2012 Health Improvement Plan
CHARLEVOIX AREA HOSPITAL HEALTH IMPROVEMENT ACTION PLAN
Charlevoix Area Hospital is committed to providing care for the people of our area when illness or injury strikes – but another, equally important role that we play is in the prevention of illness whenever possible. We work side by side with community partners like the Health Department and our Schools to provide programs and services to address identified health needs throughout the region.
Over the next three years, we will focus our attention on the priorities identified in the 2012 Community Health Needs Assessment just completed as well as initiatives already underway to prevent illness and keep our population healthy and productive.
We welcome your questions, comments and ideas on how we can do better working with community partners to make our region the healthiest in the nation!
Thank you.
Board of Directors
Charlevoix Area Hospital
Health Priority: Obesity
Charlevoix and Antrim Counties
Fit-4-Life Adult Program
Education is provided in the areas of: obesity management, nutrition, fitness, disease and risk factor management/prevention. The program’s primary objectives are to target, contain, reduce, and treat adult obesity.
Objectives/Outcomes
- Healthy weight loss is measured in 85% of participants by the end of the 14-week program.
- 90% of participants demonstrate an increased knowledge of nutrition, chronic disease management and prevention, and an increase in regular physical activity.
Fit-4-Life Kids Program
To target and contain students identified to be at high-risk for obesity, education is provided in the areas of: obesity management and prevention, nutrition, fitness, disease prevention and risk factor management/prevention. CAH School Nursing staff implements this program.
Objectives/Outcomes
- Childhood obesity decreases by 1% every year in the participating schools in Charlevoix and Antrim Counties.
- 75% of students demonstrate an increased knowledge in the areas of obesity, nutrition, exercise, and chronic disease.
CAH School Nurse Program
To increase child safety within the school system as evidenced by use of Action Plans by school nurse and school staff, we will medically manage children with chronic disease processes knowing that disease processes can be intensified with obesity within the school systems served by the program. Action Plans to be initiated in all CAH School Nurse (SN) service area for Asthma, Diabetes, Anaphylaxis, Seizure, and Head Injury, CAH School Nursing staff implements this program.
Farm-to-School Program: To provide an understanding of the process of growing, collecting, and eating local food. A refrigerator may need to be purchased for the school to facilitate healthier food options for after school programs.
Hoop House (a year round greenhouse managed by the students and the school) in Boyne Falls schools and “Fuel up to Play 60 Program” in East Jordan schools, and other schools as deemed appropriate, to be implemented by CAH School Nurses in the 2013/14 school year.
Objectives/Outcomes
- Student absenteeism rate decreases by 0.5% yearly.
- Students sent home unnecessarily decreases by 1% due to increased education and prevention.
- Students demonstrate an increased knowledge of nutrition, healthy food choices, healthy activity requirements, obesity treatment and prevention and chronic disease prevention in the school systems served by CAH SN Program in Charlevoix and Antrim counties.
- The student obesity rate decreases by 1.0% yearly in schools served.
- Increase in fresh foods available to students.
- Introduce new healthy foods alternatives to students.
CAH School Nurse BMI Obesity Screenings
To decrease the incidence of childhood obesity in Charlevoix and Antrim Counties by introducing and making healthier food options available to children. To introduce and teach a variety of healthy foods options grown at their school in the Hoop House in Boyne Falls.
Body Mass Index (BMI) monitored yearly for Grades 3, 5, 7, 9, 11 in school districts served by CAH School Nurse Program. Instruction provided in the areas of nutrition with the “Healthy Food Vote Program”. The education in this program will be tied closely to the Fit-4-Life for Kids Program. CAH School Nursing staff implements this program.
Objectives/Outcomes
- Will obtain baseline BMI data in the schools that CAH SN Program serves in Charlevoix and Antrim Counties.
- To decrease the student obesity rate by 1.0% yearly.
CAH School Nurse 5210 yearly 5K run
To introduce the children and parents of Charlevoix and Antrim Counties to a variety of healthy foods and PE opportunities: yoga, hip-hop, karate, swimming, biking and 5K run. To promote health by decreasing BMI; preventing chronic disease, and encouraging family/group exercise. To set a healthy example to the community, we plan for June 2012 to collaborate with the Charlevoix Community Pool to combine with Kids Triathlon
Objectives/Outcomes
- Increased awareness of healthy eating, exercise and the benefits of both to a healthy lifestyle.
