The Metrohealth System 2015 Community Report

Serving Our Community

The MetroHealth System 2015 Community Report 2 METROHEALTH 2015 COMMUNITY REPORT mission Leading the way to a healthier you and a healthier community through service, teaching, discovery and teamwork.

3 3 2015 Community Report

Letter from the Medication Assistance 21 President and CEO 6 Mother and Child Dependency Program 21 Expansion to Serve More Cuyahoga County Residents 7 Ohio’s Only Ebola Treatment Center 21 Oscar Hispanic Clinic 22 Partnership with Pride Clinic 22 Discount Drug Mart 7 Providence House 22 Financial Strength 8 SANE 22 Community Benefit 9 School Health Program 22 Several Additional Programs Inclusion and Diversity 10 with Cuyahoga County 23 Statistical Highlights 10 Tuberculosis Clinic 23 Young Adult Clinic 23 Employee Numbers 11

Critical Care Pavilion (CCP) 12 Patient Education and Support

Working with Minority- AA 25 Owned Businesses 12 Adult Burn Survivor Recovery Group 25 Northern Ohio Trauma Boot Camp for New Dads 25 System (NOTS) 13 Breastfeeding Clinic 25 100+ Programs For and Caregiver’s Support Group 25 With the Community 14 Childbirth Preparation Classes 25 Compass 26 Clinical Programs Cuyahoga County Public Library Burn Music Therapy 17 at MetroHealth Medical Center 26 Care Alliance 17 Cuyahoga County Women, Infants, and Children (WIC) Program 26 CHAP 17 Diabetes Self-Management Program 26 Community Advocacy Program (CAP) 17 Doula Volunteer Program 26 Comprehensive Care Practice 17 Healing Hearts 26 Discount Drug Mart 18 Language Access and Health Care at the Communication Services Center 27 Juvenile Detention Center 18 Library Cards for Newborns 27 John A. Gannon Comprehensive Burn Care Center at MetroHealth 18 MetroHealth NICU Family Support Group 27 Kidz Pride Clinic 18 Mother Nurture Project 27 MDA Clinic 18 MyChart Computer Training 27 Medicaid Technical Assistance and Policy Program (MEDTAPP) 18 Safe Sleep Initiative 27 Medical Home for Sibling Classes 28 Children in Foster Care 20 Smoking Cessation Classes 28 Medicare ACO, Trauma Survivors Network 28 MetroHealth Care Partners 21 Volunteer Services 28

4 METROHEALTH 2015 COMMUNITY REPORT Contents 5 41 41 41 41 42 42 42 43 43 43 43 44 44 44 44 45 45 45 45 45 46 47 47 47

Better Health Partnership Health Grant BUILD Affairs, The Center for Health Needs Community Health Assessment (CHNA) Roundtable Center for Reducing Health Disparities 42 CiCLEvia County Cuyahoga Council Health Care Fitness Zone 42 HEAL Healthy Cities Cleveland Initiative Healthy Cleveland 43 HIP-Cuyahoga Homeowner Classes Human Trafficking MortalityInfant La Villa Hispana with Cleveland Mentoring Program District (CMSD) School Metropolitan Scholars Program MetroHealth at La Placita Mi MetroHealth System (NOTS) Northern Ohio Trauma Partnership for a Healthy (PHNR) North Royalton DAWN Project (SRTS) Routes to School Safe Program MartinSt. de Porres 46 STANCE and Infrastructure Transit 46 Improvements 46 True2u/CMSD Registration Voter Revitalization 25th Street West Window of Health Opportunities Youth Jobs Unlimited Summer Partnerships with Community Organizations 31 31 31 31 33 33 33 34 35 35 36 36 36 36 36 36 36 36 37 37 38 38 38 38 39 39 39

Institute of Burn Ethics MetroHealth Research MetroHealth Center Simulation Affiliated with Hospital Teaching Reserve University Case Western of Medicine School Wellness Center Wellness Advocacy Bringing Education, (BREAST) and Support Together Amigas Unidas Community Health Initiatives Advocacy Recruitment Diversity (DOTS) Doctors on the Streets Easier Access for All Employer Eighth Largest County in Cuyahoga Campaign Employee Service Day Employee Van Enrollment Service Training Food of Mothers and Infants Friends Hearts Against Hunger Grants Holiday Housing Committee Initiatives Injury Prevention Foundation The MetroHealth Prime MetroHealth Select MetroHealth Reach Out and Read Convention Republican National Community Engagement (RNC) for Adults with Training Disabilities Developmental 39 Transformation Force Violence Task Aamoth Family Pediatric Pediatric Aamoth Family MetroHealth in the Community MetroHealth Research and Training and Research Letter from the CEO

In spite of immense financial pressure on all health systems, especially public health systems, we have kept our commitment to you.

