On March 23, 2012 it became a requirement for all hospital organizations operating a state-licensed hospital facility to compete a community health needs assessment (CHNA) at least every three years. The report must include a description of the community the hospital serves, the process and methods used to complete the assessment, input from persons representing the interest of the community, a prioritized description of the community health needs and a description of the existing health care facilities and available resources in the community. The CHNA must be available to the public by being posted on the hospital or organizational website.
Hospitals must develop a written plan addressing each need identified in the CHNA, as well as provide implementation strategies for meeting the community needs (Adams, 2011).
In the given case study, Trinity Community Hospital has complete their CHNA by identifying the communities major risk factors, ill health causes and actions required to address these issues. Trinity Hospital’s CHNA targets cancer, orthopedics and cardiovascular services within the hospitals primary service region. To complete the assessment the hospital utilized information from epidemiology surveys, planning guidelines from state healthcare facilities, physician interviews, interviews with other healthcare professionals and community focus groups. A.1. Major Risk Factors Identified in the Assessment
Oncology Services
In the evaluation of oncology services, the CHNA identifies that 15% of the population will be over 65 within the next five years. The CHNA also identifies that 50% of men and 33% of women are expected to develop cancer during their lifetime and that new cancer cases are expected to grow from 3,200 in the present year to 4,282 in five years (an increase of 34%).
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Every member of society should be required before the age of 21 to perform at least 1 year of community or government service, such as in the Piece Corps, the military, a hospital, the Environmental Conservancy Corps, a rural or inner-city schools, or some equivalent organization. It has been suggested that to improve communities of United States and to solve the problem of too few workers for ...
The assessment also identifies that that the existing facilities that prevent, diagnose and treat cancer are already stressed. Current practices are at capacity and the facilities and equipment are not keeping pace with growth and patient volume. The CHNA identifies additional needs for chemo units, linear accelerators, advanced imaging equipment and operating suites. Patients and health care professional complain that the services are poorly coordinated and are fragmented, causing a delay in services, tests and treatments. Little emphasis is placed on ways to prevent or control cancer and education programs to aid in lifestyle modification are sporadic and infrequent. Orthopedic Services
The CHNA identifies that the needs for orthopedic service will rapidly increase in the next five years. Orthopedic cases for the community are expected to increased from 11,800 to 17,338 (an increase of 46%).
The community’s inpatient spine and joint procedures are expected to increase by 30% and the outpatient spine and joint procedures are expected to increase by an alarming 350%. The CHNA states that existing resources, hospitals and physicians currently available will not be able to meet the needs for the orthopedic service in the future. Hospitals will need additional surgical suites, imaging equipment, and rehab and physical therapy capacity. Patient care coordinators will be needed to assure that service are available and schedule in a timely fashion. Educational programs to aid in accident prevention training, as well as healthy lifestyle choices will be needed, especially for the elderly and athletes. Cardiovascular services
The CHNA identifies that the cardiovascular needs of the community will also increase in the next five years. Coronary artery disease cases are expected to increase from 54,000 to 65,700 (an increase of 21.6%), diagnostic cath lab procedures are expected to increase from 10,800 to 13,140 (an increase of 22%) and angioplasties are expected to increase from 4,000 to 5,032 (an increase of 25.8%).
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Gleneagles hospital Kuala Lumpur provides clear information about direction to service site on the websites. The address of Gleneagles hospital Kuala Lumpur is No 282 & 286 Jalan Ampang, 50450 Kuala Lumpur. Gleneagles hospital describes the location of the hospital where is located on Embassy Row on the main Jalan Ampang, Kuala Lumpur. The hospital location is central and easily accessible by ...
