2. Message to Community
Excela Health is proud to present their 2016 Community Health Needs Assessment
(CHNA) Report. The report was developed with research collaboration from the
Center for Applied Research (CFAR) at the University of Pittsburgh at Greensburg
and the Healthy Communities Initiative (HCI) of Xerox Corporation. This report
provides findings at multiple levels of analyses. Data was collected and analyzed
from primary data sources such as: key stakeholder interviews, focus groups with
demographically representative community members, and a community survey.
Also, secondary data sources were collected and analyzed using data sources from
HCI as a starting point for the analyses conducted by CFAR. The CHNA process then
included a data review with the CHNA Steering Committee followed by developing a
detailed implementation plan. This plan was then crafted to allow for the
implementation of best practices toward issues most concerning Excela Health in
their service of Westmoreland County. The Executive Summary for the 2016
Community Health Needs Assessment for Excela Health and its three hospitals,
Westmoreland, Latrobe and Frick is included below.
This CHNA allows Excela Health to meet the requirements of the IRS 990, a federal
requirement for non-profit health organizations and hospitals. However, the main
purpose of the CHNA is to identify the health strengths and weaknesses of
Westmoreland County to determine opportunities and threats, which may impact
developing and enacting an implementation plan. The CHNA also provides business
leaders, community groups, public health and health care providers, educational
and religious institutions, policy makers and social service agencies, and
Westmoreland County residents with detailed information to allow for improving
community health. Developing an implementation plan will further permit these
stakeholders to work toward health care outcomes based on strategic decision
making.
For Excela Health and other stakeholders in Westmoreland County, improving the
health of the community remains an important priority. Providing education on
health care, improving patient care, and implementing program improvements are
ways in which Excela Health is working toward providing community resources in
efforts to strengthen community health.
Executive Summary
In December of 2014, The IRS issued final regulations providing guidance regarding
the requirements for charitable hospitals added by the Patient Protection and
Affordable Care Act of 2010. The requirements include the completion and
implementation of a Community Health Needs Assessment (CHNA). The initial
CHNA for Excela Health was approved by the Board in May, 2013 and focused on the
Community Health concern of Obesity which has been linked to Diabetes,
Hypertension and Coronary Heart Disease. To address this Community Health
3. concern, Excela Health entered into partnerships with our Excela Health Medical
Group physicians, Regional Employers, School Districts and Community -based
organizations. These partnerships focused on primary physician support of lifestyle
changes, healthy eating, and improved access to exercise and fitness support.
Improvements have been measured and these initiatives will continue.
Excela Heath has worked closely with the Center for Applied Research (CFAR) with
University of Pittsburgh, Greensburg to complete the next CHNA, which will include
the time period from July 2016 through June 2019. With the expertise and support
of the CFAR, we have reviewed Secondary Data provided through our partnership
with the Healthy Communities Institute and Primary Data through surveys, focus
groups and interviews. As a result of this data and input from our diverse and very
knowledgeable Community Health Steering Committee, in May, 2016 the Excela
Health Board of Trustees approved that the next CHNA focus on three Community
Health Issues as priorities:
1) Build on our present community partnership initiatives and continue our
focus on reducing “Obesity” and the negative impacts of Diabetes,
Hypertension and Coronary Heart Disease. Implementation Initiates will
include continued partnerships with our Excela Health Medical Group with a
focus on prevention and medical management of Diabetes. It will also include
continued Partnerships with Regional Employers to provide wellness
services, School Districts to support Project Fit America Programs and
Regional YMCA ‘s to expand the Diabetes Prevention Programs and
continued outreach programs such as Mall Walkers.
2) Add a focus on “Substance Abuse”. Implementation Initiatives will include
Partnerships with Westmoreland County and the Drug Task Force and efforts
from our Excela Health Medical Group and professional staff regarding
developed guidelines and education for our physicians to follow and to
support their medical decision in the hope of reducing the prescribing of
these medications.
3) Add a focus on Women’s Health primarily related to reducing the” Incidence
of Breast Cancer”. These Implementation Initiatives will include
documentation and measurement of many of the initiatives presently under
way through Excela Health to improve access to the diagnoses and treatment
of this health concern.
These initiatives will continue to help Excela Health to make connections with the
Regional Employers and the populations that we serve in our communities
improving the health and well-being of every life we touch while increasing our
market share as the preferred provider of Health Services in the region.