We are here for all of you every day, providing everything from primary care to the highest level of trauma care there is, and we’ve expanded dozens of programs to deliver that care to you where you live, work and play. We established clinics in Discount Drug Mart stores. We added two new emergency departments, and another is under construction. We reopened former HealthSpan locations in Bedford, Cleveland Heights, Parma and Rocky River.

Today, nearly everyone in Cuyahoga County can drive to one of MetroHealth’s more than 20 locations in 10 minutes or less. Our Critical Care Pavilion expansion, the addition of 85 state-of-the- art intensive care rooms, is complete. As we promised, that $82 million project opened before the Republican National Convention. With a specialty disease care unit designed to house patients with Ebola and other highly contagious diseases, the Critical Care Pavilion gives us the capacity to handle just about any emergency that might ever arise.

We did all that and we provided $223 million in community benefit, including care for those who couldn’t afford it, and still we ended 2015 with $29.8 million in operating income, money in the bank.

It took hard work, ingenuity and collaboration, but we did it. We expanded our services, remained financially strong and never wavered from our mission of providing exceptional care to everyone.

We are MetroHealth. This is what we do.

AKRAM BOUTROS, MD, FACHE President and Chief Executive Officer The MetroHealth System

6 METROHEALTH 2015 COMMUNITY REPORT Expansion to serve more 40,000 Cuyahoga County new patients residents.

To meet the needs of communities east and west of our Emergency Department on West 25th Street, we created freestanding emergency departments in Cleveland Heights 60 and Parma, in buildings formerly occupied by HealthSpan. physicians hired In the first quarter of 2016, when HealthSpan stopped delivering direct patient care in our area, we leased and reopened much of its clinical space. We also hired about 335 of its employees, including more than 60 physicians. By welcoming 40,000 new patients from throughout the county, we increased our patient volume by 16 percent. 20+ Many former HealthSpan patients can continue seeing their total locations physicians at the same sites as before - in Bedford, Cleveland Heights, Parma and Rocky River. And they have the added benefit of belonging to the entire MetroHealth network, with more than 20 other Cuyahoga County locations.

You can find a listing of health centers and physicians at metrohealth.org/locations

Delivering care where, when and how patients want it.

MetroHealth opened walk-in clinics at Discount Drug Marts in Independence, Olmsted Falls and Parma Heights – to provide easy access to care for anyone in the community. Health care in a retail setting offers convenient hours and parking and the appeal of being able to drop in without an appointment. The partnership with Discount Drug Mart has the potential for growth in Cuyahoga County as we work together connecting care with convenience.

7 7

a year of financial 2015, strength...

$905M $934M $855M

$783M

$769M $40M Taxpayer Support

The Cuyahoga County subsidy (taxpayer support) provided 4.3% of total operating revenue.

Operating revenue for the last 5 years 2011 2012 2013 2014 2015 $29.8 million operating income

8 METROHEALTH 2015 COMMUNITY REPORT

$223 million community benefit

Investing in Cuyahoga County through programs to increase access to health care services and improve community health

Portion of operating expenses that goes back to our community

24.6% The MetroHealth System* (2.8X national average)

11.4% Cleveland Clinic**

10.8% University Hospitals**

8.9% U.S. Hospitals Average***

*MetroHealth community benefit calculation for the year ended 2015 **From Schedule H of the 2014 IRS Form 990 ***From Ernst & Young 2014 Schedule H Benchmark Report for the American Hospital Association, based on 2011 data (most current available)

9 9 Inclusion and Diversity, a MetroHealth value.

We foster a community where our differences are celebrated and everyone has an opportunity to be part of our success. Our 2015 goal was to increase racial, ethnic and gender diversity of candidates.

2015 Hiring Diversity “ Inclusion is the deliberate act of welcoming that 69% 32% diversity and creating an of the managers of the nurses and physicians hired represented environment where all hired represented racial, ethnic and/or racial, ethnic and/or gender diversity can thrive and succeed. ” gender diversity AKRAM BOUTROS, MD, FACHE President and Chief Executive Officer The MetroHealth System All applicants are considered on their individual merits and the most qualified candidates are selected.

Statistical Highlights 1,156,594 Patient Visits

3,008 102,207 6,655 Babies Delivered Emergency Trauma Activations 10 Department Visits

10 METROHEALTH 2015 COMMUNITY REPORT We know that preventive care is the best medicine

As the county health system, we’re essential to Cuyahoga County. We’re here for you – more than 1.2 million of you! From 2012 through 2015, MetroHealth added 604 employees, bringing our total to 6,759. That’s what it takes to provide the health care and services that will improve our community’s health well into the future. We’re here for traumatic injuries and illnesses, and we’re here so that, together, we can work toward you being healthier every day. It’s called health care vs. sick care.

new employees in the last +604 3 years

1,710 NURSES

551 PHYSICIANS*

371 Employee RESIDENTS growth by year * All active MetroHealth physicians 2012 2013 2014 2015 are faculty of Case Western Reserve AND WE’RE STILL GROWING University School of Medicine.

