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Strategic Initiatives and Process for Public Participation
In keeping with the formal organizational values of "partnerships" and "our people, our community," as well as our belief in openness, inclusiveness, and transparency, NMC strives to provide multiple opportunities for public input in the hospital’s current services and our plans for the future. The goal is to foster discussion with community members in various formats relating to the health of the community, needs in the community, hospital services, and opportunities for improvement within our hospital and our local health care system.
Collaboratively Assessing and Addressing Community Needs & Priorities:
The hospital has been a long-standing collaborative partner in two formal community assessment and reporting projects (in addition to the work done in 2004 and 2006 through the Act 53 process). The Franklin Grand Isle United Way’s “Who We Are, How We Live, What We Need – Guide for Community Leaders” is a foundational document in planning efforts. Data and insight from that document is typically shared with the NMC Board, Leadership, and Medical Staff leaders during the hospital’s annual planning process – either directly during years of updates or indirectly as reference material associated with other presentations. NMC has also been an active participant in the development of the Franklin Grand Isle Community Partnership’s “Bridges to Community Well Being -- Regional Report Card.” The priorities, outcomes, and indicators from this document are similarly incorporated into planning considerations at NMC. Both of these community-based initiatives are developed by using a blend of statistically-valid quantitative community data, input from providers and community leaders, and qualitative/anecdotal data and input from the community at large. In 2009, the community collaborated to merge these two documents – further reducing duplication of effort and providing a single publication to summarize the community’s needs and the actions being taken to address those needs. NMC has had an active role in that effort. Naturally, as appropriate and feasible, the hospital is an active participant in, and supporter of, community-based collaborative efforts to address many of the issues identified in these reports.
Achieving Openness, Inclusiveness, and Meaningful Public Participation:
NMC uses a variety of strategies to formally and informally engage the community in our own strategic planning efforts, decision making, and efforts to improve the health of our community:
- A statistically-valid community perceptions survey, typically administered every three years in keeping with the NMC strategic planning process (most recently completed in February of 2010), to ascertain what the community knows about their local hospital-based healthcare resources, how they feel about those resources, what could be improved, and what is needed;
- A variety of other survey processes for both patients, members of the general public, and community leaders (historically including written surveys, telephone surveys, focus groups, personal interviews, etc);
- A variety of community discussions in various formats relating to hospital plans and activities, community needs and priorities, and health care topics;
- Personal contact facilitated through direct community involvement by hospital Staff, Board, and Medical Staff as volunteer members of local Boards, initiatives, and organizations;
- Personal contact facilitated through the geographic distribution of NMC Board Members and hospital staff.
NMC also gathers valuable public input through participation in community planning events by representatives of the NMC staff. These public meetings are typically focused on planning what the community can do in areas outside the direct provision of healthcare (such as crime and public safety, transportation needs, environmental conservation, Vermont’s energy future, etc). NMC participates as both a major employer and a healthcare provider, maintaining an active ear for opportunities in terms of “what can the hospital do” that may be supportive of the community’s efforts. These ideas are then funneled into the hospital’s short-term and long-term planning, creating a multi-directional planning channel that directly links the hospital to the community’s own efforts.
NMC engages the community through our role in a wide variety of community partnerships and initiatives. We take great pride in the community involvement by our staff as individuals as well as the formal involvement of NMC as an organization. The following is a sampling of the broader groups in which NMC participates within our community as an organization:
- The Franklin Grand Isle Community Partnership;
- The Franklin Grand Isle United Way (as a partner and supporter, not as a member agency);
- The Center For Health & Wellness;
- The Champlain Valley Area Health Education Center;
- EMS District 1;
- The Franklin Grand Isle Work Force Investment Board;
- The Franklin County Industrial Development Corporation;
- The Franklin County Regional Chamber of Commerce;
- The Grand Isle County Chamber of Commerce.
In addition, NMC also engages the community in our efforts by welcoming their active participation in the hospital, through:
- Service as an NMC Volunteer (110 active volunteers, contributing 18,680 hours).
- Service as an NMC Auxilian (356 members);
- Service as an NMC Incorporator (121 members);
- Service as an NMC Staff Member (600 employees);
- Service as an NMC Physician (77 Active/Associate staff); and
- Service as an NMC Board Member (12 members).
NMC’s Strategic Plan – Priorities & Updates:
NMC’s Board, Medical Executive Committee, and Leadership Team work together – drawing in expertise and facilitation from QHR -- to develop the hospital’s strategic plan. A comprehensive rewrite is conducted every three years, with yearly updates in the intervening years. Consideration is given to community needs and perceptions; demographics and other aspects of the local environmental assessment; political/regulatory pressures, marketshare, utilization, and financial performance; and a variety of additional factors.