The 2016 Westmoreland County Community Health Needs Assessment (CHNA)
examined strengths and weaknesses of the community to provide critical
information with the goal of making positive improvements in the arena of
community health. The findings of this work allow community agencies and
providers discussed above to engage in strategic decision making toward the goal of
4. improving access to resources and developing interventions to improve the health
of Westmoreland County residents.
In collaboration with the Center for Applied Research (CFAR) at the University of
Pittsburgh at Greensburg and the Healthy Communities Initiative (HCI) of Xerox
Corporation, this version of the CHNA built on an earlier effort by Strategy Solutions,
Inc. designed to ensure compliance with the current Internal Revenue Service (IRS)
guidelines for charitable 501 (c) (3) tax-exempt hospitals.
Consistent with IRS guidelines, the service area for the Excela CHNA is defined as
Westmoreland County. This primary area of health service is broad in area, diverse
in demographic and socio-economic indicators, and decentralized in the provision of
health care services. These conditions add to the complexity of the CHNA. When
possible, the Implementation Plan will address the needs for specific populations in
high-risk areas in each of the service areas for the three Excela Health hospitals.
This CHNA includes detailed data collection, analysis, and evaluation of the
following relevant community health areas:
Access to Quality Health Care
Chronic Disease
Demographic and Socio-Economic Indicators
Environmental Concerns and Constraints
Infectious Disease
Injury
Mental Health
Nutrition
Older Adults and Aging
Physical Activity and Nutrition
Substance Use and Abuse
Transportation
Women’s Health
Process
Data Collection and Methodology
Primary qualitative data collected for the CHNA includes 9 focus groups, 10
stakeholder interviews, and 526 completed community surveys from May 2015
through April 2016. These individual and group interviews were held with
respondents to include a variety of Westmoreland County resident’s interests and
viewpoints based on demographic, educational, and socio-economic status. These
included representation from specific populations such as the medically
underserved, low-income or minority groups in each of the three hospital service
areas for Westmoreland, Latrobe and Frick Excela Health hospitals.
5. Questions posed during these sessions allowed us to gather detailed information on
knowledge and perceptions on the strengths and weaknesses of community health
as well as ways in which opportunities could be utilized, and threats avoided.
In addition to focus groups and interviews, a paper-based and online community
survey was used to gather information from residents. Questions asked on the
survey were designed to gather detailed information on knowledge and perceptions
of community health in a similar design to the focus groups and interviews. Once
these data were collected, data were sorted by theme and responses to questions
were grouped into categories. This allowed for the content analysis of data, which
was then presented to the CHNA Steering Committee for feedback and
prioritization.
The CHNA Steering Committee is composed of key stakeholders, directors,
managers, and community health professionals with a vested interest in health care
issues in Westmoreland County. Feedback and prioritization of topics from the
CHNA Steering Committee, along with information from focus groups, interviews,
and community survey from May 2015 through April 2016 were used to develop a
CHNA Implementation Plan. The Steering Committee represented a number of
community service providers including: Excela Health, Excela Health Physicians
Practice, United Way of Southwestern Pennsylvania, Westmoreland Community
Action, Westmoreland Chamber of Commerce, Westmoreland County Human
Services, Westmoreland Area Agency on Aging, YMCAs of Greater Pittsburgh,
Westmoreland Intermediate Unit, WeDAC, PA Department of Health, American Red
Cross, Redstone Presbyterian Senior Care, and University of Pittsburgh at
Greensburg. The CHNA Steering Committee helped to identify existing health care
facilities and health and human services with the community available to respond to
health needs of the community. The Pa 211 Southwest dataset is a very important in
helping to identify existing resources based on need. These resources include skilled
nursing facilities, personal care homes, meals on wheels providers, home health
services and drug and alcohol providers. The participation of these committee
members allowed for a richness of input from the local community on the most
pressing needs on community health in these areas.