11 11 CCP, the first major project of the Transformation.

The Critical Care Pavilion (CCP), which opened campus. We’d like to be better neighbors in the in 2004, houses our Emergency Department, West 25th Street community. That’s why we’re including our Level I Adult Trauma Center, and meeting with local government and citizen surgical services. The 100,000 square-foot, groups to help a food desert become lush with two-story addition provides 85 new state-of- healthy foods, to attract new businesses, to plan the-art patient rooms for intensive and critical for a place to gather, mingle and maybe even care patients. It also includes a special disease exercise together and to build housing for our care unit. employees so they can walk to work.

The one-year project is on time and on budget, We see a future with a revitalized hospital and scheduled to open in July, just prior to the campus in the midst of a vibrant neighborhood. RNC. It’s just the beginning of reimagining and Together, we can build a healthier community rebuilding about 75 percent of our current main along the West 25th Street corridor.

100,000 sq. ft., 85 new two-story addition patient rooms

Embracing local and $148m spent on procurement, the purchase of goods minority-owned and services businesses.

As the county hospital, we are always looking $29.8m for ways to better serve our community. One diverse and local spend of those ways is by working with more local and minority-owned businesses. We’re in the midst of some major construction on our main campus and in Brecksville, and have plans for much more, so we’re trying to engage more local and diverse vendors. $9.4m spent on In 2015, we hosted seven “How to Do construction Business with MetroHealth” sessions, led projects throughout the year by MetroHealth’s Office of Inclusion and Diversity. With help from our Supply Chain and Construction/Transformation Departments, the meetings attracted more than 200 local vendors, suppliers and contractors. $2.3m diverse and local spend

12 METROHEALTH 2015 COMMUNITY REPORT Saving precious minutes.

In 2010, MetroHealth and Cleveland Clinic formed the Northern Ohio Trauma System (NOTS) to improve patient outcomes from trauma. NOTS worked with local Emergency Medical Services (EMS) crews on evaluating the severity of an injury to decide whether a patient should go to a verified Level I Adult Trauma Center like MetroHealth or can be taken to a Level II or Level III Trauma Center. Instead of taking patients to the closest emergency department and then often transferring to the appropriate trauma center, EMS take patients directly to the best place for their immediate needs. Transporting patients to the right place for the right care at the right time saves lives.

24% decrease in trauma deaths in Cuyahoga County.* *Comparison of 2006-2009 to 2010-2012, latest data available from the Ohio Trauma Registry

mothers, fathers, aunts, uncles, daughters, sons, friends saved since 2010 because of +800 this collaboration

A Special Thanks to Our NOTS Partners

CLEVELAND SOUTHWEST CITY OF CLEVELAND CUYAHOGA CUYAHOGA COUNTY PUBLIC CLINIC GENERAL DEPARTMENT OF PUBLIC COUNTY BOARD OF SAFETY AND JUSTICE SAFETY HEALTH SERVICES

13 13 Doing the right thing for the entire community.

Have you ever worried about all those caught up in the heroin epidemic, the homeless, how well Cleveland kids are learning? You probably have and so have we! That’s why MetroHealth has more than 100 programs in the community that we initiated and run, work on with community partners and participate in.

14 METROHEALTH 2015 COMMUNITY REPORT Programs for and with the community +100 on the following pages...

15 15 1 Clinical Programs

From home visits for newborns to an Ebola treatment center, comprehensive health care is aimed at protecting everyone in the community and providing excellent lifelong care.

