MARKETING

Leading the Way To Community Health

BY RHODA WEISS

uring this era of reform, it is becom­ from UniHealth employees, will be built this win­ ing increasingly important for health­ ter in south central \x>s Angeles. D care systems to extend their commit­ It is believed that UniHealth's Heal L.A. pro­ ment to the community beyond gram was the most extensive pcrson-to-person health fairs and education to programs that offer intervention conducted by an organization fol­ solutions to the largest health-related challenges lowing the riots. The program has received more their communities face. than a dozen regional and national awards and These interventions must be based on the has become a prototype for intervention pro­ community's needs, not the institution's priori­ grams throughout the nation. ties. Building bridges to the community will help How It Worked A community outreach team, including members from throughout the compa­ position health systems as true partners for better Ms. Weiss is a health. ny, was formed to determine what UniHealth In this spirit, UniHealth America, Burbank, could do to help heal the city. This team devel­ Santa Monica, CA, one of the nation's largest not-for-profit oped the month-long Heal L.A. program to pro­ healthcare systems has undertaken two major vide aid to the community in three major areas- community health interventions in the last two CA-based goods, money, and volunteer time. The program years under the auspices of the UniHealth was designed to provide both short-term and America Foundation. healthcare long-term support to people in need. The Heal L.A. project received final approval HEAL LA. consultant. on August 20, 1992. Because the launch date was As the aftershocks of the April 1992 Los Angeles September 1, the program had to be quickly and riots continued to rock the community for several effectively announced to more than 20 months after the flames were extinguished, a UniHealth America hospitals, health maintenance UniHealth survey revealed that food, baby sup­ organizations, and other operations. Plans also plies, and in some cases even basic clothing were had to be developed to collect and distribute not available to riot victims. To address this situa­ food and baby goods. tion, the system mounted Heal L.A., a program In three days, Waskul wrote and designed that raised more than $150,000 to help people more than 20 pieces, ranging from letters and fly­ suffering from riot-induced problems. Every ers to a commemorative T-shirt to a prototype dime went directly to help an individual or family newsletter. Vendors agreed to donate services at in need. cost, reducing the total cost of providing pro­ "The survey showed that the overwhelming gram materials to UniHealth's 13,000 employees majority of food shelters helping riot-affected to less than SI0,000. families were losing the battle to provide enough The program's success was the result of several for the community," says Greg Waskul, Uni­ key factors: Health vice president. As a result of the survey, • Endorsement by senior managers. Top man­ the problem, which had been virtually ignored by agers showed their commitment by agreeing that the media for months received massive coverage the company would match all employee monetary by the local press. contributions. As part of its long-term intervention, • Personal recognition for participants. Every UniHealth became the first company to commit contributor received a button, while everyone to building houses with the Los Angeles Chapter giving a significant donation of food, baby of Habitat For Humanity. Two homes, one paid goods, volunteer time, or money received a com­ for by the company and one by contributions memorative T-shirt, as well as a letter from the

76 • JANUARY-FEBRUARY 1994 HEALTH PROGRESS chief executive officer (CEO). OPERATION IMMUNIZATION • Rapid dissemination of information. A one- During the summer of 1993, UniHealth America page newsletter was sent by modem or Fax to embarked on another major community-based every UniHcalth operating unit each morning, initiative called Operation Immunization. The where it was immediately photocopied and dis­ program, undertaken in partnership with the Los tributed. Even' operating unit was contacted Angeles Times Valley Edition, is becoming one daily to dig up news. If something important of the most comprehensive private-sector health happened anywhere in the system on Tuesday, it initiatives ever undertaken. was certain to appear in Wednesday's newsletter. "Next to AIDS, the shortfall in proper immu­ • Special donation days. Donations picked up nization of children is perhaps our greatest public dramatically on "Deposit Day" for food and baby health problem," says Waskul. He points out that goods and on "Payroll Deduction Day," when less than 50 percent of American children under employees were asked to fill out payroll deduc­ Bh> showing age two are properly immunized. In Los Angeles tion forms if they wished. County, the numbers are even worse. Even • The appeal of the home-building project. that though it spent more than S75 million on immu­ The "UniHouse" concept struck a responsive nization in the last five years, the count)' has an chord with UniHealth employees. Not only did conditions immunization rate for two-year-olds of only 41 contributions increase significantly when the pro­ percent. ject was announced, but more than 200 people had worsened The support of Operation Immunization by volunteered to help with the construction. UniHcalth President and CEO Terry Hartshorn • The impact of the survey. By showing that greatly since and Los Angeles Times Valley Edition President conditions had worsened greatly since the riots, Jeffrey Klein has been a key to its success. The the survey mobilized UniHealth employees and program was created by a team that included alerted the media to the extent of the problem. the Los Waskul and Los Angeles Times executives The Results The results of Heal L.A. were extraor­ Charmaine Alexander, Diane Kowalski Weegar, dinary: Angeles riots, and Kay Heitzman. The effort has attracted the • The program raised total contributions of support of a number of leading organizations, more than $152,000, according to Waskul. the survey including Thrifty Drug Stores, the Permanent "UniHealth will be the first company in Southern Charities Committee of the Entertainment California whose employees raised the money to mobilized Industry, Heal the World Foundation, Heal L.A. build a house in South Central L.A. for people in Foundation, Operation USA, and the Los need. In addition, employees donated enough employees Angeles Immunization Coalition. food to feed more than 1,000 families (4,000 Operation Immunization is being conducted as people) and to feed and clothe more than 3,000 a pilot project throughout the San Fernando babies for a week." and alerted Valley, which has a population of 1.9 million peo­ • News coverage was extensive. Stories ple. Within three years, it is expected to be oper­ appeared in the Los Angeles Times aid more than the media to ating throughout Los Angeles and Orange coun­ 20 other newspapers, as well as on the Associated ties. Press newswire and a number of television and the extent of The UniHealth-Lw Angeles Times effort is de­ radio news programs. signed to inform parents about the importance of • The survey moved others to help. After the problem. immunization for their children. All materials will UniHealth's findings were announced, a number be written in English, then recreated in Spanish of groups, including a major television station, for the valley's large Hispanic community (more initiated food drives that increased the flow of than 35 percent of the population). This impor­ food to the community until food banks could tant work is being done on a pro bono basis by an pick up the slack. Hispanic advertising agency, Cruz/Kravetz By stepping forward when others were silent, Ideas, the California Hispanic/American Medical the people of UniHealth America became leaders Association, and Louey Rubino Design Group. in the battle to help solve a critical community Educational Components In addition to an ongoing health problem. The program succeeded because public service campaign, which began in August, it addressed a simple question, What is most Operation Immunization includes educational needed in the communitv? Continued on page 84