CHNA Prioritization Criteria
The table below contains the criteria used with the CHNA Steering Committee to
establish which priorities would be set, which would best match the needs of the
community with resources from Excela Health to address
Scoring
Item Definition Low (1) Medium High (10)
1. Magnitude
of the
problem
The degree to which the problem
leads to death, disability or
impaired quality of life and/or
Low numbers of
people affected;
Moderate
numbers/ % of
people affected
High
numbers/ %
of people
6. Scoring
Item Definition Low (1) Medium High (10)
could be an epidemic based on
the rate or % of population that is
impacted by the issue
no risk for
epidemic
and/or
moderate risk
affected
and/or risk
for epidemic
2. Impact on
other health
outcomes
The extent to which the issue
impacts health outcomes and/or
is a driver of other conditions
Little impact on
health
outcomes or
other
conditions
Some impact on
health
outcomes or
other
conditions
Great impact
on health
outcomes
and other
conditions
3. Capacity
(systems
and
resources)
to
implement
evidence
based
solutions
This would include the capacity
to and ease of implementing
evidence based solutions
There is little or
no capacity
(systems and
resources) to
implement
evidence based
solutions
Some capacity
(system and
resources) exist
to implement
evidence based
solutions
There is solid
capacity
(system and
resources) to
implement
evidence
based
solutions in
this area
Following the CHNA Steering Committee Meeting, three important topics were
selected for focus. These were:
1. Obesity, Exercise, and Nutrition
2. Substance Abuse
3. Women’s Health
Secondary Data Sources
Secondary data sources of data were obtained from Healthy Communities Initiative
of Xerox Corporation. These data were from a variety of public data sources on a
large number of topics relevant to community public health.
Sources of data include:
American Community Survey
American Lung Association
Annie E. Casey Foundation—KIDS Count
Center for Medicare and Medicaid Services
County Health Rankings
Environmental Protection Agency
Feeding America
Institute for Health Metrics and Evaluation
Local Initiatives Support Corporation
National Cancer Institute
7. National Center for Educational Statistics
Pennsylvania Behavioral Risk Factor Surveillance System
PA Department of Education
PA Department of Health
PA Uniform Crime Reporting System
US Bureau of Labor Statistics
US Department of Agriculture
Topics of community health interest include:
Access to Quality Health Services
Built Environment
Chronic Diseases
Communicable Diseases and Immunizations
Economy
Education
Family Planning
Food Safety
Injury and Violence Prevention
Maternal, Fetal, and Infant Health
Mental Health and Mental Disorders
Older Adults and Aging
Oral Health
Nutrition, Physical Activity, and Weight
Social Environment
Substance and Tobacco Use
Transportation
Wellness and Lifestyle
Findings
Highlights of Findings from Primary Data Sources
Structured Interviews with Key Stakeholders
• Most Salient Issues Raised
– Poverty is a key issue: came up in every single interview, younger
people moving away due to lack of jobs, extreme poverty in places,
and high levels of unemployment
– Substance Abuse: county has a large problem with heroin and
prescription opioid abuse, drug problems are coupled with crime,
violence, depression and mental health issues, overdoses are
predominately white middle aged people
8. – Transportation: rural areas, poverty and income is the real issue, few
reliable forms of public transportation
– Insurance: Affordable Care Act—deductibles too high for services,
underinsured and uninsured residents is a problem, stigma for lack of
insurance, and drug addiction programs poorly covered
– Prevention/Safety: food support, better emergency services are
needed, more leadership and collaboration needed on prevention
– Women’s Health: high levels of gender violence and associated trauma
– Other Issues: aging population, lack of diversity, diabetes and
cardiovascular health
– Exercise/Weight/Nutrition: poor food choices, and high levels of
obesity
Focus groups with Participants from Various Demographic Groups and Interests
• Most Salient Issues Raised
– Substance abuse: heroin—a huge problem, but use of Narcan and new
Drug Court shows potential to help
– Economic issues: lack of jobs, large pockets of poverty county-wide,
and homelessness for children
– Transportation: big problem in rural parts of county, transporting and
taking clients to appointments and clinics—mobile van would help
– Insurance Acceptance: problematic disconnects among UPMC,
Highmark and Excela on this issue, co-pays are not clear to clients
– Prevention/Safety: more preventative cancer screenings, better
geriatric care, good county parks and programs for county kids
– Exercise/Weight/Nutrition: too many fast food places, not enough
healthy food options
Online and In-person Community Survey
The following services, needs, and health concerns were ranked by how much of a
problem the participants feel that they are in their community. The answers are
categorized as the following:
VS: Very Serious Problem (1); S: Serious Problem (2); SW: Somewhat of a Problem (3);
SP: Small Problem (4); N: Not a Problem at All (5)
10. 28 Tobacco Use in Pregnancy 76 116 153 76 35 456 2.73 1.32 1.15
29 Transportation 136 112 111 63 45 467 2.51 1.68 1.30
The following table lists the top and bottom eight concerns within the community
and the concerns with the most and least variance in responses.
