2013 Community Health Needs Assessment UNC REX Action Plan
Information collected through the 2013 CHNA will guide UNC REX Healthcare’s efforts to improve the overall health and wellness of residents in Wake County over the course of the next three years. The next CHNA will be available by June 30, 2016.
Implementation Strategy Development
UNC REX Healthcare has always been a good community partner. Providing more than $89 million in community benefits in FY12, having a very active executive team serving on community boards and a strong presence in numerous community partnerships, UNC REX holds a solid understanding of community challenges. Data provided in the 2013 CHNA provided further insight that has shaped brainstorming and strategy implementation. Coupling this information with data provided by the UNC REX Strategic Planning and Finance teams has helped shape the UNC REX plan of action.
Applying evidence/leveraging resources
The best way to address community health planning is to identify health disparities, gaps and unmet needs alongside a balance of community needs, resources, strengths and perceptions. Data in the 2013 CHNA provided timely, useful information which affirmed current strategic priorities and offered opportunities for further evaluation.
While the 2013 CHNA placed greatest emphasis on the top three identified findings deserving greatest attention, UNC REX also plans to place emphasis on the closely identified fourth item, as well. As a health care organization, resources are readily available to address the fourth area in greater scope.
These top identified areas and how UNC REX plans to address them are as follows:
- Poverty and Unemployment: Continued emphasis on making UNC REX an excellent place to work, cultivating a diverse workforce that provides a variety of skilled labor and professional positions and continuing to grow and create jobs is of high priority.
- Healthcare Access and Utilization: Strategic analysis of the Wake County market to determine areas which have greater needs for medical care, including reviewing opportunities to expand the primary care and urgent care footprint. And, creating a plan to address utilization of emergency departments vs. primary care. Additional research into expanding opportunities for Medicare and Medicaid access is warranted. With the introduction of the Affordable Care Act (ACA) UNC REX will structure education and enrollment sessions to encourage utilization of health care services.
- Mental Health and Substance Abuse: Coordinating efficiencies in health care delivery to best address those suffering with mental illness is of great emphasis. Efforts are underway to assist with access to outpatient services and collaborate with other community providers to meet needs of this patient population.
UNC REX has made a commitment to the Wake County Crisis Collaborative. This initiative will require UNC REX representatives (ED Director and ED Manager) to meet monthly with community provider leaders (hospitals and mental health agencies) and work collaboratively with this inter organizational group to:
- identify resources for wrap around outpatient services and how patients can access the services
- collaborate with Wake county magistrate’s office to address the sharing of support for those patients under involuntary commitment
- support the work of the Wake County Crisis Center
- promote collaboration and cooperation among provider hospitals and agencies to address specific community issues
Additionally, working with Wake County leadership, Alliance Behavioral Health and UNC Health Care System, UNC REX has plans to incorporate greater access to enhanced mental health services to Wake County patients. Monthly coordination meetings with Alliance Behavioral Health are underway to address specific needs of Medicaid or indigent mental health patients presenting to UNC REX. A commitment to provide a behavioral health case worker on-site, weekly, at UNC REX to assist social workers and staff in coordinating access to behavioral health services has been made.
With the transition to UNC REX Health Care’s oversight of the WakeBrook facility in 2013, patients will have much-needed access to higher levels of behavioral health and medical care. The new inpatient psychiatric beds at WakeBrook will be filled with direct REX Emergency Department Coordination. UNC REX clinical staff is also participating in the Chronic Pain Initiative with Community Care of North Carolina (CCNC), where a collaborative, proactive approach to aiding patients with chronic pain issues is taken. This is with the hopes of reducing the incidence of overdose and death due to abuse.
Further support for the National Alliance on Mental Illness (NAMI) and the Foundation of Hope’s Walk for Hope is also planned.
Obesity and Wellness
During the next three years, UNC REX will expand its footprint with heart and vascular services and begin construction on the county’s first heart hospital.
The five REX Wellness Centers geographically spread across the county will continue to be an integral part of improving fitness and nutrition, supporting community activities, providing education and offering healthy fruits, vegetables and local, organic meats through the LoMoMarket. Supporting local initiatives that expand access to fresh fruits, meats and vegetables, will continue to be a focus at the Downtown Raleigh Farmers Market. This initiative will also showcase health experts who will provide education on a variety of health topics and cooking demonstrations to teach people how to cook and eat different health foods.
Additionally, greater integrated partnerships with the American Heart Association and others to provide screenings and no-cost interaction with health experts about cardiovascular disease will work to address the obesity epidemic. Expanding free online tools such as HeartAware Risk Screening and StrokeAware Risk Screening for health assessment and provide timely follow up. Additionally, a new program to screen at-risk diabetic patients is underway in research phase to educate patients; millions of Americans unknowingly live with diabetes.
Measuring and Reporting Results
Over the course of the next three years, UNC REX will monitor and track efforts and outcomes directly related to programs and services with a focus on needs identified in the CHNA.
UNC REX will evaluate results for the following:
- Healthcare Access: measure the percent of uninsured who enroll in an insurance exchange through UNC REX Healthcare as a result of outreach efforts.
- Obesity/Wellness: measure the number of people reached by wellness initiatives. Measure the number of people taking online screenings; and evaluate the impact of online screenings by assessing changes in high risk health factors. Measure perceptions of health care utilization, chronic conditions and preventive health behaviors through quantitative research.
- Mental Health: track the number of mental health patients diverted from the emergency department to more appropriate care.
With changes to health care and mental health systems, increases in chronic and communicable diseases, and challenges of the economic climate, building partnerships with public health, hospitals and health care organizations, non-profits and other non-traditional partners is essential for community health improvement. In order to effectively meet the needs of Wake County residents, establishing effective partnerships is essential.
Some key partnerships that support community health improvement that UNC REX Healthcare is part of include:
- Alice Aycock Poe Center for Health Education
- Alliance Medical Ministries
- American Heart Association
- Urban Ministries
- North Carolina Prevention Partners
Over the next three years, UNC REX commits to continue to:
- Monitor and investigate the health needs and issues in the community
- Mobilize community partnerships to improve community health
- Educate and empower residents to live healthier lives
- Develop programs and policies that support community health improvement efforts
- Increase residents’ access to health and mental health services
Global platforms to reach residents in Wake County, such as the free, UNC REX On Call, a live, call-in monthly health program on WRAL-TV and streamed live on wral.com will continue to provide an educational platform to residents in Wake County. This show, featuring topics such as primary care, cancer, obesity, cardiovascular disease, women’s health and mental health, is another way UNC REX can educate the public.
Improving access to high quality health care and managing costs efficiently is a priority at UNC REX, as is empowering and educating our community to take action to improve their health status. Research and evaluation leads to better information about the effectiveness and impact of our work, ultimately leading to better discussions, decision-making and outcomes.
UNC REX Healthcare is dedicated to supporting the ongoing efforts of health systems and community partners in Wake County to:
- Encourage collaborations across sectors
- Guide individuals toward making informed health decisions
- Measure the impact of prevention activities
For additional information, please contact UNC REX Healthcare Vice President of Communications and Marketing Lisa Schiller at (919) 784-4420 or via email.