16 Clinical Programs 17 When a MetroHealth provider identifies a legal identifies a provider When a MetroHealth health, has an impact on a patient’s issue that in MetroHealth’s enters a referral the provider then provider The medical record. electronic to the patient of the referral a hard copy gives seek help directly can so they family or patient’s the example, For Aid professional. from a Legal gain and families program can help individuals protect against utility shutoffs access to food, from mold removed and get allergy-provoking medical-legal partnership has The a home. toward to greatly help patients navigate proven health. better CARE PRACTICE COMPREHENSIVE Care practice at MetroHealth Comprehensive The a Primary persons Care Medical Home for offers conditions, medical of all ages with complex or disabilities, addressing delays developmental The their associated unique health care needs. practice has been serving special needs the coordinated with population and their families multidisciplinary more than 50 years. care for in the areas of Specialty clinics are offered Spina Bifida/Hydrocephalus, Cerebral Palsy, Assessment and As Craniofacial. Behavior transition from adulthood, they patients reach practice, in the pediatric to adult providers with remaining with a practice that is familiar Care Practice the Comprehensive them. In 2011, awarded to be the first MetroHealth practice was 3 Level Assurance Qualitya National Center for of Care as a Excellence for (highest) Recognition Primary Care Medical Home. - COMMUNITY ADVOCACY PROGRAM (CAP) PROGRAM ADVOCACY COMMUNITY through the CAP years, more than 12 For program, MetroHealth has partnered with the legal to remove Aid Society of Cleveland Legal MetroHealth patients. to health for barriers nurses, social workers MetroHealth physicians, Aid Legal with four work and other providers several and one paralegal who cover attorneys on children, focus They MetroHealth locations. Spanish speakers the elderly, pregnant women, and individuals recently released from prison. CHAP the by referred patients MetroHealth welcomes (CHAP), Partnership Access Health Cuyahoga a non-profit organization dedicated to providing access of health care a coordinated system uninsured adults. low-income, the county’s for its coordinated network, CHAP connects Through who patients without insurance to providers discounted primary care and specialty care. offer on the principle of shared founded CHAP was responsibility its founding and is represented by members, including hospital community systems, health centers, free clinics, local governments, organizations in the and other key foundations County health arena. Cuyahoga nity health center, which serves the uninsured which nity health center, and underinsured health care needs of Greater and A MetroHealth physician residents. Cleveland and nurse are assigned to the health care clinic Alliance Care in collaboration with are working servicesThe to establish an OB/GYN practice. include the MetroHealth medical staff by offered prenatal care and consultation gynecologic for serviceThis on a population is focused issues. mortalitythat has high infant rates and often and is an effort gynecologic care needs, complex needed for the education and care to provide babies. pregnancies and healthier women, CARE ALLIANCE OB/GYN servicesMetroHealth provides to the Alliance, a nonprofit commu patients of Care BURN MUSIC THERAPY Gannon Compre- A. at the John Music therapy is at MetroHealth Burn Care Center hensive and other dressing changes used during often conducted at Clinical studies procedures. during that music therapy MetroHealth revealed reduces pain, discomfort, procedures significantly tailored is Therapy anxiety and muscle tension. to needs – he or she chooses to a patient’s along with the type participate in music therapy music therapy of music used. MetroHealth’s serve to program is expanding trauma and rehabilitation unit patients. DISCOUNT DRUG MART staff specially trained to provide care for them. In 2015, The MetroHealth System opened its Founded in 2008, the Kidz Pride Clinic has worked first walk-in clinics at Discount Drug Mart in with nearly 100 children and teenagers ranging Independence, Olmsted Falls and Parma Heights. from age 5 to age 21. Providing mental health Same-day service is offered to anyone who needs and medical treatment and access to support is care, from young children to older adults. The a major step to decreasing the health disparities clinic is staffed by a nurse practitioner who can that LGBTQ youths often face. prescribe medications, provide sports physicals, assess a person’s basic medical needs and help MDA CLINIC with the diagnosis and treatment of illnesses such as allergies, earaches, eye conditions, rashes, skin MetroHealth is home to the only Muscular conditions, sinus infections and sore throats. This Dystrophy Association (MDA) Clinic in Cleveland. is another step toward providing services where, A national event raises money to pay for medical when and how patients want them. care for people who have muscular dystrophy, amyotrophic lateral sclerosis (ALS) and many other diseases. In Northeast Ohio, that care is HEALTH CARE AT THE JUVENILE provided at the MetroHealth MDA Clinic at no DETENTION CENTER charge to patients or their families. MetroHealth provides daily health services for130-180 youths, male and female, who are MEDICAID TECHNICAL ASSISTANCE AND in the juvenile justice system at the Cuyahoga POLICY PROGRAM (MEDTAPP) County Juvenile Detention Center (JDC). Upon entering, all youths are screened by MetroHealth In 2012, the MEDTAPP Medicaid Healthcare registered nurses and licensed practical nurses Access Grant was awarded to MetroHealth and for communicable diseases, allergies and need for Case Western Reserve University. The goal of this medications. MetroHealth physicians and advance grant is to recruit, train and retain a primary care practice nurses complete comprehensive exam- workforce to serve the Ohio Medicaid population. inations every weekday morning and order med- The MEDTAPP team has initiated a number of ications as needed. The nursing staff responds innovative patient care models, including home to minor and emergent health issues 24/7. When and weekly group visits for chronically ill patients. a youth has a medical need outside the scope It also trains medical students outside of the tra- of the clinic practice, an appointment is made at ditional clinical setting. It delivers care to shelters, MetroHealth with the appropriate provider. urban housing developments and other locations in the community. This interdisciplinary health care team is comprised of medical students, JOHN A. GANNON COMPREHENSIVE BURN physicians, registered nurses, medical assistants, CARE CENTER AT METROHEALTH psychiatry staff, psychology staff, social workers The center is one of only two adult and pediatric and counselors. The following are MEDTAPP burn centers in the state of Ohio verified by the programs. American Burn Association and the American Asia-International Community Health College of Surgeons Committee on Trauma. The Center (A-ICHC) Burn Care Center treats more than 1,200 outpa- Once a month, a post-doctoral psychology fellow tient and inpatient burn injuries every year. It has provides behavioral health services including been a leader in burn care since it was formed mental health assessments and counseling. in 1970. Using a multidisciplinary approach, the The collaboration provides needed services Burn Care Center functions 24 hours a day, seven to low income, underserved members of the days a week and provides an outpatient clinic community. available for patients who need wound care but Correctional Health Program do not require hospitalization. The Center also Established in 2013, this partnership teams provides customized educational programs for leadership and resources from MetroHealth with the general public and training for medical and Cuyahoga County Corrections Center health care emergency personnel. providers to improve treatment for 2,200 inmates at the Cuyahoga County Corrections Center. KIDZ PRIDE CLINIC MetroHealth’s physician medical director, opera- tions director, attending physician, six mid-level Working in conjunction with MetroHealth’s Pride providers (physician assistants and certified nurse Clinic, the first of its kind in Ohio, the Kidz Pride practitioners), nursing supervisor, paramedic, Clinic gives lesbian, gay, bisexual, transgender, dentist and dental hygienist augment the facility questioning (LGBTQ) youth the opportunity to staff of more than 50 nurses and medical techni- work with physicians, psychologists and support cians. A dedicated pharmacy along with specialty