Most Concerning Least Concerning Highest Variance Lowest Variance
Drug Abuse Access to medical care
providers
Affordable health care
(related to co-pays and
deductibles)
Asthma
Tobacco Use Prescription drug
availability and access
Insurance coverage Stroke
Obesity and Overweight Access to dental care Access to mental health
services
Cardiovascular Disease and
Stroke
Transportation Availability of specialists Affordable and adequate
housing
1Hypertension/High Blood
Pressure
Delinquency/Youth Crime Recreation opportunities Transportation 1Heart Disease
Diabetes *Early childhood
development/child care
Access to high quality
affordable foods
2Mortality from Heart
Disease
Hypertension/High Blood
Pressure
*Quality of public education Recreation opportunities 2High Cholesterol
High Cholesterol Access to mental health
services
Quality of public education Drug Abuse
*same mean 1same variance 2same variance
High Cholesterol, Hypertension/High Blood Pressure, and Drug Abuse were the
three concerns in which respondents feel that they were the greatest problem in
their community while having the least mixed feelings about it.
12. The tables above show the scores and trends for Westmoreland County compared to
both state and national indicators on community health indicators. These indicators
were grouped by topic to show which topics were more salient in Westmoreland
County. These data, provided by HCI, are consistent with findings in the primary
data supporting substance abuse, prevention and safety, transportation, women’s
health and exercise, nutrition, and weight management as the top five issues. These
findings in the secondary data are similar in both scope and topic to interviews,
focus groups, and a community survey with Westmoreland County residents.
13. Highlights of Implementation Plan in Progress for 2013 CHNA
GOAL – Reduce overweight and obesity through screening, education, healthy eating
and physical activity initiatives. These initiatives will continue to be conducted
through partnerships with primary care physicians, employers, school districts and
community organizations. Work in this area began in 2012 and is continuing. This
goal will be enhanced and modified in continuing and future CHNA efforts.
NOTE: Excela Health includes three acute care hospitals; Excela Westmoreland,
Excela Latrobe and Excela Frick Hospitals. The CHNA initiatives related to each of
these three hospital service areas have been identified in this implementation plan.
Other initiatives will be supported system-wide and will be implemented to
improve community health in all three Excela Health hospital service areas.
Partnerships with Primary Care Physicians:
Diabetes and cardiac disease patients have a high incidence of co-morbid
depression. The COMPASS program (Care of Mental, Physical, and Substance Abuse
Syndromes) is a collaborative care model aligned with NCQA PCMH standards and
Chronic Care Model. The COMPASS program is a 3 year initiative funded by CMS’
Healthcare Innovation Challenge. The program integrates mental health services
into the primary care setting. The program includes PHQ-9 screening, a care
manager working with the primary care physician and a consulting psychiatrist.
Eligible adults are those with Medicare and/or Medicaid insurance and sub-
optimally managed diabetes and/or cardiovascular disease.
Nine percent of Westmoreland County residents have been diagnosed with diabetes.
According to the National Standards for Diabetes (2012) diabetes self-management
education is a critical element of care for all people with diabetes. Self-management
education is key in providing patients with support to encourage behavior change
and to maintain healthy diabetes-related behaviors, as well as addressing
psychosocial concerns.
Diabetes Referrals Year One Year Two Year Three Total/Average
# of Patients Referred 239 210 570
% of Patients Attending at Least One
Session
53% 50% 69%
57.33%
Percent EHMG patients with diabetes
achieving HEIDIS 75th percentile for:
