Strategic Initiatives and Process for Public Participation


Community Health Needs Assessment

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: Our community has a strong history of collaboratively assessing and addressing community health needs and priorities.  Building upon this shared commitment to a healthier community, NMC complied with the Federal mandate and completed “The Community Health Needs Assessment” in 2018/19 as a follow-up to the 2015/16 version.  Facilitated by Quorum, this comprehensive effort included both a review of quantitative statistics relating to our areas health as well as a significant qualitative survey of local residents’ perceptions of health in our community.  This data was then studied and prioritized by a broad-based group of community leaders.  Top priorities identified include:

  • mental health;
  • substance abuse;
  • obesity;
  • suicide;
  • domestic & sexual abuse;
  • food insecurity;
  • tobacco use & vaping. 

This assessment was also considered as foundational data during NMC’s work to develop our Strategic Plan. Click here to read the 2018/2019 Community Health Needs Assessment.

The new 2022-24 Community Health Needs Assessment for Franklin and Grand Isle counties (NMC’s service area) was conducted in the Spring of 2022 by NMC and community partners with facilitation by The Center for Rural Studies at the University of Vermont. The assessment is now progressing through the finalization stages and is due for adoption by the NMC Board in June of 2022. Once adopted it will be posted online on NMC’s website and broadly available as per requirements. NMC and the community partners, likely working through the newly forming Accountable Communities for Health, will then create and implement an action plan to address priorities within the assessment. That plan will also be posted and shared broadly and is anticipated to be available before February of 2023.

Annual Progress Report on CHNA 

Action plans to address the priorities of the 2019 CHNA have been developed and are being implemented by NMC and other organizations – both individually and collaboratively. The full CHNA document carries those action plans.

In reflection on the 2018/2019 CHNA, much of the planned work on priorities gave way at some level to the focus on responding to the COVID-19 Pandemic in 2020, 2021, and 2022. This pandemic disrupted health improvement efforts within healthcare, education, municipalities, and worksites. Navigation of the pandemic became the focus of a tremendous and positively impactful community-wide response that helped contain spread of the virus and led to outstanding vaccination rates.

Despite disruption in the past years due to COVID, related work did include:

  • The RiseVT community campaign to embrace healthy lifestyles featured prevention work (albeit steadily decreasing as resources were reallocated, with this program due to sunset in June of 2022) with individuals, schools, businesses, and municipalities to raise awareness of the importance of wellness and help make the healthy choice the easy choice through community engagement, policy advancement, and infrastructure improvements. 
  • The transition of care and service through NMC’s chronic pain and addiction service to community partners The Howard Center and The Phoenix House to create sustainability along with a refocusing of pain management within Primary Care aligned with established protocols. 
  • Continuation of partnerships in mental health care and the embedding of mental health in primary care offices, efforts that tie directly to the continued work to care for mental health patients safely in the Emergency Department with the approval of a certificate of need for a comprehensive renovation of the Emergency Department (project paused during pandemic, expected to launch in summer of 2022);
  • Continued emphasis on smoking prevention and succession in collaboration with Northwestern Counselling & Support Services, Blueprint for Health; and the Franklin Grand Isle Tobacco Prevention Coalition; 
  • Continued emphasis on the prevention of, early detection of, and coordinated care of cancer through NMC’s nationally accredited community cancer program; 
  • Support of efforts relating to awareness and prevention of suicide, domestic abuse, and sexual abuse – with NMC’s sexual assault nurse examiners in the Emergency Department and strong community partners including Voices Against Violence and Watershed Mentoring; 
  • Other strategies aligning with awareness, education, resource allocation, and collaborations relating to the identified priorities.