18 METROHEALTH 2015 COMMUNITY REPORT Clinical Programs 19 - - - - behavioral health services provider. People with with People health servicesbehavioral provider. engage mental and persistent often illness severe health and/or behavioral a psychiatrist in care with physical to their neglecting to attend team while and treatable result, preventable a As health. disease as diabetes, heart health concerns such the death in leading causes for and hypertension, mentally or inade ill population, go undetected borns in the early postpartum period. Medical borns in the early postpartum nutrition recovery, residents assess postpartum quately addressed. With MetroHealth’s help, the With MetroHealth’s quately addressed. physical can seek Resources clients at Recovery mentalhealth care along with health care. Home Visit Program med multiple patients who have Home visits for pairs of providers by ical problems are conducted and a medical student. comprised of a resident neu with stroke, are challenged patients Many makes rological issues or terminal illness, which A continuum of care is achieved mobility difficult. are scheduled through home visits, which throughout the week. Visits Home Postpartum Mom and Baby comprehensive medicine residents provide Family fills This at home. of mom and baby evaluations underserved income and low patients a gap for Center not visit MetroHealth Medical who may program promotes the The post-deliveryfor care. of at-risk mothers and new well-being overall - - - - - Family Medicine Chronic Disease Program Program Medicine Chronic Disease Family 400 more than diabetes (CDP) - evaluated on-site patients since inception, instituted self-management course diabetes six-week inmates. for fessional staffing improved throughput by throughput staffing improved fessional as care preventive 50 percent while offering as tooth extraction. well Dental modern two Suite and personnel - dental areas, support equipment and pro • • Health Care for Recovery Resources Recovery for Health Care primaryMetroHealth provides individu care for als at Recovery Resources, a community-based a community-based Resources, als at Recovery prehensive care is provided with an efficiency that efficiency that with an is provided care prehensive daily the 70-100 the cost of that care for lowers days. stay of 45 an average patients who have MetroHealth programs: 2015 New paedics, suturing) improve the standard of care improve paedics, suturing) inmate transports for while reducing the need services.to the hospital for Incorporation of link to a key provides electronic medical records More com system-wide. MetroHealth specialists services and OB/GYN complement in psychiatry “vir real-time care team. MetroHealth’s the health program, on-site chronic visit” telemedicine tual x-ray/ in-house (CDP), expanded disease program imaging and laboratoryultrasound support and (e.g., care, ortho ongoing skills training wound of mom and baby, mom’s mood or mental health MEDICAL HOME FOR and whether the baby has a safe sleeping envi- CHILDREN IN FOSTER CARE ronment. The goals are to reduce infant mortality In partnership with the Cuyahoga County rates and increase breastfeeding rates. Division of Children and Family Services (DCFS), Shower Clinic MetroHealth provides children in foster care MetroHealth is running a free outpatient clinic with a centralized place to receive both routine in conjunction with the Malachi Center Shower and sick care including physicals, immunizations program, which opens its doors for homeless and assistance with behavioral and/or mental individuals to shower and clean their clothes. health concerns. When a child is removed from MetroHealth offers weekly basic health screen- a home, the child is first brought to MetroHealth ings and monthly podiatry services. This outreach for an examination and any immediate care that is an effort to treat and build trust so this popu- is needed. For this “triage,” a dedicated nurse lation will begin to take advantage of additional practitioner is ready to welcome children 24 health care options and services to which they are hours a day, seven days a week, 365 days a year. entitled. Treating physicians also distribute much- Children receive a 30-day exam by the same needed items for the homeless: wool socks, medical team that they met during triage, to help over-the-counter medications and reading glasses. build a consistent and trusting relationship with In the past year, 498 patients were seen at the the team that they will continue to see at future outpatient clinic. appointments. A Care Coordinator meets the child and foster care family at the 30-day appointment Transition Program and thereafter tracks compliance with appoint- This is a home visit program specifically for ments, how the child is adjusting and any referrals patients who were recently discharged from to specialists that the child may need. the hospital and are considered at high risk for readmission due to past behavior. Within 72 hours All visit information is entered into the electronic of discharge, providers visit to make sure patients medical record – EPIC, which allows MetroHealth are following medical directions and properly tak- providers to review the overall plan of health ing medications. Family medicine providers bring care and management, even if a child is seen at residents and medical students on the visits, another health care system. which can be valuable learning experiences.

