Being Well, a Focus On the Whole Patient
It's not too far of a stretch to say, if you get sick, you go to the hospital, right? And for well over a century, that's been the thought process. Hospitals are there for when you are ill. But what if there is a different way to approach your health, a preventative whole body approach that hospitals are looking to in order to not just see patients when they are ill, but to be there and actively involved in the quality of the life of the patient?
May sound a bit farfetched for generations that came before, but now patients are looking to their hospitals, their health care providers, to help with not just reactive care but preventative.
Memorial Hospital of Converse County has been working in the past 12-18 months on overall population health, and even has hired a Director of Population Health, Tom Holt, to help drive this initiative internally. What has started as an internal drive has even worked out into the greater community of Douglas in wider campaign initiatives to encourage citizens to eat healthier, be more active, or simply more aware of the choices they are making daily and how they effect their long term health. MHCC's Population Health Department works toward creating a proactive, multidisciplinary team approach directed toward prevention, education and health promotion, increasing awareness and engagement in the company-wide health management programs and creating a culture of health.
We spoke with Tom, and also Chief Culture Officer Frank Wiederrecht on the importance of this initiative and how it is showing long term health benefits for the hospital as well as their hopes for the long term progress of the program for our community.
Speaking on the progress towards a culture of greater wellness, Frank Wiederrecht reflected, "The hospital realized that preventative health is the way of the future. Population health more specifically, so we hired a director of Population Health. Tom [Holt] had come and spoken at one of our Leadership Development Institutes, and we were very impressed with him, his credentials, his background and it seemed like an ideal fit. So we recruited him actually, and created the position for him."
Holt took that thought a bit further as to his work in population health directly, "I think Western Medicine focuses very much on reactive [medicine] in our community. Not that that's a bad thing, I think that we [as a medical community] want to increase the quantity of their lives. I think my role comes down to how do we increase the quality of their lives as well? So we use the phrase of upstream versus midstream versus downstream. So downstream is responding to the medical emergency as it happens, like you need medical care right now. Midstream is your family doctor, you see them often for check ups. And there are some preventative care measures they can provide," explained Holt. Then there is the upstream, "As far as hospital fitness and if we are providing this service to the greater community we also have to have the upstream. We need to try to see things as they are progressing. And right now our focus has been our employees: how can we improve our employees wellness overall through both broad and laser-focused interventions so that we can reduce their insurance costs and increase their health?"
Vocationally speaking, patients all too often look to their doctors or nurses, anyone in health care to be models of good behavior when it comes to "walking the walk." We wondered if this is in fact a fair assessment and if this is a community role that health care providers should be fulfilling. "It should be. I remember when I was a kid, in the 60s you would see even on TV that more doctors preferred Lucky Strike than any other brand of cigarette, or something like that. And quite a few doctors and nurses smoked. And we've reduced those numbers [in the decades since], but the fact of the matter is there are still health care providers that still smoke," said Wiederrecht. He then continued "What we know is that weight is also an issue, that it causes all sorts of problems and as we look at our population here of health care workers that are facing this particular health concern. And we shouldn't be; we should be models. One of the things I am excited about is that [internally] we are working on those numbers. We are working on these in-house initiatives, these different challenges and everything, we've contracted Interactive Health Services which helps us out. We do routine blood tests. People that work here get a cut on their insurance rate if they participate in all of these efforts. Also we're doing the laser-focus study; we have a cohort that Tom's leading of about 14 people and who want to want it. They have signed up for a 4-6 month deal on losing weight."
Holt added, "It's a comprehensive intervention. It's not just a diet. It's not just an exercise plan. It's not just a behavioral plan. Its ALL of those combined. Basically what we want to do is, in a safe environment, allow these people to share about what's going well and what things we think they can change. And we focus on nutrition, exercise and behavior change. You have to have a reason to change: they have to want to want it. They have to eat clean which we teach them what to eat and what not to eat. Right now they are in the initial phase, then the weight loss. And they have to be super strict as they begin and we discuss their resistance and blood sugar levels etc. We are monitoring the entire time. For the small group, they are required to have personal accountability by weighing in and having other biometric measurements frequently taken."
When looking internally another concern has been the intake of food and availability to the staff to make healthier choices while working. Wiederrecht continued, "We have worked with the heads of the kitchen staff to make sure there is a clean meat or clean vegetable available at every meal served in the cafeteria. It might not be the featured menu item, but it used to be I would walk in there on certain days and couldn't find a thing to eat [that fit my meal plan], it was at times a pretty hefty carb load. But, nope, we now have, for example, chicken breasts we can have on our plan!"
Past population health initiatives also included campaigns encouraging a lessening of soda consumption: Stop the Pop; an increase in healthier eating habits: Vegetable and Fruit Challenge; an increase in physical activity, Steps Challenges, On The Move, and also local 5k and 10k events either hosted by the hospital or encouraged participation. The month of May will continue this effort at increasing activity levels and place a goal of getting 10,000 steps a day in front of participants.
If you would like more information on how the hospital is making continued strides to not just improving their internal health but also the lives and health of those in our community through these initiatives, be sure to sign up via this link for helpful email updates delivered to your inbox monthly. Also stay tuned to our Facebook page as we showcase how this program is gaining ground each and every month!