winnebago community health assessment project presented by captain lynn lowry april 28, 2011
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Winnebago Community Health Assessment Project Presented by Captain Lynn Lowry April 28, 2011. Objectives. Look at the Indian Community Health Profile Project Toolkit (ICHPP) as starting point resource Describe the Winnebago Community Health Assessment Journey - PowerPoint PPT PresentationTRANSCRIPT
Winnebago Community Health Assessment Project
Presented by Captain Lynn Lowry
April 28, 2011
Objectives
• Look at the Indian Community Health Profile Project Toolkit (ICHPP) as starting point resource• Describe the Winnebago Community Health Assessment Journey• Identify recommendations from the lessons-learned by the Winnebago Community Health Assessment process
The goal of all Indian Health programs is:The goal of all Indian Health programs is:
To elevate the health of American Indians and To elevate the health of American Indians and Alaskan Natives to the highest possible levelAlaskan Natives to the highest possible level
Overall GoalOverall Goal
What is a Community Health Assessment?
The Indian Community Health Profile The Indian Community Health Profile Project Toolkit Project Toolkit
From Northwest Tribal Epidemiology CenterFrom Northwest Tribal Epidemiology Center http://www.npaihb.org/resources/project_toolkits/http://www.npaihb.org/resources/project_toolkits/
The ICHPP is an instrument for assessing overall community health, whichThe ICHPP is an instrument for assessing overall community health, which• Uses a broad definition of healthUses a broad definition of health It covers multiple domains of health: physical, mental, environmental, and It covers multiple domains of health: physical, mental, environmental, and socialsocial• Generates data that are useful and usable at the communityGenerates data that are useful and usable at the community levellevel Contains 15 Contains 15 recommendedrecommended health indicators health indicators• Works within the context and interest of communitiesWorks within the context and interest of communities• Engages the community in systematic approach to Engages the community in systematic approach to eliminating health disparitieseliminating health disparities
Tribal interestin &support forimprovedhealth
Implementstrategies
Re-apply indicatorsto measureprogress towardimproved health
Identify priorityhealth concerns
Create workinggroup
Developindicators
Conduct datacollection
Report indicatorresults
Use indicator results,to identify prioritiesfor action
Design actionstrategies
Flow diagram of the Indian Community Health Profile process.
• Socio-demographicSocio-demographic
• Health StatusHealth Status
• Mental Health and Functional StatusMental Health and Functional Status
• EnvironmentEnvironment
The 15 recommended The 15 recommended Health Indicators From ICHPPHealth Indicators From ICHPP
Two measureable indicators
Four measureable indicators
Eight measurable indicators
Two measurable indicators
Winnebago Community Health Assessment Project Goal
Develop a strategic plan to improve health delivery services for the Winnebago community through health assessment and community engagement activities
Promotes opportunities for community engagement in a systematic approach to improve the health status of
community and community members
Promotes opportunities in:• Defining current overall health status • Implementing activities to improve overall health status• Measuring overall health status on a regular basis to determine the amount of improvement
Winnebago Community Health Assessment Project Purpose/Objectives
Winnebago Community Health Assessment Project Workgroup and
ConsultantsWinnebago Community Health Assessment Workgroup (WCHAW):
Tipi Means, Health EducatorLCDR Nichole Vetter, RN, Public Health Nurse
Pat Medina, MS, Tribal Health AdministratorCAPT Lynn Lowry, MSN, Director of Public Health Nursing
Nicky Solomon, Community AdvocateRuby Bellanger, Community Advocate
Consultants:Maurine Orwa, PhD, Northern Plains Tribal Epidemiology Center,
Aberdeen Area Tribal Chairmen’s Health BoardShinobu Watanabe-Galloway, PhD, College of Public Health,
University of Nebraska Medical Center
Winnebago Community Health Assessment Project INITIAL Timeline
May 2006
Aug 2006
Jul 2006
Jun 2006
Sept 2006
Oct 2006
Nov 2006
Dec 2006
Review copy of ICHP Manual, conduct pre-planning meeting and begin project readiness checklist
Meet with EPI center for partnership and technical assistance
Work on resolution for Tribal Council
Obtain Tribal Council approval for Project
Customize Project Activity Log
Form a Working Group, Choose a leader
Draft Community Health Profile Timeline
Finalize Community Health Profile Timeline
Announce Project to Community and invite volunteer participation
Formalize Technical Assistance Partnership with EPI center and invite to Winnebago for site visit
Draft Indicator list, define community, review existing models
Get technical feedback
Prepare Project Summary IRB approval
Revise Project goals and finalize workgroup membership
Finalize list of indicators
Revise BFRSS/YRBS survey questionnaires
