Hospitals combine efforts on community outreach

Better coverage, more topics, less duplication

Maybe you've heard the analogy of the bundle of sticks: Banded together they are strong, but a single stick is weak. With this concept in mind, four hospitals in Spokane, WA, merged their community health education programs to better serve the people who live in the area. By pooling resources, the hospitals are able to spend more time assessing the needs of the community, cover more topics in outreach classes, routinely conduct screenings for a wide array of topics, avoid duplication of efforts, and make better use of the expertise at each facility.

"We can cover more territory. With this joint venture, we can reach the entire city," says Cindy Albrecht, RN, MSN, director of Community Health Education and Resources for the Inland Northwest Health Services in Spokane.

A board of directors made up of the chief executive officers and chief financial officers from the four participating Spokane hospitals oversees the project. The hospitals include Deaconess Medical Center, Holy Family Hospital, Sacred Heart Medical Center, and Valley Hospital and Medical Center.

In addition to Albrecht, who is program director, two managers have been hired. One is in charge of wellness programs and works with businesses on outreach projects and sets up special programs such as family health fairs. Another manager oversees health education and is primarily responsible for developing disease management programs.

As programs are shaped, there are several issues that are being addressed and methods of implementation being considered. They include:

· Providing easily accessible information.

It's difficult to fit health education into people's busy schedules. For example, couples don't always have time to attend a childbirth class. Therefore, staff are contemplating having videos available at the health resource center so people can obtain the information at a convenient time if they miss the class. Questions would be answered by staff on hand.

They are also considering replacing consumer magazines with information on health related topics in physician waiting rooms. For example, a parent would find literature on children's diabetes to read while waiting for a pediatric appointment instead of People magazine, says Albrecht.

· Determining the best target group for education. Rather than developing classes on asthma to educate the community, Inland Northwest Health Services is looking at other ways to reach the community to help control this chronic disease. One method being considered is to educate school teachers about the signs and symptoms of asthma. In this way, they would be able to identify children who are at risk and recommend medical intervention, explains Albrecht. (To learn how Albrecht conducted her assessment of community outreach, see story, p. 67.)

· Increasing number and variety of health screenings. "Screenings have been sporadic, and there are some screenings that have not been provided at all, such as tuberculosis," says Albrecht.

Most hospitals perform breast cancer screenings once a year in October during Breast Cancer Awareness Month, but they should be done more often, she explains. Therefore, screenings will be more frequent and combined with other activities. For example, if an activity is planned with a group of senior women, the health care workers might also explain self-breast exam and show the women the correct way to do it.

· Improving existing programs that work. If a program implemented at a hospital is working, it will not necessarily be discontinued. It depends on how well it fits the needs of the physicians and people in the community.

For example, the childbirth classes at each hospital will remain in place because the physicians wanted the mothers to be able to choose which hospital they went to for the class. However, the existing programs kept in place are being evaluated to see how they might be improved.

To improve attendance at childbirth classes, physicians are following up with patients to make sure they sign up for class in a timely manner and don't wait until the last minute. Also, the class waiting list at each hospital is being monitored by the health resource center. If there are enough women on the waiting list at each hospital to form one class, a class is started.

"The hospitals are working together and taking turns offering the new class," says Albrecht. The lists are easy to monitor since all women call the health resource center to register for classes at the various hospitals.

· Standardizing education across the continuum of care. The hospitals in Spokane are also looking at ways to standardize education across the continuum, not just in one area such as community education. Therefore, they formed a citywide diabetes committee with representatives from each hospital, the physicians in the community, and health insurance companies.

"We need to have good communication. We don't want patients to be caught in the middle, learning one thing in the hospital and something else in the outpatient area," says Albrecht.