BROADENING OUR FOCUS: Identifying Regional Priorities from the Needs of Our Communities
Total Page：16
File Type：pdf, Size：1020Kb
BROADENING OUR FOCUS: Identifying regional priorities from the needs of our communities. April 2017 Produced by Horizon Health Network’s Department of Population Health Promotion & Chronic Disease Management Message from Horizon’s Manager of Population Health It feels great to be preparing this report and to be maternity floor staff, is an experience I still hold at this stage of the process! close to my heart. As a young adult, one of my closest friends was in an ATV accident and, even In 2012, when Horizon Health Network’s (Horizon’s) today, when we get the chance to catch up, I am Community Health Needs Assessment (CHNA) grateful for the emergency services that saved her portfolio became housed in our department life. My mother’s rare form of cancer brought my of Population Health Promotion and Chronic family and I to many parts of Horizon’s oncology Disease Management, I provided oversight to the system; during her illness, the Extra-Mural nurses consultant groups we outsourced the work to. felt like family members and during her death, After trying that approach, my team and I began the staff of the palliative care unit were… well I to rethink the process and make plans to build wouldn’t even have the words to describe their capacity within Horizon for conducting CHNAs. In capabilities. I get it! As an organization, we need 2014, I took a leave from my current position as to prioritize the provision of quality health care Manager of Population Health to become Research services. But as our rates of chronic disease rise, Lead for the CHNA portfolio full time. It was a this essential system I deeply value is threatened challenging experience by times, but a decision I and experiencing more and more strain. We’ve all do not regret. tried our hand at patching holes in it, but ultimately Given my previous education and work experience, our only long-term option is to make the bold and I have a strong understanding of the concept and courageous decisions needed to reverse this trend. theory of population health. I also thought my As an organization with the mission of Helping understanding on a personal level was strong. I People Be Healthy, I believe we have the ability was mistaken. My understanding of population and responsibility to work further upstream and health has deepened and changed significantly improve the health status of the individuals, during my time with the CHNA portfolio. Deep communities and populations that we serve. As listening, holding space, reading transcript, important as they are, we know that traditional hearing stories and then rehearing them through health care services play a very small role in what the analysis process; seeing and hearing what actually makes an individual and a population the concept of population health looks and feels Be Healthy. Through the CHNA experience I’ve like on the ground in people’s lives, took my met many staff that “get it” and witnessed them understanding from one of an intellectual knowing striving towards this goal; so much amazing work, to one that I could actually feel, connect with and so many great ideas and committed people. But, experience. There were difficult realities shared, given how grand the challenge is before us, I tough conversations had, some rather unpleasant can’t help but wonder how much impact these exchanges, and even some tears. There were times, individual examples can have at a population level. at this level of knowing, that I was emotionally A transformation is required on a larger scale. My impacted and shaken. However, through it all hope for this report is that it brings the real issues the experience has further enlightened me and I that have a significant impact on health status believe there is potential for the experience to also to the forefront of our discussions, our decision- be an enlightening one for our organization. That is making, our actions and our investments, and why we felt it was important to create this report. in that context, our organization and population Like many Canadians, I deeply value our public thrive. health care system and personally know the importance of quality health care delivery. My Allison Holland daughter was born in this system and the support Manager of Population Health given to me as a young mother, by the amazing BROADENING OUR FOCUS: Identifying regional priorities from the needs of our communities. 1 Acknowledgments The undertaking of Community Health Needs Assessments on a regional scale was a large endeavour for Horizon and there are many people to thank: the Horizon staff who supported us in each community, the 374 Community Advisory Committee members who actively guided us through each assessment, the over 1,200 New Brunswick residents who gave of their time to participate in consultations, Horizon’s Communications team, the New Brunswick Health Council, the team members of the department of Population Health Promotion and Chronic Disease Management, and, of course, the three amazing project coordinators who joined our team and kept each assessment moving forward. Your contribution was greatly appreciated! BROADENING OUR FOCUS: 2 Identifying regional priorities from the needs of our communities. Contents 1. Introduction. .5 2. Background . .7 2.1 Community Health Needs Assessment Guidelines for New Brunswick .............. 7 2.2 The Population Health Approach ........................................... 7 2.3 Defining Community Boundaries ........................................... 9 3. Community Health Needs Assessments in Horizon . 10 3.1 Communities within Horizon .............................................. 10 3.2 CHNA Leadership in .................................................... 10 3.3 Horizon’s CHNA ....................................................... 11 3.4 CHNA as an Ongoing Process: Regional Actions .............................. 12 4. Broadening our Focus and Taking a Regional View . 13 4.1 Our Reach: A Regional look at Community Consultation ........................ 13 4.2 Regional Data Analysis .................................................. 15 4.3 Horizon’s Regional Priorities .............................................. 16 5. Moving Forward . 26 5.1 Horizon’s Core Value: We Act with Integrity and are Accountable ................. 26 5.2 Maintaining Community Engagement ...................................... 26 5.3 Investment in Relationship ............................................... 27 5.4 Collective Impact: A Structured Approach to Collaboration ..................... 28 5.5 What Next? The Need for Solid Action and Financial Plans ...................... 29 6. Conclusion . 31 Appendix A: Horizon’s CHNA 12-Step Process. 32 References. .33 List of Figures Figure 1: New Brunswick Health Council’s Population Health Model ................... 8 Figure 2: New Brunswick Health Council Community Boundaries Map ................. 9 Figure 3: Focus Group Participants ............................................ 14 Figure 4: The Colaboration Spectrum ......................................... 27 Figure 5: The Shift: 5 Condition of Collective Impact .............................. 29 List of Tables Table 1: New Brunswick Health Council Community Name and Number ............... 9 Table 2: Communities within Horizon .......................................... 10 Table 3: Overview of CHNA Leadership in Horizon ............................... 11 Table 4: Horizon’s CHNA 12-Step Process ...................................... 12 Table 5: Focus Group Sessions ............................................... 14 Table 6: Horizon’s Regional Priorities .......................................... 16 Table 7: Isolated vs. Collective Impact ......................................... 28 BROADENING OUR FOCUS: Identifying regional priorities from the needs of our communities. 3 BROADENING OUR FOCUS: 4 Identifying regional priorities from the needs of our communities. 1. Introduction The practice of Community Health Needs Council, 22 communities within Horizon have Assessment (CHNA) is not a new endeavour. participated in the CHNA process. To provide In fact, many communities across Canada and some context, section 3 of this report shares what globally have utilized CHNA to do community the CHNA process looked like at the individual health planning for many years, including within community level. Each participating community, the province of New Brunswick. Some CHNA through a Community Advisory Committee, set work in New Brunswick was initiated and sourced local level priorities based on the available data by individual community coalitions; some were and data collected; reflected in a final report government-funded, and others were completed for each community.4 For this particular report, in correlation with the development of the however, the main focus is not on these local level Community Health Centre model of care. In CHNAs and their resulting priorities. Section 4, 2012, the province of New Brunswick announced Broadening our Focus and Taking a Regional that there would be a new round of CHNAs View, delves into the purpose of this report by conducted; a recommendation under the Primary looking at the consultation reach achieved at a Health Care Framework for New Brunswick.1 regional level, the process used for a regional Shortly after that announcement, the Community level analysis, and the resulting 20 regional level Health Needs Assessment Guidelines for New priorities that emerged. Section 5 discusses what Brunswick2 were developed to help standardize this all means for