Annual CAH 5K Turkey Trot
To prevent/treat adult and childhood obesity by promoting family/group exercise to the families of Charlevoix and Antrim Counties. To set a healthy example to the community. We stage a 5 Kilometer/3.1 mile Run for all ages every Thanksgiving morning at CAH.
Objectives/Outcomes
- Increased awareness of the benefits of exercise and family/friend interaction.
Wellness Wednesday Program
Total Cholesterol, HDL, LDL, triglycerides HDL/TC ratio, blood glucose levels, BMI, blood pressure, pulse, muscle and fat percentages and point-of-care education of all results tailored to the individual, offered at low cost 8 times per year. CAH employees free once per year. Pedometers with teaching materials provided. CAH plans to further expand this program to meet the needs of the Charlevoix and Antrim County by offering program 10 times per year beginning in 2014.
Objectives/Outcomes
- Increased CAH employee and the general public’s knowledge of cholesterol and blood glucose levels, healthy weight loss goals, how obesity is tied to chronic disease including cardiovascular disease (CVD), hypertension, arthritis, cancer and type II diabetes.
- 80% of participants will demonstrate an increased awareness of chronic disease, obesity treatment/prevention, diabetes, and cholesterol values.
Business Health Screenings
To increase community knowledge of cholesterol and blood glucose levels, healthy weight loss goals, how obesity is tied to chronic disease including CVD, hypertension, and diabetes and their associated risk factors, we stage on-site cholesterol screening is provided to area businesses. Weight, BMI, blood pressure, heart rate, muscle and body fat percentages are assessed. Participants are provided individual and private counseling specific to their individual screening results. Dietician consultation and office ergonomic evaluation and training by a team of Occupational Therapists are also available.
Objectives/Outcomes
- 75% of participants will demonstrate an increased knowledge of information provided.
Business and Employee Lunch and Learn
To promote a healthy lifestyle and decrease the incidence of obesity and chronic disease by increasing area business employee knowledge of a variety of health related topics including CVD, hypertension, arthritis, cancer and type II diabetes; a collaborative program between CAH and area businesses. Health-related topics are demystified by CAH professionals as chosen by area businesses. Topics include but are not limited to: Body Mass Index/Obesity Management, Diabetes and Prediabetes, My Plate, Hypertension, Understanding Cholesterol, Office Ergonomics, Injury Prevention, and Strength Training.
Objectives/Outcomes
- 75% of participants will demonstrate an increased knowledge of information provided.
Cardiac Rehabilitation Programs
To promote medically supervised exercise to those recovering from a cardiac event or those with cardiovascular disease, while decreasing risk factors such as obesity.
To provide Medical Fitness Programs at low cost for continued exercise for prior cardiac patients and the general public.
Objectives/Outcomes
- 90% of participants will demonstrate and increased knowledge of information provided related to obesity and CVD risk factors and management.
- Participants do not return for additional inpatient care for heart disease or related co-morbidities.
Yoga Classes
To decrease and prevent obesity while promoting flexibility and injury prevention in the CAH employee and to the general public with the anticipated expansion of this program, free yoga classes for CAH employees provided biweekly. CAH plans to expand this program to include more employees and public offerings.
Objectives/Outcomes
Increased community and CAH employee access to varied forms of physical fitness options.
Tai Chi Classes
To decrease and prevent obesity while promoting joint-friendly, low impact exercise while improving physical function, muscle strength, flexibility, mobility and balance. Free Tai Chi classes for CAH employees. CAH plans to expand this program in collaboration with the Charlevoix County Commission on Aging Senior Center.
Objectives/Outcomes
- Increased community and CAH employee access to varied forms of physical fitness options.
CAH Employee Health Screening
To increase the CAH employees’ knowledge of cholesterol and blood glucose levels, healthy weight loss goals, and the correlation between obesity and chronic disease including CVD, hypertension, arthritis, cancer and type II diabetes.