20 METROHEALTH 2015 COMMUNITY REPORT Clinical Programs 21 - - Cleveland Treatment Treatment Center Cleveland Addiction Against Community Action Fortaleza Women for Center Hitchcock Talbot for Matt Women Association Northern Ohio Recovery Services Psych Resources Recovery Health Signature and Mental Health Addiction, Alcohol, Drug CountyServices of Cuyahoga Board County Children Department of Cuyahoga Servicesand Family Court County Drug Cuyahoga Dugan Center May House Merrick House Providence Seeds of Literacy HospitalsUniversity • • • • • • • • • • • • • • • • • a non-judgmental environment to deal with the to deal with a non-judgmental environment caused by emotional problems medical and opiates or as prescription such drugs addiction to untreated yet their addictions are Whether heroin. or Subutex are receiving Methadone or they treatment program, through a community drug care expert provides the MetroHealth program communityand coordinates with agencies to services.optimize been seen with opiate addiction have Patients more than a decade. In 2013, at MetroHealth for a care obtained to provide grant funding was program. coordinator and establish a formal with opiate mothers struggling 178 In 2015, to babies who had exposure addiction, and 108 served.opiates, were Community Partners: Providers: Treatment Substance Use Services: Wrap-Around for Partners CENTER TREATMENT EBOLA OHIO’S ONLY desig was MetroHealth System The In 2014, sive care to patients with an Ebola diagnosis. sive because of its facility chosen MetroHealth was training and configuration and readiness, staff an caring for when medical expertise overall disease patient. MetroHealth will work infectious nated an Ebola treatment center by the U.S. the U.S. nated an Ebola treatment center by Disease Control and Prevention Centers for (CDC). MetroHealth is the only designated Ebola treatment center in Ohio, joining only 54 others that designation recognizes The in the nation. comprehen MetroHealth is prepared to provide - -