Pilot Offices vs All Other EHMG Offices
BP < 140/90 67.13/57.56 67.06/67.19 69.53/71.42 65.92/64.94
HbA1c < 8% 68.57/64.86 67.06/67.19 63.36/63.94 66.34/65.33
HbA1c >9% 13.03/13.84 9.94/9.84 11.52/9.89 11.50/11.19
LDL < 100 58.45/56.61 55.39/54.15 66.41/68.02 60.00/59.59
14. COMPASS Year One Year Two Total Goal Program Ended June 30, 2015.
# of patients
enrolled 111 28 142
12/Quart
er
Improve
depression score
for 40% of patients 52% 55% 55%
40%
Absolute
Difference
A1c of < 8.0 9% 17% 17%
20%
Absolute
Difference
BP < 139/89 30% 49% 49% 20%
Patient
Satisfaction NA
Very
Satisfied
Very
Satisfied NA
Patients “very satisfied” with care
relative to any other response at one
year vs. baseline. Baseline vs. 1-year
follow-up survey across the 18
Medical Groups in COMPASS
Physician
Satisfaction NA
Very or
Somewhat
Satisfied
Very or
Somewhat
Satisfied NA
Clinicians “very” or “somewhat”
satisfied with resources available
relative to any other response at one
year vs. baseline. Baseline vs. 1-year
follow-up survey across the 18
Medical Groups in COMPASS
BMI
Goal was to improve compliance with
documentation of BMI in patient medical
record and increase referrals to education
sources with abnormal BMI results.
EHMG working on correction of coding to demonstrate compliance
with BMI measurement. Also looking at improving compliance
with Plan of Care for abnormal results. It was determined by
EHMG Primary Care Group that project was not indicated once
coding is corrected.
EXERCISE IS MEDICINE
Goal was to evaluate the Exercise is Medicine Program
to increase physical activity assessment and referrals
to education services.
This program was not evaluated at this time due to a
multitude of other projects needing to be implemented
over the past three years.
Partnerships with Schools:
Regular physical activity in childhood and adolescence improves strength and
endurance, helps build healthy bones and muscles, helps control weight, reduces
anxiety and stress, increases self-esteem, and may improve blood pressure and
cholesterol levels (CDC, 2013).
Project Fit America is a 2 year program designed to create new and sustainable
opportunities for children to be active, fit and healthy as part of the everyday school
15. experience. This is accomplished through educational programs and equipment that
will allow the school to successfully teach fitness year after year.
Project Fit America
Fall
2014
Spring
2015 Fall 2015 Spring 2016 National Average
Annual Outcome
Measures
Sit Ups 35 37 - 6% DUE 9/15/16 DUE 9/15/16 14%
Mile Run 10:39 9:56 - 7% DUE 9/15/16 DUE 9/15/16 5%
Flexed Arm Hand
(seconds) 10 13 - 30% DUE 9/15/16 DUE 9/15/16 27%
Pull Ups 1.6 1.9 - 19% DUE 9/15/16 DUE 9/15/16 48%
15 Meter Pacer Run
(laps) 65.5 79 - 21% DUE 9/15/16 DUE 9/15/16 18%
20 Meter Pacer Run
(laps) 27.6 31 - 12% DUE 9/15/16 DUE 9/15/16 17%
Healthy Habits A-Z
Education Series -
Middle Schools Year One Year Two Year Three Total/Average
# of classrooms
engaged in program 29 7 12 72
# of students engaged
in program 925 196 825 1946
Average post-
education knowledge
score 8% Increase 10% Increase 16% increase
Behavioral goal - post-
education
86% of
students
report a
change
92% of
students
report a
change
71% of
students
report a
change
Golden Hour High School
Project Year One Year Two Year Three Total
# of school districts
engaged in program 12 11 18 41
# of students engaged in
program 1189 1096 2412 4697
16. Healthy Habits Essay
Program
Year
One Total/Average Program was only done Year One
# of school districts engaged
in program 11 11
# of students engaged in
program 8000 8000
Partnerships with the Community:
According to the Community Preventative Services Task Force effective community-
wide campaigns to increase physical activity should involve many community
sectors, include highly visible, broad-based, multicomponent strategies (e.g., social
support, risk factor screening or health education) and may also address other
cardiovascular disease risk factors, particularly diet and smoking. The Community
Preventive Services Task Force recommends community-wide campaigns on the
basis of strong evidence of effectiveness in increasing physical activity and
improving physical fitness among adults and children.