Total Cholesterol, HDL, LDL, triglycerides HDL/TC ratio, blood glucose levels, BMI, blood pressure, pulse, muscle and fat percentages and point-of-care education of all results tailored to the individual, offered at low cost 8 times per year. CAH employees free once per year.
Objectives/Outcomes
- Employees can articulate healthy living goals.
- Reduced employee health service utilization due to obesity
CAH Employee Health Benefit Promotion
A collaborative effort with the CAH Wellness Committee to educate CAH employees in the health benefit opportunities that are available to them to promote a healthy lifestyle in the CAH workforce and decrease the incidence of obesity and chronic disease in the CAH employee by increasing their knowledge of insurance benefit health opportunities: Health Coaching, Smoking Cessation, Weight Management, and Chronic Disease Management and benefits of completing a yearly Health Risk Appraisal.
Objectives/Outcomes
- 85% of CAH employees will demonstrate an increased knowledge of their health benefits.
- Increased knowledge of their insurance benefit health opportunities: Health Coaching, Smoking Cessation, Weight Management, and Chronic Disease Management.
- To offer exercise alternatives to those with health limitations or injury.
Health Priority: Chronic Disease
Charlevoix County
Community Health Fairs and Wellness Events
Education is provided to the general public in the areas of: childhood and adult obesity management and prevention, nutrition, exercise options, fitness, disease prevention and risk factor management/prevention. Free on-site non-fasting cholesterols, BMI, body and muscle values are assessed and results provided with teaching tailored to the individual.
Annual Children’s Health Fair promotes breastfeeding and other topics associated with preventing childhood obesity and promote child/infant safety.
Objectives/Outcomes
- To increase CAH employee and the general public’s knowledge of cholesterol and blood glucose levels, healthy weight loss goals, how obesity is tied to chronic disease including CVD, COPD, hypertension, arthritis, cancer and type II diabetes.
Wellness Wednesday Program
Total Cholesterol, HDL, LDL, triglycerides HDL/TC ratio, blood glucose levels, BMI, blood pressure, pulse, muscle and fat percentages and point-of-care education of results tailored to the individual offered at low cost the first Wednesday of most months. Offered at low cost to the public and free once per year for CAH employees. Plan to further expand this program to meet the needs of the Charlevoix and Antrim County diabetic population by providing a finger-stick A1C level to monitor diabetes management.
Objectives/Outcomes
- 80% of participants will demonstrate an increased awareness of chronic disease, obesity treatment/prevention, diabetes, and cholesterol values.
Fit-4-Life Adult Program
Education is provided in the areas of: obesity management, nutrition, fitness, disease and risk factor including chronic obstructive pulmonary disease (COPD) management/prevention. The program’s primary objectives are to target, contain, reduce, and treat adult obesity thus preventing and treating chronic disease.
Objectives/Outcomes
- 90% of participants demonstrate an increased knowledge of nutrition, chronic disease management (COPD, CVD, HTN, arthritis, cancer, DM) and prevention, and an increase in regular physical activity.
Fit-4-Life Kids Program
Education is provided in the areas of: obesity management and prevention, nutrition, fitness, chronic disease prevention and risk factor management/prevention. CAH School Nursing staff implements this program.
Objectives/Outcomes
- 75% of students demonstrate an increased knowledge in the areas of obesity, nutrition, exercise, and chronic disease.
CAH School Nurse Program
Medical management of children with chronic disease processes that can be intensified with obesity within the school systems served by the program. Action Plans to be initiated in all CAH SN service areas for Asthma, Diabetes, Anaphylaxis, Seizure, and Head Injury, CAH School Nursing staff implements this program. Provide CPR training to students and staff.
Objectives/Outcomes
- 75% of students demonstrate an increased knowledge of nutrition, healthy food choices, healthy activity requirements, obesity treatment and prevention and chronic disease prevention in the school systems served by CAH SN Program in Charlevoix and Antrim counties.
Tai Chi Classes
Free tai chi classes for CAH Employees. CAH plans to expand this program in collaboration with the Commission on Aging Senior Center of Charlevoix County
Objectives/Outcomes
- To decrease and prevent chronic disease while promoting flexibility and injury/fall prevention in the CAH employee and to the senior citizen public with the anticipated expansion of this program.