HEALTH PROGRESS JANUARY-FEBRUARY 1994 • 77 HEALTHCARE MARKETING MANAGEMENT ETHICS Continued from page 77 Continued from page 79

health, and from service for individu­ als to service for the community. Foou r IMPLEMENTING THE DECISION elementary schools IDNs will be accountable not only for managing their assets, but—even have been chosen as more important-for enhancing the health status of the communities they sites for immunization serve. For planners this means creat­ ing incentives not only to guarantee clinics. effective delivery but also to establish processes and standards for ensuring proper utilization of services and components targeted at three major ics are assisted by UniHealth physicians measurement of outcomes. groups: and nurses, as well as nurses affiliated • Schools. In more than 500 elemen­ with other area hospitals. The clinics ASSESSING EFFECTIVENESS tary school classrooms in the San will be opened periodically throughout But measuring clinical outcomes will Fernando Valley, fourth- through the year to build confidence within the be only part of the task. An equally sixth-grade students are receiving a community. important challenge will be to find four-week health education course on • Discount stores. The Operation ways to assess the effectiveness of the immunization. A second health educa­ Immunization team is setting up peri­ large-scale changes providers must tion unit will be made available to odic clinics at a major discount store in implement as they form IDNs. teachers in the spring. UniHealth and an area with a large Hispanic popula­ The U.S. Catholic bishops argue the Times sponsored a poster contest, tion in an attempt to reach parents that the best measure of any health­ with cash prizes for winning class­ who cannot be reached through the care initiative will be the extent to rooms. Immunization presentations schools. which it guarantees universal access, from nurses and other healthcare pro­ • Door-to-door program. In one ZIP enhances the quality of care, and con­ fessionals are also available to teachers code, volunteers will go door-to-door trols costs ("A Framework for who request them. In addition, educa­ to tell parents about special clinics in Comprehensive Healthcare Reform," tion materials are being sent home to their neighborhoods. This tactic has Health Progress, September 1993, parents. This cooperation between Los been especially successful in developing pp. 20-23). Using the principles that Angeles Schools and the business com­ countries, but has seldom been used in inform CHA's proposal (see Box, p. munity is the linchpin of the program. the United States. 79), planners can perhaps sharpen • Businesses. Operation Immuniza­ their view of the concrete steps need­ tion materials are being made available BE A LEADER ed for reform to be effective. to more than 3,500 businesses in the "In every community across the For example, prospects for universal San Fernando Valley. UniHealth and nation, there is something important a access will be enhanced to the extent the Times are also placing immuniza­ healthcare institution can offer to that plans embody CHA's principles tion information throughout the valley improve the community's health," of shared responsibility and freedom business community. VVaskul says. "Find it and lead the of conscience. Planners might con­ • Churches and synagogues. All effort to do something meaningful structively associate the call for high- churches and synagogues throughout about it. You'll inevitably touch the quality care with the principles of pub­ the area will be contacted through the hearts of those you serve in a way lic accountability and sound adminis­ Valley Interfaith Council. Special you'll never be able to do simply by tration. Finally, CHA's call for a ratio­ emphasis is being placed on the providing quality healthcare." nal, effective allocation of resources Catholic Church, in an attempt to reach The success of the Heal L.A. and and for fair financing can be connected members of the Hispanic community. Operation Immunization programs is constructively with the U.S. bishops' Immunization Clinics Immunization clin­ that they addressed major community requirement for controlling costs. ics began operations in early 1994, healthcare needs. The company Whatever the spin we give these with all immunization materials donat­ believes that the future success of its principles, we must use them to en­ ed by the I.os Angeles County Depart­ healthcare business will depend in large hance accountability to the public in ment of Health. Three types of sites part on the strength of its relationship planning healthcare initiatives. Plans are being used to determine their effec­ in its local areas. There is no way to for healthcare reform must be based tiveness in reaching target populations: better strengthen these ties than for the on ethical principles if we are to fulfill • Schools. Four elementary schools healthcare institution to help solve the our vision of community service dedi­ have been chosen as sites for the clin­ real health problems of the community cated to promoting health. a ics. School nurses who oversee the clin­ it serves. •

84 • JANUARY-FEBRUARY 1994 HEALTH PROGRESS