NA) NA NA Behavioral Health Cardiovascular

Disease Diabetes Obesity Stress

Nutrition Co-morbidity with

physical health conditions

(Diabetes, etc.)

As San Diego County's only licensed chemical dependency recovery hospital, this particular identified community health need does not fall within the scope of SMC’s services and resources. However, in light of findings from the 2016 CHNA, SMV/SMC is beginning to consider incorporating primary health screening into behavioral health events, in order to address the issue of mind-body integration and effects of physical health on behavioral health and vice versa. Similarly, collaborations to provide nutrition education and resources at behavioral health events are also of interest. Initial conversations with the SMV Business Development Specialist, the SMV Director of Outpatient Services and the SMC Manager began in late FY 2016, and options/partnerships continue to be explored. In addition, SMC provides patients a weekly nutritionist for ongoing nutrition education critical to recovery.

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