Yoga Classes
Free yoga classes for CAH employees provided biweekly. CAH plans to expand this program to include more employees and public offerings
Objectives/Outcomes
To decrease and prevent the chronic disease, arthritis while promoting flexibility and injury prevention in the CAH employee and to the general public with the anticipated expansion of this program.
Better Breathers Club – in development
Health Priority: Diabetes
Antrim County
CAH Diabetes Education Program
To expand current Diabetes and Prediabetes Programs by targeting more individuals that are at high risk through Wellness Wednesday program, business health screenings, CAH Diabetes Drive-Through Program, community wellness events, (Project Connect and the Commission on Aging yearly Picnic and Health Fair). Provide information regarding the classes that are available for both diabetes and prediabetes.
Objectives/Outcomes
- 90% of all participants will have two Hgb A1C levels yearly.
- 85% of participants will demonstrate an increased knowledge of the diabetes disease process.
- 90% of participants will have an LDL level yearly.
- 75% will decrease their BMI score if applicable (those with a BMI >30).
- 75% of participants with hypertension will maintain or decrease high blood pressure.
Wellness Wednesday Program
Total Cholesterol, HDL, LDL, triglycerides HDL/TC ratio, blood glucose levels, BMI, blood pressure, pulse, muscle and fat percentages and point-of-care education of results tailored to the individual offered at low cost the first Wednesday of most months. Offered at low cost to the public and free once per year for CAH employees. Plan to further expand this program to meet the needs of the Charlevoix and Antrim County diabetic population by providing a finger-stick A1C level to monitor diabetes management
Objectives/Outcomes
- To provide affordable access to Diabetic A1C levels in Antrim and Charlevoix Counties. Immediate results are provided and instructed upon by a RN to assure optimal learning.
- To prevent, screen and assist in the management of chronic disease processes: hypertension, diabetes, high cholesterol, osteoporosis, and obesity. Participants screened with high-risk results are given the tools to seek appropriate care.
CAH Diabetes “Drive-Through”
A new Program to begin at CAH in which anyone from the community can instantly obtain their blood glucose results. Diabetics can instantly obtain their A1C results. Registered Nurses and a Diabetic Educator available for teaching.
Objectives/Outcomes
- To assist in the management of pre-existing diabetics.
- To isolate new or at-risk individuals for diabetes.
- To refer as appropriate to further diabetes education opportunities.
- To provide point-of-care diabetic teaching.
- 75% of participants will demonstrate and increased knowledge of diabetes and prediabetes.
CAH School Nurse Program
Offer children and families at high-risk for diabetes free blood glucose and cholesterol screening in schools served by CAH SN Program in Antrim County
Objectives/Outcomes
- To increase access to diabetes screening to children and their families with the intention of isolated those with or at risk for diabetes. To instruct these individuals in the diabetic disease process, and treatment options.
- To offer Dietician, Diabetic Education
Health Priority: Access to Care
Antrim and Charlevoix Counties
CAH School Nurse Program
CAH Registered Nurse (RN) medically manages children in the schools served by the CAH School Nurse Program. CPR instruction made available to teachers and students. Provide the medical expertise and access to the care of registered nurse in the school setting where the program didn’t exist before. Triage injured and sick children. Provide medication and disease process teaching to non-medical professionals within the school system. Action Plans to be initiated for Asthma, Diabetes, Anaphylaxis, Seizure, and Head Injury. CAH School Nursing staff implements this program.
Objectives/Outcomes
- To promote health and wellness, injury prevention, chronic disease management/prevention, medication and skilled medical procedural care and instruction in the school systems served by the CAH SN Program.
- To elevate the medical safety/knowledge and to serve as medical liaison for families in need of social and medical services within the community within the nine school systems in Antrim and Charlevoix Counties served by the CAH SN Program: Charlevoix, St. Mary’s Catholic, NW Academy, Boyne Falls, Boyne Concord Academy, East Jordan, Ellsworth, Central Lake, and Bellaire schools.
Community Health Fairs and Wellness Events
Education is provided to the general public in the areas of: childhood and adult obesity management and prevention, nutrition, exercise options, fitness, disease prevention and risk factor management/prevention. Free on-site non-fasting cholesterols, Bone Density Screenings, BMI, body and muscle values are assessed and results provided with teaching tailored to the individual.