Mall Walkers Year One Year Two
Year
Three
Total/Avera
ge Comments
Number of
Programs 15 19 17 51
Number of
Attendees 2566 2990 2941 8497
Blood
Pressures
Taken 2009 2415 2147 6571
Pedometer
Program:
Contributing
Members 279 256 206 741
Total Steps 174,934,201 154,030,942 164712540 493,677,683
Unable to count steps for Excela
Square
Ave. Steps/Day 8569 8998 9969 27,536
Unable to count steps for Excela
Square
Average
weight loss 8.75 lbs. 9.25# 9.75 9.25
Healthy Dining Year One Year Two Year Three Total
# of New restaurants engaged in
program. 5 0 6 11
Total restaurants engaged 19 19 25 25
17. Hunters Heart Check Year One Total/Average Only done in Year One.
# of Participants 186 186
Glucose results > 99 92 (52.8%) 92 (52.8%)
Cholesterol > 199 77 (43.5%) 77 (43.5%)
BP > 120/80 126 (85.7%) 126 (85.7%)
BMI > 24.99 131 (69.1%) 131 (69.1%)
Abnormal EKG 30 (16%) 30 (16%)
Golden Hour Year One Year Two Year Three Total
# of Programs provided 14 11 47 72
# of Participants 2684 1789 8105 12,578
Healthy Habits A-Z Greensburg
YMCA Year One
Only asked to participate in YMCA summer program Year
One.
# of Children educated 166
Average pre-education
knowledge score
Average post-education
knowledge score
5%
Increase
Diabetes Prevention
Year
One
Year
Two
Year
Three Total/Average
Implement program at 2
additional YMCAs 2
2 - Total
4 4
# of Participants 7 24 21 52
Average
attendance/session 75% 69% 78% 74%
16 Week Outcomes
Average % body weight
lost 6.14% 3.80% 5% 4.98%
National Average - 4.6%
Regional Goal - 5%
Average minutes of
exercise/week 74 105 110 96
National Average - 117
minutes
Regional Goal - 90 minutes
Partnerships with Employers:
According to the CDC, building workplace “cultures of health” can improve public
health in the United States. This culture can be created when employers provide
financial and organizational support for evidence-based health promotion
interventions, consistent communication with workers that encourages positive
health behaviors, social and organizational support from peers and supervisors,
policies, practices, procedures and organizational norms that support a healthy
18. lifestyle, financial or other types of incentives for participation in health
improvement activities and a common purpose that is dedicated to a healthier
workforce (CDC, 2013).
“Modifiable health risks that lead to disease can be decreased through workplace-
sponsored health promotion and disease prevention programs. The importance of
the worksite as a means for promoting health is underscored by its inclusion in
Healthy People 2020” (CDC, 2013).
Excela Health Employee Wellness Year One Year Two Year Three Total/Average
Number Employees Screened 2851 2853
Data Due
10/12016
Data Due
10/12016
Number of Spouses Screened 957 952
Data Due
10/12016
Data Due
10/12016
Total Screened 3679 3803
Data Due
10/12016
Data Due
10/12016
Employee/Spouse Participation
Rate 92% 93%
Data Due
10/12016
Data Due
10/12016
Average Lifestyle Score 63.70% 64.40%
Data Due
10/12016
Data Due
10/12016
% High Cost Members 24.90% 0.7% 0.8% Norm 1.1%
Preventative Screenings:
Calendar
Year 2013
Calendar
Year 2014
Calendar
Year 2015 Regional Norm
Colorectal 65% 68% 68.20% 61%
Mammography 84% 81% 78.60% 66%
PAP 76.40% 76% 75% 69%
Flu Shot 94.70% 92.46% 95% NA
Physical Exam 32% 35% 37.80% 24%
Prostate 41% 46% NA NA
Provide Annual Employer Health
Care Symposium Year One Year Two Year Three Total/Average
# of attendees 114 120 135 369
# of employers represented 64 71 84 73 Ave.
Partner with Regional Employers to
Provide Wellness Works Services Year One Year Two Year Three Total
# of New Employers Engaged 9 17 10 36
19. Enhance Employee Wellness
Partnership with Westmoreland
County Year One Year Two Year Three Total
# of Bio-Metric Screenings 886 803 908 2597
Consider development of a collective
impact infrastructure to support
community health improvement
initiatives
Outcome
Evaluate 2 evidence-based shared
measurement systems.
Two measurement systems were evaluated. The
Healthy Communities Institute platform was
purchased in March 2016 and will be integrated
into the Excela Health public website
Educate Steering Committee members on
types and essential functions of
backbone organization.