Achieving Openness, Inclusiveness, and Meaningful Public Participation

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:

  • Patient satisfaction/Engagement surveys of hospital and hospital-employed-physician-practice patients to measure the patients’ perceptions of their care and identify opportunities for improvement;
  • The meetings of the NMC Incorporators, a 150-member group of geographically representative individuals from throughout our service area who elect the NMC Board, approve hospital bylaw changes, and serve as direct connections to the pulse of the community;
  • A variety of community discussions in various formats relating to hospital plans and activities, community needs and priorities, and health care topics;
  • Community perceptions surveys, typically administered in keeping with the NMC strategic planning process or community health assessment efforts, 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 (most recent completed in May of 2022);
  • The availability of open public comment sessions at NMC Board Meetings on a scheduled basis;
  • 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 food insecurity, 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 Unified Community Collaborative of Franklin & Grand Isle;
  • The Regional Clinical Performance Council of Franklin & Grand Isle;
  • The Franklin Grand Isle Community Partnership;
  • The United Way of Northwestern Vermont (as a partner and supporter, not as a member agency);
  • EMS District 1;
  • The Franklin Grand Isle Work Force Investment Board;
  • The Franklin County Industrial Development Corporation;
  • The St. Albans Rotary Club;
  • The Franklin County Regional 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 (more than 80 active volunteers, contributing over 8,000 hours – numbers which reflect reductions due to the pandemic).
  • Service as an NMC Auxilian (more than 300 members);
  • Service as an NMC Incorporator (nearly 150 members);
  • Service as an NMC Staff Member (more than 800 employees);
  • Service as an NMC Physician and Advanced Practice Provider (more than 100 Active staff); and
  • Service as an NMC Board Member (up to 12 members).

NMC’s Strategic Planning Efforts

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.  NMC established its FY’20-22 Strategic Plan in the Spring of 2022.  The new strategic plan was developed with the NMC staff, managers, Incorporators, physicians, and Board members. It was endorsed by the Leadership Team, the Medical Executive Committee, and the Planning Committee of the Board before being adopted by the full Board..

To start the planning process, a comprehensive Market assessment was completed by QHR planning consultants with assistance from NMC Leadership and Finance staff.  This assessment included a review of population projections, demographic shifts, operational statistics, community health assessment results, market share data, competitive forces, financial data, national benchmarks, results of stakeholder interviews, community perceptions, health care trends, and NMC’s Mission, Vision and Values.  The environmental assessment showed that our population is continuing to grow, but growing slowly. 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 significantly.  Based on the findings of the Environmental Assessment and the results of the extensive multi-disciplinary planning process, the following critical issues were identified as top priorities to be addressed during FY’20-22:

  • Quality and Safety: Achieve “zero” preventable harm. Sustain “zero” preventable harm.

  • Financial Sustainability: Keep care local by enhancing CORE SERVICES, achieving OPERATIONAL EFFECTIVENESS, and supporting COMMUNITY PARTNERSHIPS.

  • Engagement: Foster a culture which inspires and engages our people and our community. 

For each year of the three year strategic plan, an annual operating plan and an annual quality plan are created to define and track efforts to address the critical issues.  Key strategic initiatives are developed to address each critical issue, with timelines and responsibilities identified. 

Progress on the annual operating plan and the annual quality plan is reported to the Board on a monthly basis. In addition, dashboards of measures are used by the NMC Board and Leadership to monitor NMC’s status, providing empirical guidance to the strategic initiatives which flow from the strategic plan.  

NMC is conducting its next round of strategic planning which will map the organization’s course for Fiscal Years 2022, 2023, and 2024 during the Spring and Summer of 2022.  The Community Health Needs Assessment and the Community Perceptions Survey and the Market Assessment have been completed. NMC conducted a formal strategic planning retreat in May of 2022 which will lead to the completion of NMC’s FY 22-24 Strategic Plan – with adoption by the NMC Board anticipated prior to Sept 30, 2022.

For more information on strategic planing and public participation, please contact: Jonathan Billings, Chief Operating Officer, NMC, 133 Fairfield Street, St. Albans, VT 05478 (802) 524-1044 * (802) 524-1291 fax * [email protected]