The Heart of New Ulm: Population Health Takes a Village Rebecca - - PowerPoint PPT Presentation

The Heart of New Ulm: Population Health Takes a Village

Rebecca Lindberg, MPH, RDN Karen Moritz, RN, BSN, PHN Cindy Winters March 21, 2018

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Poll #1

Tell Us About Your Organization

Poll #2

Tell Us About Your Partnerships

Today’s Webinar Presenters

Rebecca Lindberg, Rebecca Lindberg, MPH, RDN , RDN

Director, Population Health & Professional Education Minneapolis Heart Institute Foundation

Cindy Cindy Winter inters

Manager, Heart of New Ulm Project Minneapolis Heart Institute Foundation

Kar aren M en Moritz,

• ritz, RN

RN, , BS BSN PHN PHN

Director, Brown County Public Health

Objectives

Understand how to drive a community transformation agenda to propel health as a shared value across community partnerships Identify strategies for leveraging data to target and engage those most at risk and sharing data for community engagement and impact Summarize a sustainable framework for community transformation guided by the social determinants of health

“A healthy person

• ver a given decade

will spend about two hours with their

• doctor. The idea that

that two hours will determine their health for that decade is pretty unreasonable.”

Initial Partnerships Established

Primary Objectives

Improve the proportion of 56073 zip code residents (age 40-79 years; active

Allina health record) with controlled modifiable heart disease risk factors

• ver 5 years. *
• 1. Elevated blood lipids (i.e., total/LDL/HDL cholesterol, triglycerides)
• 2. High blood pressure
• 3. Uncontrolled glucose (i.e., type 2 diabetes, pre-diabetes)
• 4. Obesity
• 5. Tobacco use
• 6. Physical inactivity
• 7. Low fruit/vegetable consumption
• 8. Uncontrolled stress
• 9. Medication underutilization/non-adherence

2009 Community Diagnosis | New Ulm

41% Obese 35% Overweight 38% Metabolic syndrome 17% Consumed 5 fruits and vegetables a day

Electronic Health Record & Community Surveillance

Over 90% of New Ulm’s population has an active EHR

Photo Credit : https://www.eclinicalworks.com/products-services/eclinicalworks-v10-ehr-suite/

Data Collection Strategy

Community Needs

• Resident

surveys

• Focus groups
• CNA

Environmental assessments

• Physical environment
• Nutrition environment
• Policy and environmental

assessment

Screening data

• Behavioral
• Health-related data

Electronic health record

• Risk factors
• MI
• Demographics

Data Integration Plan for assessment, monitoring and communication Desired Impact

National/ State/Local Data

• MI
• Police
• Public health

5 Year Changes in Risk Factors

2008/09 n = 6082 2012/13 n = 6388 Total Cholesterol (mg/dL) 193.4 ± 0.5 187.8 ± 0.5 Cholesterol at Goal (< 200 mg/dL) 58.3 65.1 Triglycerides (mg/dL) 140.4 ± 1.1 132.4 ± 1.2 Triglycerides at Goal (<150 mg/dL) 66.4 70.1 Lipid medication 22.9 31.8

* Continuous outcomes are reported as mean ±standard error, and categorical outcomes are reported as percent. ** Residents age 40-79, adjusted for age and gender

Behavior Changes Among Screening Participants age 40-79

Measure 2009 (n = 3,123) 2011 (n = 1,976) 2014/15 (n = 1,008) Smoking 7.9 7.4 5.5 Physical Activity (at least 150 minutes per week) 63.9 73.1 76.2 Fruit and Vegetables (5 or more servings per day) 16.3 26.6 30.2

Screening analysis is age and gender adjusted to account for differential age and gender distributions in each screening time period.

Co Compa mparison rison of

• f HO

HONU NU C Cha hang nges es to to NH NHANES ANES

NHANES 2009-10 NHANES 2011-12 NHANES Change HONU 2008-09 HONU 2012-13 HONU Change BP at goal (<140/90 mmHg) 83.1% 82.5%

• 0.6

79.3% 86.0% +6.7 BP medication 35.2% 36.8% +1.6 38.3% 47.6% +9.3 LDL at goal (< 130 mg/dL) 64.3% 63.7%

• 0.6

68.0% 72.0% +4.0 Cholesterol at goal (<200 mg/dL) 47.5% 46.9%

• 0.6

58.3% 65.1% +6.8 Not Obese (BMI <30) 62.5% 62.3%

• 0.2

55.9% 55.2%

• 0.7

NHANES data selected for participants age 40-79, white non-Hispanic to provide a comparison group similar to New Ulm resident demographics, sample weights applied for analysis

New Ulm versus Comparison Community

Managed better: Blood pressure Total cholesterol Triglycerides

Healthcare Community Worksite

10 Year + Project

Intervention Strategy

Smoking policies, Complete Streets Policy, City Comprehensive Plan Program partnerships, community events, community-wide health challenges, social marketing campaigns Interventions delivered through healthcare, employers, restaurants, grocery stores, convenience stores, and schools Interventions provide social connection opportunities, business leader engagement opportunities, Phone coaching, provider education & training, lipid clinic

Improving community health will require new models of collaboration

Sustainability Strategy

From the beginning define: Agenda around common values and goals Partners’ roles and responsibilities Cost sharing responsibilities How interventions/strategies integrate into existing community structure Measureable outcomes Communication strategies Training needs

Photo by rawpixel.com on Unsplash

Community Leadership

HONU Vision

Schools Grocery Store Chamber Restaurant Health System Medical Center Foundation Large Business City Community Rep.