Ongoing.
Other Needs Identified in the CHNA But Not Addressed in This Plan:
Each of the five identified overall community health needs is important and is
addressed by numerous program and initiatives operated by the health system and
other community partners. However, limited resources and the need to allocate
significant resources to the priority needs listed in the above plan does not permit
inclusion of the additional needs of elderly access to care and mental
health/substance abuse concerns in this implementation plan. Additionally, several
initiatives to address these needs have been recently implemented or are scheduled
for implementation within the next several months by Excela Health.
Mental Health/ Substance Abuse:
Excela Health recently opened a Behavioral Health Crisis Response Center
that will serve residents on a 24/7 basis.
All Excela Health Behavioral Health staff have completed the Mental Health
CPR certification class. Goal is to expand training to all clinical staff at Excela
Health.
The Youth Suicide Prevention in Primary Care program will be implemented
in at least one Excela Health primary care office in the next fiscal year.
Excela Health, in partnership with the Westmoreland Drug & Alcohol
Commission and Southwestern Pennsylvania Human Services, will
implement the Mobile Case Manager program to expedite the disposition and
treatment of emergency department patients presenting with substance
abuse issues. The program will be implemented within the next fiscal year.
20. Elderly Access to Care:
Excela Health is currently participating in the Western Pennsylvania
Community Care Transitions program in collaboration with the
Southwestern Area Agency on Aging. This evidence-based program provides
a transitions coach at each of Excela’s three hospitals to work with Medicare
beneficiaries with specific chronic illnesses and/or frequent readmission.
The coach works closely with the hospital discharge planning team to
develop the discharge plan and also informs participants of available
community resources and provides access to long term living services. The
two year pilot program resulted in demonstrated reductions in 30 day
readmission rates.
Project RED (Re-engineered Discharge), funded by the Agency for Healthcare
Research and Quality, has demonstrated a 30% reduction in post-discharge
readmissions rate and emergency room visits as well as improving patient
satisfaction. Project RED is comprised of 12 mutually reinforcing actions
including organizing post-discharge services and medical equipment, patient
education on diagnosis and medications and telephone follow up conducted
by discharge educators.
Implementation Plan—Areas of Development for the 2016 CHNA
In addition to increased support and monitoring of the initiatives discussed above
regarding the obesity community health concern which began in 2012 and will
continue into the 2016 CHNA Implementation Plan, there are two new areas of
development moving forward with the 2016 CHNA Implementation Plan First,
Excela Health is collaborating with Westmoreland County Human Services Drug
Overdose Task Force (DOTF) to support their priorities and objectives. The DOTF
goals and strategies include:
Priority I: Education and Training
Objective 1: Provide community education to increase public awareness of the risks
of prescription drug abuse, safe use/storage/disposal, and available resources for
help.
Objective 2: Educate and train health care professionals (e.g., physicians and
pharmacists) on best practice guidelines for safe prescribing and identifying
prescription drug misuse through screenings.
Objective 3: Promote increased utilization of the statewide Prescription Drug
Monitor Program (PDMP) to decrease misuse and diversion of prescription drugs
(Fall 2016).
Objective 4: Coordinate and advise Community Coalitions efforts to reduce
overdoses. (Use PL principles)
21. Priority II: Treatment and Overdose Prevention
Objective 5: Provide timely access to continuum of care for individuals addicted to
prescription /street drugs.
Objective 6: Expand access to naloxone for overdose prevention. See Training
/Distribution plan.
Objective 7: Prioritize and implement prevention programs for targeted high risk
populations within the county
Priority III: Tracking, Monitoring, and Data Exchange
Objective 8: Increase data collection and information sharing across organizations
to enhance data driven practices
Priority IV: Partnership with Law Enforcement & Corrections
Objective 9: Achieve 100% Police Department participation in Narcan program.
Objective 10: Collaborate with law enforcement to identify and initiate a “warm
hand off” system for overdose cases.
Priority V: Community Advocacy for needed support in reducing drug
epidemic. Create awareness of critical issues and develop resources to fund
needed programs.
Objective 11: Positively influence policy, at the Westmoreland, State, and Federal
levels, by identifying and communicating community factors that are contributing to
prescription drug abuse.
Objective 12: Develop resources to fund effective prevention and treatment
programs in collaboration with public and private sources.