The assessment identifies the needs for additional facilities, equipment and physicians to provide care for those suffering from cardiovascular diseases. All hospital in the community will need to plan for additional cardiac cath labs, surgical suites and cardiac rehab capacity. Patient care coordinators will be needed to assure that patient receive timely care and there is a strong need for education in regard to cardiac risk factors, healthy living and lifestyle modification. A.2. Trinity Community Hospital: Addressing the needs in the CHNA Oncology Services
Trinity Hospital’s five year plan addresses the need for oncology service expansion and the plans for development of a regional cancer center. Their strategy includes disease focused clinics for breast, gastrointestinal, lung and prostate cancers. They plan to offer comprehensive medical, surgical, radiation and support service, as well as evidence-based treatment and access to leading clinical trials. The hospital plans to emphasize cancer prevention and control by developing community education programs, screening and risk assessment, and to reach out to underserved communities. The hospital plans to fast-track scheduling and use patient navigation to enhance services. The hospitals target outcomes for the regional cancer center includes an increase in radiation oncology treatments to 9,100 and chemo treatments to 7,000. The plans for the oncology center include a simulator linear accelerator and an infusion suite. The CHNA expresses a need for additional operating suites and chemo units. These two areas do not appear to be addressed in the five year plan. Orthopedic Service
The Essay on Community Service 9
Community Service Thaakat in Urdu means the quality or state of being strong, someone or something that gives strength, a source of moral and mental power or encouragement. Strength, courage, and validity are all synonyms of Thaakat. Thaakat Foundation is a non-profit organization that aims to inspire and promote charitable giving. Volunteer work opportunities are offered among students and young ...
Trinity Hospital’s five year plan addresses the need for the development of a regional orthopedic center noted for clinical and service excellence. The hospital plans to offer clinical programs and service for spine, total joint and hand needs, comprehensive rehab and support programs and best practices and treatment protocols. The CHNA also states a need for additional surgical suites; this does not appear to be addressed in the five year plan. The hospital’s plan includes emphasis on prevention of injury and disease by providing community education, screening and risk assessment and by reaching out to underserved communities. The CHNA state a need for targeting the elderly and those participating in athletics and fitness. The plan addresses the need for fast-track scheduling and coordination of services. The orthopedic center plans to serve 2,100 surgical cases and 6,500 physical therapy visits. The new regional orthopedic center entails a 5,000 square foot physical therapy/rehab center and radiology expansion with a second MRI unit. Cardiovascular Services
Trinity Hospital’s five year plan addresses the need for a cardiovascular center noted for clinical and service excellence. The hospital plans to offer distinctive clinical program and services in relation peripheral artery disease, heart failure and electrophysiology. They will focus on cardiology for women and evidence-based treatment. The hospital plans to emphasize prevention and control of cardiovascular disease through community education, screening and risk assessments and service that reach out to the underserved communities. The hospital has included fast-track scheduling and coordination of service in their plan. The hospital plans to increase diagnostic cardiac catheterizations to 2,000 and peripheral vascular procedures to 500. The cardiovascular center will include two new cath labs and a cardiac rehab expansion. The CHNA expresses a need for additional surgical suites, but this is not mentioned in the five year plan.
B. Health Planning Summary with Recommendations on Outstanding Community Needs Over the past year Trinity Community Hospital built a CHNA that targets the needs for cancer, orthopedic and cardiovascular services in their community. According to the Center for Disease Control (CDC) essential public health services should be responsible for: 1. Monitoring – Identify and solve community health issues. 2. Diagnose and investigate – Community health problems and hazards 3. Inform and educate – empower citizen about health issues 4. Mobilize – Develop community partnership to identify and solve health problems 5. Develop Policies and plans – Should support community and individual health efforts 6. Enforce – Laws and regulations must be in place to protect health and ensure safety 7. Link – People need to have access to personal health services 8. Assure – Public and personal health care workforce should be competent 9. Evaluate – Population-based health services should be evaluated for effectiveness, accessibility and quality 10. Research – To develop new insights and innovative to solution to health problems (CDC, 2012)
The Essay on Inpatient and Outpatient Hospital Services 2
Inpatient hospital services are services that provide patients a place to stay overnight. Inpatient care facilities can also be provided for special services. A couple of examples of an inpatient care setting are a skilling nursing facility or a long-term care facility. “A skilled nursing facility (SNF) provided skilled nursing and/or rehabilitation services to help with recovery after a hospital ...
Trinity Hospital has a mission in their five year program plan “to provide outstanding care for all our patients”. Their vision is “to position Trinity Community Hospital as a premier provider of cancer, orthopedic and cardiovascular services”. The values stated in the five year program plan are “to emphasize four basic principles of success as we work to achieve our mission and vision: Quality and safety, service excellence, staff achievement and growth and profitability. The CHNA identifies an increase demand for oncology, orthopedic and cardiovascular services. Trinity Hospital cannot currently meet the upcoming needs of the community and have develop their five year plan to aid in meeting the community’s needs. The population in the community is aging and within the next five years 15% of the population will be over the age of 65. The hospital currently has numerous specialists that have privileges at their hospital, but most of those hold privileges at competing hospitals also. The hospital currently has 150 beds in the hospital, 136 medical or surgical and 14 beds for intensive care.