Objectives/Outcomes
- To promote health and wellness, injury prevention, chronic disease management information and options to the residents of Antrim and Charlevoix Counties.
Wellness Wednesday Program
Total Cholesterol, HDL, LDL, triglycerides HDL/TC ratio, blood glucose levels, BMI, blood pressure, pulse, Bone Density Screenings, muscle and fat percentages and point-of-care education of all results tailored to the individual, offered at low cost 8 times per year. CAH employees free once per year. Plan to further expand this program to meet the needs of the Charlevoix and Antrim County diabetic population by providing a finger-stick A1C level to monitor diabetes management CAH also plans to further expand this program to meet the needs of the Charlevoix and Antrim County by offering program 10 times per year beginning in 2014.
Objectives/Outcomes
- To provide affordable access to cholesterol, bone density score, and Diabetic A1C levels in Antrim and Charlevoix Counties. Access to care also includes as well BMI score, body muscle and fat percentages, blood pressure, pulse. Immediate results are provided and instructed upon by a RN to assure optimal learning. To prevent, screen and assist in the management of chronic disease processes: hypertension, diabetes, high cholesterol, osteoporosis, and obesity.
- 75% of participants have no or limited health insurance
Woman’s Access to Healthcare Grant
CAH Foundation has written a grant requesting funding from Hestia Women’s Giving Circle through the Charlevoix County Community Foundation to assist women in gaining access to reproductive healthcare.
Objectives/Outcomes
- To provide increased access to reproductive healthcare for women in need.
Emergency Room Clinic
After hours care provided in the Emergency Department at a reduced clinic rate.
Objectives/Outcomes
- To provide an alternative to emergency room rate to after hours non-emergent patients.
CAH Diabetes “Drive-Through”
A new program to begin at CAH in which anyone from the community can instantly obtain their blood glucose results. Diabetics can instantly obtain their A1C results. Registered Nurses and a Diabetic Educator available for teaching/counseling.
Objectives/Outcomes
- To assist in the management of pre-existing diabetics.
- To isolate new or at-risk individuals for diabetes.
- To refer as appropriate to further diabetes education opportunities.
- To provide point-of-care diabetic teaching.
- 75% of participants will demonstrate and increased knowledge of diabetes and prediabetes.
CAH Circle of Strength - Mammogram Voucher Program
To continue to provide free mammograms to woman with little or no health insurance that do not meet the criteria for assistance through the BCCCP Program of the Health Department of NW Michigan.
Objectives/Outcomes
- To provide promote breast health by providing access to free mammograms and other woman’s health issues.
Physician Recruitment
Understanding that we anticipate an influx of newly insured patients, in addition to those insured but unable to find a primary care provider, we are aggressively seeking internal medicine and family practice physicians as well as mid-level providers for offices throughout the region.
Objectives/Outcomes
- Fill expected need by the year 2018
Cardiology Services
In partnership with Traverse Heart and Vascular Center, we have arranged weekly clinics in Charlevoix so that patients will not have to travel far from home for cardiology care.
Oncology Services
In partnership with Ervin Hire, Oncologist at McLaren Northern Michigan, we have arranged for weekly Oncology clinics in Charlevoix so that patients will not have to travel far from home for Oncology care.
Other specialty clinics include Pain Management, Plastic and Reconstructive Surgery and Neurosurgery.
Health Priority: Mental Health
Charlevoix County
Fit-4-Life Adult Program
Education is provided in the areas of: stress management depression that is common factor in those suffering from chronic disease and obesity.
Objectives/Outcomes
- To promote the mental health and well being of the participants.
CAH Employee Mental Wellness
CAH Social Worker certified in counseling will be available to assist CAH employees as they desire with areas of stress and mental health. Yearly stress-reducing presentations are offered and encourage active participation in the CAH employee.
Objectives/Outcomes
- To promote the mental health and well being of the CAH workforce.
REMEC
Educational opportunities available to the community and the CAH employee on the topics of adult and adolescent depression
Objectives/Outcomes
- To help prevent children, adolescents, and adults from developing significant depression.