DEPENDENCY PROGRAM DEPENDENCY A care coordinator facilitates this program with high- the outcomes for the goal of improving and their babies. women risk, drug-dependent are offered and their infants women Pregnant MOTHER AND MOTHER CHILD ment is given to understand the patient’s financial to understandment is given the patient’s is then able to social worker The circumstance. individual. plan with each a personalized develop helping patients apply includes plan often The helping Assistance Programs, to Pharmaceutical insurance option is patients understand which them and assisting with the application best for process. In some cases, the individual simply needs guidance on maintaining a budget to afford MetroHealth his/her medication(s). In 2015, more than $30,000provided in free medications program. through the voucher MEDICATION ASSISTANCE MEDICATION medication are afford who cannot Patients Work’s the Department of Social to referred more than Assistance program. For Medication a voucher MetroHealth has offered years, 16 patients who qualify to allows program, which once every twelve a medication voucher receive an assess months. In addition to the voucher, viders work together to give patients high quality, patients high quality, together to give viders work results in health more coordinated care, which consistent care receive Patients care savings. helping them to stay healthier and contributing All primary population health. care to improved earned have MetroHealth System The sites within Assurance Quality for the National Committee Medical Home (PCMH) (NCQA) Patient-Centered accessible, 3 Designation (highest) for -- Level high quality coordinated health care. METROHEALTH CARE PARTNERS METROHEALTH is MetroHealth Care Partners Established in 2014, Accountable Program a Medicare Shared Savings Care MetroHealth Care Organization (ACO). care for to ensure comprehensive works Partners members. Primary individual care nearly 10,000 other health care pro specialists and physicians, MEDICARE ACO, MEDICARE ACO, The Foster Care program began in November began in November Care program Foster The care team the foster 2015, of December As 2013. in 3363 triage children 3,134 with has worked follow-up comprehensive 30-day visits and 1390 multiple triages, can have A child appointments. appointment occurs, the 30-day before even change in when there is a as it is the first step $358,830 will provide DCFS placement. In 2016, an while MetroHealh will cover the program for additional $400,000. closely with hospitals and health departments STD and HIV screening, HIV prevention utilizing in the community and in the state to meet the Pre-Exposure Prophylaxis (PrEP) and treatment, needs of Ebola patients. Community partners are and transgender health services including hor- the Ohio Department of Health, Cuyahoga County monal medical care, mental health and surgical Board of Health and Cleveland Department of care referrals. Gender non-binary, gender-fluid and Public Health. transgender children and youth are able to receive supportive and affirming care at the multidisciplinary Kidz Pride Clinic. The MetroHealth Pride OSCAR HISPANIC CLINIC Clinic and the Kidz Pride Clinic are committed to The Oscar Hispanic Clinic has a bilingual staff to removing barriers, improving access and, most address the specific medical, psychological and importantly, providing quality health care for all social needs of Hispanic youth. The goals are to LGBTQ patients in Cuyahoga County. improve the health and well-being of Hispanic children through education, prevention and interven- PROVIDENCE HOUSE tion. The clinic was opened in 2004 as the Health Services for Hispanic Children and Adolescents The MetroHealth System provides all the medical Clinic. In 2015, it was renamed the Oscar Hispanic services, seven days a week, for Elisabeth’s Clinic in memory of Oscar Gumucio, PhD, former House, the Prentiss Wellness Nursery at co-director of the clinic. Providence House in Cleveland. The Wellness Nursery serves children from birth to 10 years old who have medical needs and no longer require PRIDE CLINIC inpatient hospital care, but whose families are Founded in 2007, the MetroHealth Pride Clinic currently unable to meet their medical needs due is the first in the region devoted to serving to family crisis or unstable living environments. the health needs of the lesbian, gay, bisexual, MetroHealth clinicians assess patients, provide transgender and questioning (LGBTQ) commu- physicals, administer medication and educate nity. Specially trained physicians and support parents before their children return home. staff create an open and honest environment to provide care that respects unique health needs. SANE Care includes primary care and specialty services, MetroHealth has a team of Sexual Assault Nurse Examiners (SANE) who are specially trained to provide timely, coordinated, comprehensive and compassionate care to pediatric and adult victims of sexual assault. This care is available 24 hours a day and seven days a week. When an adult or child has endured a sexual assault and comes to the Emergency Department, the forensic exam can take anywhere from two to eight hours, depending on the emotional and medical needs of the patient. Citing the need for a private, comforting room within or near the Emergency Department, Elizabeth Booth, a MetroHealth nurse, participated in the recent MetroHealth Think Tank competition, similar to TV’s “Shark Tank.” An attendee who heard her presentation was so moved that he donated $100,000 to finance a new space within the hospital that will provide more privacy and security for patients and staff during this difficult time.

SCHOOL HEALTH PROGRAM The School Health Program (SHP) mission is to improve access to health care by partnering with the community to advocate for and support the health and well-being of children in the Cleveland Metropolitan School District. The SHP was developed in 2013 to bring MetroHealth primary care to children who are at risk of not receiving care due

22 METROHEALTH 2015 COMMUNITY REPORT Clinical Programs 23

YOUNG ADULT CLINIC ADULT YOUNG at age care, generally out of foster Aging without adrift people young many leaves 18, for Medical Home The care. adequate health has expanded Care program Foster Children in and health education, advocacy to help provide care. people coming out of foster young care for to an afternoon can go adults, ages 18-25, Young to help them provides clinic that MetroHealth care, mental needs and care, well health with sick also can seek advice They education. psychosocial benefits and for referrals about resources and as a result of aging for qualify programs that they also help to care. MetroHealth staff out of foster care and other connect them to dentaleye and of these many might need. For specialists they care in a familiar are seeking adults, they young care as a received place, where they child in foster care. in foster child -