There are 20 operating rooms and an emergency room. The hospital did lose their OBGYN program and their general surgeries have declined over the past three years. The hospital is located in a thriving community with high tech businesses and industries. The city has a population of 400,000 and the county 900,000, with a population growth of 4% each year. The population is 49% male and 51% female. Key financial indicator have dropped due to a decrease in patient volume, thus it is important for the hospital to maintain some of their $25,000,000 capital reserve for projects other than new program development. The areas of the CHNA that are addressed in the five year plan are the need for education, screening and risk assessments, outreach to underserved communities, fast-track scheduling, patient navigation, support services, evidence-based treatments, equipment and space. What the five year plan is vague about is the need for physicians and nursing personnel to run the new programs and the need for surgical suites. The plan should include detailed information about recruitment of new physicians and employees. It may be wise for Trinity hospital to look to their board member for guidance on recruitment efforts.
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: God has been in this documentation, in giving such strength and guidance that accomplish this documentation paper. I would like to thank and extend my profound gratitude to those who helped me, such a way and even in a small way. Mr. Romy G. Ebi, my subject teacher who gave his valuable guidance for his worthy advice and warm support during the implementation of our OUTREACH PROGRAM. Finally, I ...
One board member, Mrs. Cathy Promo, feel confident that extensive marketing and advertising could reverse the hospital’s downward utilization trend. Mrs. Promo’s expertise can be utilized to advertise the changes that are ahead for Trinity Hospital. Mrs. Maria Lopez is another board member that can help the hospital reach out to minority groups that may be underserved. She owns a newspaper that is popular in the Latino community and this could be a way to advertise or bring educational material to minority groups. Dr. David Joint is a board member that is an orthopedic surgeon and his group is planning to open a branch office near Trinity Hospital. This board member may be key in developing the new orthopedic program and recruiting new orthopedic surgeons to the hospital. Dr. Randy Sharp is a general surgeon that works frequently at Trinity Hospital. He has taken an interest in the cancer services and is planning to recruit a subspecialty-trained oncologic surgeon. Dr. Sharp may be very helpful in starting up the oncology department. The hospital currently has four cardiologists that hold privileges at the hospital.
These doctors may be key in developing the upcoming cardiovascular services. By allowing specialist to buy into the program early and aid in decision making they will likely take ownership of the project and be apt to work in the programs after they are developed. Other issue the CHNA and five year plan did not address is the need for an increase in surgical suites and OBGYN services. All three areas, oncology, cardiovascular and orthopedic services, call for an increase in surgical suites. This will be a major issue in the future, as if a surgeon or patient cannot get a surgical suite or operating room in a timely manner they will take their needs elsewhere. One of the hospital’s competitors is only ten miles away and they have a 700 bed facility, strong orthopedic and neurosurgery programs, a trauma center and a comprehensive heart center. Another competition is only seven miles away and is a 350 bed facility and has strong orthopedic services and cardiac services (including open heart surgery).
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As we mentioned above, Bumrungrad International Hospital attracted most of the experienced doctors with accredited medical degree. (MD, DO, ABMS Member Board, ACGME, and the American Board of Medical Specialties) There are 3400 full time staff, 1200 licensed doctors and more than 900 nurses in Bumrungrad International Hospital, Thailand. Why Human Resource Management? Firstly and the most absolute ...
Neither of these competitors excel in all three area of cardiovascular, oncology and orthopedics. Thus, it is important for Trinity Hospital to excel in all three and be the hospital of choice. If excellence is achieved in all three areas, the hospital will likely need to expand and allow for more patient rooms and operating rooms in the future. Another area overlooked in the CHNA is the need for OBGYN services. In the region 51% of the population is female. This indicates a strong need for OBGYN services to meet community needs. The hospital’s OBGYN services were phased out due to their primary physicians moving to another hospital. It is essential that Trinity Hospital investigate the need for these services and the cost associated with building the program up again.
References
Adams, Anne. 2011. Guidance Issued on Community Health Needs Assessments for Exempt Hospitals. Retrieved July 1, 2012 from website:
http://www.healthcarereforminsights.com/2011/08/04/guidance-issued-on-community- health-needs-assessments-for-exempt-hospitals/