Based on these identified priorities and objectives, Excela Health will support
several of these through the CHNA Implementation Plan. These include:
Objective 1: Provide community education to increase public awareness of the risks
of prescription drug abuse, safe use/storage/disposal, and available resources for
help.
Excela Health (EH) will help to increase public awareness through our EH
Sponsored Employer Symposiums on Substance Abuse in the Workplace, Youth
Suicide Prevention Program, and our Behavioral Health Crisis Response Center with
appropriate referral for treatment.
22. Objective 2: Educate and train health care professionals (e.g., physicians and
pharmacists) on best practice guidelines for safe prescribing and identifying
prescription drug misuse through screenings.
Excela Health will support this objective through our Peer to Peer Education
Program for our Physicians, Mental Health CPR Certification Classes, Mobile Case
Manager Program with the County Drug and Alcohol Commission.
Objective 3: Promote increased utilization of the statewide Prescription Drug
Monitor Program (PDMP) to decrease misuse and diversion of prescription drugs
(Fall 2016).
Excela health will support this objective through our Peer to Peer Education
Program discussed above and Physician protocols for ordering prescription drugs.
Objective 5: Provide timely access to continuum of care for individuals addicted to
prescription /street drugs.
Excela Health will suppor5t this objective through our Inpatient and Emergency
services, Behavioral Health and Crisis Center services and our new partnership with
Gateway and all that this provides in terms of continuum of care.
Objective 8: Increase data collection and information sharing across organizations
to enhance data driven practices.
Excela Health will provide data support from our data collection from patient
encounters on a bundled basis to ensure patient privacy.
Objective 12: Develop resources to fund effective prevention and treatment
programs in collaboration with public and private sources
Excela Health will provide documentation and support of the need for funding to
support effective prevention and treatment programs.
The second area of the 2016 CHNA implementation plan development will be in the
area of breast cancer. Improvements in awareness, access, diagnosis, and treatment
initiatives are under development. One immediate improvement is to allow texting
in order to make a mammography appointment.
TEXT FOR A MAMMOGRAPHY APPOINTMENT
Now there’s one less excuse to skip your 3D mammogram. Skip the phone call and
text MAMMO to 245-87 only at Excela Health. First in the region with 3D
mammography, Excela Health is now the first to bring you text for mammograms.
Text us for your appointment, we’ll do the rest and text you back when your
appointment is confirmed. So really there is no excuse. At Excela Health, you can
walk in on a Wednesday or text MAMMO to 245-87.
23. 2016 CHNA Implementation Plan Action Steps
Excela Health is proud to present their 2016 Community Health Needs Assessment
(CHNA) Report. The report was developed with research collaboration from the
Center for Applied Research (CFAR) at the University of Pittsburgh at Greensburg
and the Healthy Communities Initiative (HCI) of Xerox Corporation. This report
provides findings at multiple levels for existing community efforts in obesity, and
discusses the additional work in Substance Abuse and Women’s Health, specifically
Breast Cancer with a focus on Screening Access, Diagnosis and Treatment.
The Excela Health Board of Trustees initially approved efforts in obesity, and now
work is being extended into Substance Abuse and Women’s Health. The 2016 CHNA
Process and Health Needs Priorities were approved by the Excela Health Board of
Trustees in May, 2016. The Board will approve the 2016 CHNA Implementation Plan
in October, 2016 and following approval, this 2016 CHNA Implementation Plan will
also be made available to the public for questions, review, and comments.
Acknowledgments
We would like to acknowledge the efforts of those who contributed to the
development and completion of the 2016 Excela CHNA. These include:
Excela Health:
Ron Ott, Senior Vice President of Community and Government Relations
Nancy Urick, Manager of Community and Government Relations
HCI of Xerox Corporation:
University of Pittsburgh, Greensburg: Dr. Sharon P. Smith, President; Dr. Geoffrey L.
Wood, Director of the Center for Applied Research; Dr. Franklin D. Wilson, Faculty
Affiliate; Ms. Diane Cheek, Faculty Affiliate; Ms. Victoria Causer, Faculty Affiliate;
CFAR Research Assistants—Emily Gernhardt, Rachel Haras, Nichole Johnson,
Mitchell Kirk, Kaleigh Murphy, Taylor Szczepankowski, and Joshua Watson.
