Whole Community Care

As much as 80% of our health is influenced by factors outside the medical system. Things like our income, housing, access to healthy food, and social connections, all have significant impact on our health. Population Health examines how these factors, often called the “social determinants of health” impact the health of certain populations.

 

In 2016 Jefferson Healthcare established its own Population Health department and began looking at interventions for East Jefferson County that address some of its most pressing social needs. The department works to create a bridge between traditional, individual medical care, and a community whose day-to-day needs are met.

Food

Jefferson Healthcare is committed to providing healthy food to our patients, staff and the broader community.  Over 4,000 people in Jefferson County face challenges in accessing or affording healthy food. This portfolio is specifically focused on projects that address those challenges.

Early Life

Lifelong health is determined to a great extent by the things we are exposed to in our earliest years.  This portfolio explores family support during that time.  A pilot safe sleep program provides baby boxes to expecting parents, modeled after a program in Finland that started in the 1940s.

The Population Health Department has also been a strong advocate for bringing more high-quality childcare to east Jefferson County. In partnership with Peninsula College and the Olympic Peninsula YMCA, the Jefferson Healthcare Population Health Department received a grant from the Washington State Department of Commerce. This grant funded a county childcare needs assessment, and the feasibility planning and program development for an early learning center.

 

Housing

In 2017, Jefferson Healthcare received a grant from the Washington State Department of Health to evaluate the role of hospitals in housing.  With this funding, Jefferson Healthcare partnered with OlyCAP and others to implement a housing pilot for our most vulnerable patients.

The cultural shift for healthcare

The Institute for Healthcare Improvement’s Triple Aim recommends health systems redesign to improve patient experience, decrease costs, and improve the health of whole populations.  Population health strategies at the local level are key to meeting Triple Aim goals.

Rural health systems can work nimbly with colleagues and community agencies to make a targeted difference in community health.

Interventions to Lower Costs and Improve Health

There is a growing emphasis on creating health without increasing spending.  By incorporating strategies to take better care of a community, not just an individual, we are creating an effective and fiscally responsible path toward that aim.

Jefferson Healthcare’s population health strategies

 

Population Needs
  • Publish community profiles of county sub-populations
  • Highlight differing needs to focus strategic planning
Social Factors
  • Past focus has been housing, food insecurity, and social isolation
  • Expand to transportation, financial security, and early life
Clinical Gaps
  • Integrate behavioral health into primary care teams
  • Establish dental care services for low-income residents
  • Create medication assisted opiate addiction treatment program within primary care clinics
  • Embed full spectrum reproductive health into primary care
Advocacy and Policy
  • Advocate for expanded allowable services within rural health clinics and modernized rural payment structures
Community-Based Projects
  • Partner with community organizations to implement and expand community-wide programs
Data-Driven Decisions
  • Use data provided by a centralized data team to inform decision making and projects.