More than , people give Sacred Heart, St. Joseph's ideas for the future
By JULIE MINDA
It can be difficult for a hospital's community benefit staff to ensure they are getting a complete picture of what community members want and need.
Planners at two ministry hospitals in Western Wisconsin have struck on an elegantly simple strategy to gain an extra degree of confidence in their community needs assessments — they invite input from a broad cross section of citizens, and they act on it.
Sacred Heart Hospital of Eau Claire, Wis., and its sister hospital St. Joseph's Hospital of Chippewa Falls, Wis., conducted a vast "listening campaign" that spanned five months and offered people of all stripes multiple ways to share their thoughts on what the hospitals could do to improve how they serve the community. The sessions helped the hospitals gain a deeper and richer sense of the community's expectations than they had gotten with less expansive surveying in the past; and they gave the hospitals the level of detail that will be needed in the future when the federal government begins checking to ensure that hospitals effectively assess and address community needs. The listening campaign also demonstrated the hospitals' seriousness in answering local needs, and that helps inspire other organizations to collaborate with the hospitals on solutions.
"People saw that we're sincere and that we care what they think," said Rhonda Brown, director of community health development for Hospital Sisters Health System's Western Wisconsin region.
During an Innovation Forum session at the Catholic Health Assembly in June, Brown and two colleagues will detail the "Imagining the Future" campaign during a session called "Imagining the Future: A Grassroots Approach to Community Needs Assessment Planning and Development." The other presenters will be Juliet Nguyen, director of strategic services, and Marcia Arneson, supervisor of wellness services for the Center of Healthy Living, both of Sacred Heart.
Ear to the town
Beginning in late 2010, Sacred Heart and St. Joseph's conducted the listening sessions, which included town hall-style meetings in both Eau Claire and Chippewa Falls, about 35 focus groups and opportunities for people to engage through social media and other venues. Local "netizens" provided input through Facebook and Twitter.
More than 1,400 community members participated and the hospitals have since distilled the community's input into themes, strategies and action items. They are implementing some of the short-horizon action items now, including by increasing their wellness screenings and education programs, addressing food insecurity concerns in their communities and increasing local access points for mental health care.
While hospital leaders regularly consult community advisory boards and committees, conduct surveys and hold small focus groups, in the 2010 to 2011 listening campaign the hospitals tapped into a much larger group and on a broader range of subjects than usual, said Arneson.
Said Brown: "We wanted to get real engagement and talk with people on a basic level about their concerns and about how they want us to shape things in the future."
Sacred Heart and St. Joseph's issued an open invitation to their communities, placing public service announcements, printing invitations in local papers, putting a notice on Facebook, contacting individuals on the hospitals' mailing lists and notifying community organizations. The facilities offered multiple ways and ample time for people to provide their input.
Special interests
"People were excited about the opportunity to contribute," said Arneson. People lingered after information gathering sessions. "They wanted to stay and continue to talk," she said.
While the town hall sessions attracted hundreds of involved citizens, the community benefit leaders also sought out particular subsets of the population, inviting Hmong immigrants, members of the Amish community, seniors, children and others to focus groups. About 300 people took part in those targeted focus groups — usually in groups of about five to 20 people at a time.
When asked how the hospital could improve its services, some of their responses echoed the suggestions heard in the town hall meetings. Focus group facilitators drew participants out on needs particular to their cohort. For instance, the Amish interviewees explained that Amish patients do not buy commercial insurance, but they do share the risk of high medical expenses. They collect funds door-to-door in their community to pay their hospital bills. Amish focus group participants asked for greater payment flexibility and discounts traditionally negotiated by commercial insurers. In response, St. Joseph's implemented a discount rate program for the uninsured to mirror a discount already available at Sacred Heart; and both hospitals worked with physician groups to offer discounts.
Some ideas that came out of the sessions were nonstarters. For instance, said Arneson, there are no plans for a waterslide or giant built-in aquarium at Sacred Heart or St. Joseph's, as some kids suggested.
Avalanche of information
The months of listening yielded 2,830 ideas of all kinds.
Working with students from the University of Wisconsin-Eau Claire, the Imagining the Future planners spent weeks entering all the comments into a database. The planners then worked with hospital leaders and two committees — the Community Dream Team and the Colleague Dream Team — to assess the ideas, determine their feasibility and identify overarching themes. These included:
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Health and wellness
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Health care accessibility (in terms of geography and cost)
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Human dignity and spirituality
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Healing environment
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Care coordination
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Family and patient involvement in care
Some ideas were implemented quickly. For example, Sacred Heart put a heart health questionnaire on its website. In response to a call for more interesting reading material, both hospitals collected thousands of books and magazines during a drive and placed them in waiting areas.
Other ideas will take time to implement. In response to a call for a greater focus on prevention and wellness, the hospitals will be offering more education sessions and health screenings at community events. To address the community's concern about a lack of mental health services, administrators are adding new mental health services through Sacred Heart and providing free behavioral health services to patients of the free medical clinic at St. Joseph's. And, they're engaging with local agencies to address food insecurity in the region, starting with holding community dialogues and conducting studies of local "food deserts."
In some cases, the hospitals already were offering services or programs that community members requested — and so the campuses are looking at how to raise the visibility of those services, such as using pets as therapeutic aides.
A slow process
Arneson, Brown and Nguyen, who are on the Imagining the Future planning team, said it's been a very time-intensive process to secure the input, organize it, prioritize ideas and implement them.
Plus, "you have to manage people's expectations," said Nguyen. "So we've had to educate community members on our budget constraints and on how we decide what our priorities are." They determine their priorities based on the idea's potential impact, fiscal viability and its value to patients and to the community.
It also can be difficult to determine who has the resources, capability and willingness to own the projects once they're on the action list, said Arneson. The hospital needs its staff or local organizations to help implement the ideas; and those groups must buy in to the ideas — and have the resources needed — before they can implement them.
Despite these and other challenges, the listening campaign has been well worth the effort, said Arneson, Brown and Nguyen. They said the sessions have fostered a feeling of unity in two communities that sometimes can feel divided.
And the sessions confirmed what the hospitals are doing right, said Arneson. "Over and over again, we heard about how people feel about our hospitals. They said they feel a certain spirit in our hospitals, and they want it to continue to be this way."
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