Obtain permission from data managers/custodians to access data sources
Develop data abstract forms/data base
Develop and apply population-based sampling scheme for survey
EPI center site visit
Prepare survey interviewer training materials
Train survey interviewers
Continued…
Jan 2007
Feb 2007
Mar 2007
Apr 2007
May 2007
June 2007
July 2007
Aug 2007
Conduct Surveys
Abstract data from existing sources for quality
Review data from existing sources for quality
Design original data collection procedures
Design data base
Collect original data
Conduct analysis with technical assistance
Reform final calculations for indicators
Develop data reports/summaries
Identify audience and purpose of different reports
Create reports (different formats)
Publicize reports to community members and professional groups
Make plans for using result in program planning and management
Set tentative date for next round of indicator assessment
Identify key people to regroup for next round
Evaluation-ongoing
Assess what worked, what did not work and why
Assess adequacy of time project, resources and preparation
Assess whether changes should be made to indicator list
Begin planning for development of long range
Health plan for the Winnebago Tribe, utilizing results from Community Health Assessment project
• Developed workgroup and steering committee
• Identified and analyzed the existing health data
• Developed two health status reports
• Conducted community focus groups and survey to obtain community inputs
• Analyzed focus group and survey data
• Prepared presentation and final project report
Winnebago Community Health Assessment Project Activities
Phase I Phase II
To understand the health status and concerns of
Winnebago Community:
1. Examined the existing data such as:
- Winnebago Hospital data
- Community surveys (e.g. tobacco, risk factors) that have
already been implemented before this project
2. Collected new data through:
- Survey: Young Adults
- Focus Groups: Adult women/men, housing program, seniors
Winnebago Community Health Assessment Indicator list
PHASE 1
A. Demographic Characteristics of Winnebago Community ResidentsB. Health Status of American Indian People in NebraskaC. Use of Preventive Care and Health BehaviorD. Environmental Health
FOCUS GROUPS AND SURVEYS
Phase 2
Focus Group Facilitator Training
Objectives and Expected Outcomes of Focus Groups
1.Identify concerns and priority areas among community members
2.Find out community members’ experience with the health care system
3.Identify ways to improve health status of the community
• Health concerns and priority areas• Experience with the health care system• Ways to improve the community health status
Focus Group Topics
Major Themes and Recommendations
Perception of Community Health
1. Pessimism2. Mental health; drug and alcohol problems3. Chronic diseases 4. Obesity5. Children and youth6. Spiritual decline/ineptness
A. Perception of Community Health
B. Health Care Experience
1. “Only visit clinic and hospital when I am very sick”2. Appointments3. Misdiagnosis4. Needs for specialists and improved quality of care5. Referral and follow-up problem6. Provider-patient communication and interaction7. Praises for Dr. McNamara8. Pain management is poor, especially for the elderly9. CHRs10. ER and PA11. Billing problems
C. Recommendations to Improve Community Health
1. Roles of “Self” (Individual Community Members)2. Roles of “Community”3. Roles of “Health Care System and Providers”
CHA STEERING COMMITTEE RECOMMENDATIONS
1.DEVELOP ADVISORY HEALTH BOARD
A. Charge for Advisory Health BoardB. Recommendation for Board Membership
2. IMPROVE REFERRAL AND INPATIENT FOLLOW-UP
PROCESSES
A. Needs for Improved Referral and Follow-upB. Establish Improved Case Management ProcessC. Establish Improved Discharge Plan Process
3. IMPROVE THE PROVIDER-PATIENT RELATIONSHIP AND
COMMUNICATION
A. Needs for Improved Relationship and CommunicationB.Recommendation: Reinstate the Clinical Rotations
4. IMPROVE THE AFTER-HOUR ER CARE
A.Needs for Improved ER CareB.Evaluate the Current ER Care/Services
5. ENGAGE COMMUNITY TO IMPROVE THE COMMUNITY
HEALTH STATUS
A.InterventionsB.Develop and Implement Intervention Activities
6. ENGAGE THE COMMUNITY TO IMPROVE THE COMMUNITY
HEALTH STATUS
A. Accountability and MonitoringB. Monitor progress and conduct a follow-up evaluation
Project StatusPhase I: Completed• Developed workgroup and steering committee• Identified and analyzed the existing health data• Developed two health status reports
Phase II Completed November 2008• Conducted community focus groups and survey to obtain community inputs• Analyzed focus group and survey data• Prepared presentation and final project report Phase III: Timeline to be determined• Implement activities to improve community health status• Measure health status on a regular basis to determine the amount of improvement
Summary• Existing health data shows a need for improvement in the community’s health status• Community members expressed their concerns about health care system• Based on community inputs, CHA Workgroup made several specific recommendations including the establishment of the Advisory Health Committee to follow up with these concerns