The new 2010-2013 NMC strategic plan has been reviewed with the NMC staff, managers, Incorporators, physicians, and Board members. It has been endorsed by the Leadership Team, the Medical Executive Committee, and the Planning Committee of the Board. It was adopted by the full Board at their June, 2010 meeting.
The environmental assessment conducted in the preparation of the 2010-2013 strategic plan showed that our population is growing, but slowly – an average rate of just under 1% per year for our primary and secondary service area. Much of that growth is concentrated in the southern portion of our service area (Fairfax, Georgia, and Milton). It also showed our population is aging – with the number of people over the age of 65 projected to increase by 23% between 2008 and 2013. The assessment also identified that Vermont itself has the second lowest birthrate in the nation which is declining, a trend we see reflected in our service area. NMC was right at the expected national benchmark for inpatient market share of 50% for a sole hospital in a county, however a top-performing hospitals in such areas achieve up to 70% market share. The initial physician needs analysis showed our service area could support six additional primary care providers.
Based on the findings of the Environmental Assessment and discussions during the planning process, six critical issues were identified as top priorities to be addressed:
- Access to Primary Care: NMC will be a leader in the recruitment and employment of primary care physicians, with a particular emphasis on Internal Medicine, to stabilize and expand access in our community.
- Physician Relations: We will develop mutually-beneficial trust-based relationships between NMC and the physicians. We will also assist in strengthening the relationships between our physicians – and between our physicians and other providers in the community.
- Sustainable Operational Model for New Regulatory/ Reimbursement Environment: NMC will actively participate in healthcare reform efforts while creatively adapting to the changing regulatory/reimbursement environment to preserve our ability to care for our community.
- Chronic Disease Management and Prevention: NMC will respond to the needs of our population through excellence in the management and prevention of Chronic Disease in collaboration with providers and our community.
- Distinguish Ourselves in the Market through Core Services and Process Redesign: NMC will maximize our market share through investment in the high-priority service lines where we can excel.
- Physical Space Needs: NMC will strategically invest in existing and new physical space to provide the resources necessary to care for our community.
The strategic plan carries a dashboard of measures used by the NMC Board and Leadership to monitor NMC’s status, providing empirical guidance to the strategic priority projects which flow from through the strategic plan.
Significant effort is ongoing as the hospital continues works to address priorities facing the community and the hospital, with highlights including:
- Access to Primary Care has been stabilized and expanded in the past year through retention and recruitment efforts. The Georgia Health Center physicians are now employed by Northwestern Medical Center. NOTCH continued to expand with the recruitment of Dr. Bradley Reynolds for their St. Albans Office. Dr. Max Bayard, a Family Practice Specialist, has been recruited to the community by NMC and will open “Northwestern Primary Care” in the Cobblestone building on the hospital campus in August of 2010. Work to retain our existing primary care physicians and recruit additional providers continues.
- Georgia Campus: Increased convenience of services, reduction of the impact of rural isolation, increased access to non-emergent care, and the need to increase awareness of available services in the southern portion of our service area are factors identified in various planning documents that contributed to the plans for a “Georgia Campus.” In May of 2009, NOH & NMC opened Northwestern Walk-In Clinic in the Georgia Medical Group Building. Initial community response has been very positive to the Walk-In Service. Digital mammography, x-ray, and performance rehab services are also available at the Georgia site. Given the growing population identified in the environmental assessment, we continue to focus on this outreach. The Walk-In Clinic is on pace with growth projections and community response to expanded local services has been very positive.
- Employee Health: With 600 employees of our own, healthcare costs represent a significant expense to the hospital. In an effort to achieve true long-term savings in healthcare costs while enjoying immediate improvement in morale, NMC is investing in prevention with our new “Healthy U” employee health program. This research-based proactive approach features incentives for health risk appraisals, preventative screenings, healthy activities, health education, and refraining from tobacco use. Response has been phenomenal – with participation levels nearing Year-3 projections mid-way through Year-1, including a remarkable 85% participation in the health risk appraisal component. We are seeing measurable improvements in employee’s personal health and a reduction in the overall risk factors facing our workforce.
For additional information on hospital strategic planning, capital plans, and/or depreciation schedules, please contact NMC’s Director of Planning & Community Services (see below).
Planning & Community Relations Contact Information:
For more information on strategic planning and public participation, please contact:
Jonathan Billings
Director of Planning & Community Services
NMC, 133 Fairfield Street, St. Albans, VT 05478
(802) 524-1044 * (802) 524-1291 fax * jbillings@nmcinc.org
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