Public Health

Local College

Allina Health Board NUMC Foundation NUMC Board Quality Committee Allina Associated Foundation Board Finance Committee Executive Committee MHIF Action Team Action Team Action Team Action Team

Sustainable Structure

HONU

Action Team Action Team Action Team Action Team Action Team Action Team Action Team

Capacity Building

National Leadership Academy for the Public’s Health

DO frame your messages DO be teachable DON’T pull the obligation card

President Chamber of Commerce

School Superintendent

“It takes all community members and families working together to promote healthy lifestyles. Through MHIF’s Heart of New Ulm Project we’re working on Safe Routes to School, Complete Streets, promoting fitness

• ptions, healthier concessions, and

much more.”

City Government

Healthcare public health challenge

Systems and Environmental Improvements

2013 2014 2015 2016 2017 Conventional Bike Lanes 0 miles 1.5 miles 0 added 0 added 0 added Shared Lane Markings- Designated bike routes 0 markings 0 markings 165 blocks approved 47 blocks of sharrows painted 49 blocks of sharrows painted Percent of children commuting to school by bike NA 4% Safe Routes to School Plan launched 4% 4% Signage on bike circle route 5 miles 5 miles 11 miles (completed) Enhanced pedestrian crossings 1 Signage added at 2 Complete Streets Policy Adopted October 2016

Systems and Environmental Improvements

2009 2014 2015 2016 2017 Runs offered in New Ulm 2 8 8 8 8 Pieces of

• utdoor fitness

equipment 0 pieces 5 pieces in

• ne park

0 added 9 pieces in three parks Safe Routes to School Program NA Developed plan Plan launched

• walking & biking routes

mapped and distributed

• Pilot testing wayfinding

signs to schools

• 2 Walk to

School Days

• Pop-Up

Project at 1 school HONU Bike Racks Installed 25 bike racks throughout community Bicycle Friendly Designation NA NA Honorable Mention Bronze level designation

Secured snow removal on 2 different trails Outdoor fitness equipment in 3 parks

Community Communications Strategy

Communications

Example: mple: Program Outcomes

Project Awareness Earned & Purchased Media

Funding Strategy

Federal Grants Foundation Grants Philanthropy Allina Health Corporate & Industry Grants

Poll #3

Tell Us How it is Going

Poll #4

What Gets in the Way?

Lessons Learned

Understand the health needs and readiness for change in your community Engage key stakeholders around a common agenda – speak their language Leveraging community resources will advance agenda more efficiently and cost effectively Realize communications is a key strategy throughout the process Build community capacity Think sustainability from the start Realize this is a marathon and not a sprint Celebrate successes

“Just as ripples spread out when a single pebble is dropped into water, the actions of individuals can have far reaching effects.” – 14th Dalai Lama

Rebecca Lindberg, Rebecca Lindberg, MPH, RDN , RDN

Director, Population Health & Professional Education Minneapolis Heart Institute Foundation P: 612-863-4087

rlindberg@mhif.org

mhifpopulationhealth.org/heart-of-new-ulm (documentary) Heartsbeatback.org (Hearts Beat Back: The Heart of New Ulm Project) populationhealthimpact.org (MHIF Population Health Work) @PopHealthMHIF @relindberg @ckwinters

Cindy Cindy Winter inters

Manager, Heart of New Ulm Project Minneapolis Heart Institute Foundation P: 507-217-5548 cindy.winters@allina.com

Co Cont ntac act Us: t Us:

Kar aren M en Moritz,

• ritz, RN

RN, , BS BSN PHN PHN

Director, Brown County Public Health P: 507-233-6820 karen.moritz@co.brown.mn.us

Sustainable Population Health Improvement Solutions

PHF helps organizations improve population health outcomes and lead change initiatives. Services available:

• Are You Ready for Innovation?
• Transformational Leadership Training
• Developing the Population Health Workforce
• Mapping Solutions with Population Health Driver Diagrams
• Implementing Innovative Solutions
• Strategic Communications Planning Workshop
• Comprehensive Solution Package: Solving a Population Health Challenge

To learn more:

Contact Margie Beaudry at (202)218-4415 or mbeaudry@phf.org Explore these services in detail at www.phf.org/hospitalservices

Questions for Our Speakers? Type your question in the Questions panel We will get to as many questions as possible while we are live Answers to all questions submitted will be available online a few days following the webinar

Thank you for attending

The Heart of New Ulm: Population Health Takes a Village

March 21, 2018