- If depression is present, to instruct regarding what can be done to identify it early and treat it appropriately.
Bereavement Group
This group is offered every summer at CAH in collaboration with the Health Department of NW Michigan.
Objectives/Outcomes
- The bereavement group allows those who have lost a loved one to share their struggles with others who have experienced a similar loss.
Handling the Holidays
Offered at CAH in collaboration with the Health Department of NW Michigan.
Health Priority: Abuse and Neglect
Charlevoix County
We have no current plans to address this issue as there are other agencies and organizations within our region that routinely provide preventive and other services for this population, including the Women's Resource Center, Northern Michigan Community Mental Health, the Child Abuse Prevention Council and the Health Department of Northwest Michigan.
Health Priority: Substance Abuse/Tobacco
Antrim County
CAH Smoking Cessation Program
CAH Freedom from Smoking program is offered in cooperation with the American Lung Association. “Freedom from Smoking” is a lively, interactive, eight-week step-by-step program to assist in breaking the nicotine habit. Taught by a trained smoking cessation facilitator.
Objectives/Outcomes
Participants will learn how to break the nicotine habit; get practical tips for handling stress, maintaining weight, and making changes in daily routines; and receive plenty of encouragement and support as they adjust to their post-smoking life.
75% of participants will cease nicotine habit for one year or more.
Health Priority: Maternal/Child Health
Charlevoix County
Maternal/Child Health
As one of only six Critical Access Hospitals in Michigan currently providing full-service obstetric services, Charlevoix Area Hospital has invested heavily in the provision and promotion of services for maternal and child health.
We have a current medical staff of two obstetricians and three pediatricians along with professional nursing staff that provides natural childbirth classes, lactation consultation and breastfeeding classes, siblings classes a car safety seat program and other offerings as needed.
Natural Childbirth Classes
Eight week series offered frequently throughout the year that instructs and prepares expectant parents in labor and delivery, relaxation and breathing techniques, caesarean delivery, medications, and anesthesia.
Objectives/Outcomes
- To prepare expectant parents for a healthy delivery of their infant.
- To promote the overall health and wellbeing of the expectant mother and child.
Breastfeeding 101 Classes
This class gives practical information for moms who plan to breastfeed and those who are still undecided.
Objectives/Outcomes
- To promote newborn health by facilitating maternal breastfeeding in accordance with recommendations of the American Academy of Pediatrics and the World Health Organization.
Siblings Class
This class is offered frequently throughout the year to prepare the siblings for life with a new baby using creative play, art, and tours of the birthing center.
Objectives/Outcomes
- To prepare siblings ages 2-12 years for life with a new baby.
- To promote a healthy relationship between the sibling and the newborn.
Car Seat Safety Program
This class is instructed by a certified car seat technician frequently throughout the year for parents of newly born infants.
Objectives/Outcomes
- To educate parents of newborn infants in the current regulations and requirements for infant car seat safety.
- To reduce motor vehicle related infant injury.
Infant CPR
Infant Cardiopulmonary Resuscitation classes offered frequently throughout the year to parents and expecting parents.
Objectives/Outcomes
- To educate parents of newborn infants in the current CPR techniques.
Community Health Fairs and Wellness Events
Annual Children’s Health Fair promotes breastfeeding, car seat safety and other topics associated with promoting a decrease in maternal smoking, childhood obesity and promotion of child and infant safety.
Strong Mammas Program
This class is instructed by a Physical Therapist for pregnant women interested in decreasing pregnancy-associated ligament pain while increasing their strength and flexibility.
Objectives/Outcomes
- To promote safe strength, flexibility, and pain reducing techniques in pregnant women.
Health Priority: Maternal Smoking
Antrim County
We have no current programs specifically targeting the smoking mom but we will work with area physicians to refer them to available smoking cessation programs provided as noted elsewhere in this plan. In addition, a CAH Respiratory Therapist is consulted to instruct in the danger of second hand smoke with each newborn mother with a smoking habit. A smoking cessation packet is provided with quitting techniques and state and local resource information.
Objectives/Outcomes
- To promote infant health and decrease infant mortality by decreasing the incidence of maternal smoking.