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Transforming the Hospital, Transforming the Community - Step By Step By Step

This nation’s health care system is in trouble.  Compared to the ten nations with the highest incomes in the world, the United States pays far more per capita on health care than the others but has far less in health outcomes to show for the money spent. 

Taken at face value, the statement suggests we might want to study what strategies those other nations are using. But, comparisons aside, one fact remains, and it is a fact born of our own experience.  Patients are paying more and more to receive health care.  The cost paid by hospitals to deliver that health care is steadily increasing.  Reimbursement to hospitals through programs like Medicaid and Medicare are going up, as well.  And it doesn’t take a genius to realize that, if nothing is done to interrupt that trajectory, someday, we’re all going to be in a world of hurt, so to speak.  

How does one reduce the cost of health care?  Where does the problem begin, and where can the cost be cut?  That question has been asked by countless people in any variety of positions for literally decades and, just like the spinning top it is, the conversation always seems to end up at the same place it started.  

We have to decrease the cost of health care.

Colorado, like every other state, had been holding that same conversation, and then things seemed to shift in a new direction.  Granted, terms like “rate of reimbursement” were still front and center, but the focus of health care itself seemed to change. Instead of viewing health care as a collection of different services delivered by a collection of various professionals in a systematic (and, sometimes, not so systematic) way, the patient him or herself and the disease that patient was experiencing became the focus or the center of attention.  That shift then led to a different way of understanding.  

In order to treat, for example, a person’s cancer, the whole person must be treated, for a person is more than just his or her disease. However, in order to treat the whole person, the provider must understand the totality of that person’s life and “meet them where they are”—functionally, physically and socially.  Being in “that place”, understanding the patient in that much more inclusive way might not only lead to delivering better health care, that health care might have intrinsically more value and be of higher quality.  And higher quality health care might result in, perhaps, fewer visits to the doctor or hospitalizations.  And fewer visits to the doctor or hospitalizations might result in decreased health care costs, which gets back to what started the conversation in the first place.

The next step was almost natural.  If the whole person is going to be considered in the person’s health care, the environment—or community in which that person lives and interacts—has to be included in the equation.  For example, does the person have a car to get to the doctor’s appointment?  If  there’s no car, is there public transportation?  Is there healthy food available for purchase at the local store?  Is the person living in a safe and comfortable environment?  Are there services available if he or she is struggling with mental health issues?  Or budget issues?  Or issues with substance abuse?  Are there opportunities for employment?  If employed, are there opportunities for advancement?

The simple (or not so simple) act of asking these questions led to an entirely different type of dialogue in Colorado. That dialogue led to a belief that hospitals—and not just the hospital, itself, but the role the hospital plays in the community—need to be transformed at a significant level if valuable, quality health care was going to be provided to patients.

In this way, the Hospital Transformation Program was created.  The Hospital Transformation Program (HTP) is driven by a handful of goals, none of which are mysterious and, in and of themselves, make sense.  Essentially, the purpose is to deliver health care based on certain values that is not only efficient but effective, is coordinated with any other health care providers who are involved, can be integrated into a number of different settings, helps to reduce hospitalizations that could have been avoided and has good outcomes for the person.

But the transformation doesn’t stop there.  The belief driving HTP is that effective, valuable health care delivery to people can’t and won’t work if the community where that person lives is unhealthy.  In other words, don’t just treat the whole person, treat the whole community, as well.

Toward this end, a Community Needs Assessment (CAN) was developed for Kiowa County where local residents can go online and provide input about those issues, priorities and challenges they feel are most prevalent in the community.  The results of the CNA will help determine what steps the hospital should take—or facilitate others taking—in creating a healthier community for the people who live here.

However, evaluating those results and determining what actions should be taken is not the sole responsibility of Weisbrod Hospital, nor should it be.  The people of the community are providing the input;  consequently, community members, leaders and stakeholders should be intrinsically involved in determining what is to be done and the best way to do it.

Last week, the first step was taken in this process when roughly 40 individuals from Kiowa County met at the Cobblestone to review the first collection of responses from the assessment.  
The size of responses was small—only 18 people have responded, thus far—but that data provided a glimmer into what challenges are viewed as most pressing.  The need for more housing, more mental health services, more activities for children and greater employment opportunities were among the areas identified.  However, that was just the beginning.  Two more meetings are scheduled while, hopefully, more residents will respond.

With that said, people are strongly encouraged to go to www.kchd.org or the hospital’s Facebook page to take the survey and express their opinions.

This is clearly a long and potentially involved process, but then transformation—true transformation—always is.  One fact remains:  the outcome is only as good as the effort involved in achieving it.  And, with that said, it’s hoped that Kiowa County residents will make the effort to take the assessment and express their opinions knowing their voices will be heard.

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