Services (DCFS): Toxicology services Toxicology Services (DCFS): medication consults and psychotropic probation Adult Court of Common Pleas: testing drug medical direction Tactical Office: Sheriff’s Biometric County-wide health fairs: screenings and/or flu shots at 24 county workplaces Department of Children and Family Department of Children and Family • • • • TUBERCULOSIS CLINIC TUBERCULOSIS Cuyahoga clinic houses the MetroHealth’s is the which Program, Tuberculosis County the reporting, treatment and designated clinic for cases in Cuyahoga of all tuberculosis investigation treatment and nurse evaluation, Physician County. of to all residents case management are provided County diagnosed with tuberculosis. Cuyahoga to all patients Medications are provided the as required by regardless of ability to pay, patients receive Tuberculosis Code. Ohio Revised by as recommended staff from outreach therapy Disease Control and Prevention the Centers for Health Organization (WHO). World (CDC) and the SEVERAL ADDITIONAL PROGRAMS COUNTY WITH CUYAHOGA through August. visits and other health needs, from June visits and other health needs, from June tional students. SHP also focuses on training child on training child focuses SHP also tional students. disciplines including across health professionals students, nursing students, medical residents and and public health assistant students physician graduate students. and after-school in-school SHP provides The families students, educational programming for community school per each and teachers, SHP has also partnered with other The request. Aamoth MetroHealth programs including the Arts in and Center Wellness Pediatric Family their servicesMedicine to extend to the school a summer SHP includes The communities. mobile clinics for component with weekly urgent care immunizations/shots, physicals, to lack of access. With consent, parent/guardian of access. to lack care for medical professionals MetroHealth hours. school during at school children health primaryCare includes and preventive and immunizations, as routine check-ups such as asthma diseases such help managing chronic services additional for and diabetes and referrals program model The health. including behavioral that clinic and a mobile unit includes one in-school sites, so more children school to different travels made possible by van, A second can be reached. serve soon, will addi donors and to be purchased 2 Patient Education and Support

Classes, support groups and the many services provided by volunteers help patients as they navigate new situations and partner with MetroHealth in their health care.

24 Patient Education and Support 25 - - BREASTFEEDING CLINIC BREASTFEEDING Clinic is a MetroHealth Breastfeeding The to receive their children mothers and resource for to issue related any high quality care for medical The delivery. and after both before breastfeeding, a certified a nurse practitioner, by clinic is staffed The lactation consultant physician. and a family and diagnosis medical evaluation clinic provides including with breastfeeding of issues associated gain, breast or nipple pain or infec weight infant sions allow for topics of the attendees’ choosing. attendees’ topics of the for sions allow CLASSES PREPARATION CHILDBIRTH and what to expect prepare parents for classes Free do during labor and birth to help reduce anxiety and Expectant with knowledge. mothers replace fear to be of ways a range are shown and fathers more comfortable during pregnancy and childbirth. decisions about informed Classes help them make care. Childbirth care and their infant’s their own at MetroHealth Classes are offered Preparation MetroHealth Middleburg Heights Medical Center, Health Center and MetroHealth Family November five-week Each Health Center. Broadway atcourse ends with a tour of the birthing center including a look at MetroHealth Medical Center, birthing suites and patient rooms. tions, tongue-tie, medical conditions affecting conditions affecting tions, tongue-tie, medical or reestablishing adoption milk breastfeeding, medical visits that are covered are These supply. most insurance. by CAREGIVER’S GROUP SUPPORT Support Group is a free, Caregiver’s MetroHealth’s peer support and information open group that offers monthly group helps participantsThe caregivers. for stressed or overwhelmed be feeling who may regarding options and information and provides the ses resources. Open to a wide range of ideas, - - - -

Gain emotional support and share feelings Gain emotional support and share feelings about the hospital and recovery experience process since the has changed life Discuss how injury who are coping and learn from others with similar situations to Discuss concerns regarding returning and community school work, Discuss issues related to body image and image enhancement ments and exercise Address common practical concerns such such common practical concerns Address gar care, use of pressure as wound/skin • • • • • Group members and their families may participate may Group members and their families group activities that promote social in structured BOOT CAMP FOR NEW DADS BOOT and soon-to-be to current classes are offered Free Dads is a hands-on New Camp for Boot fathers. their to learn to care for fathers for chance dads, real babies babies with the help of veteran supported by Financially and a male instructor. County Initiative, Fatherhood the Cuyahoga nine MetroHealth administers the program for Countycollaborating hospitals, the Cuyahoga County Center and the Cuyahoga Corrections Classes Facility. Correctional Community Based at MetroHealth Medical Center and are offered Health Center. MetroHealth Broadway port and participate in the pediatric burn camp as port and participate in the pediatric burn burn survivors. mentors and role models to child to attend opportunity the Burn survivors also have Burn Congress and engage in Worldwide the community activities that promote education and public awareness. ization and community re-entry. Group members ization and community re-entry. out to other burn survivors peer sup for can reach RECOVERY GROUP RECOVERY a continuum of care to group provides This needs of burn survivorsaddress the ongoing and a weekly options: are two There their families. and a monthly group day group held during the open-ended and groups are The in the evening. to: with the opportunity individuals provide ADULT BURN SURVIVOR BURN SURVIVOR ADULT AA open discus hosts meetings and MetroHealth community members of the sion to support who remaining sober and/or in getting are interested Alcoholics the official follow Meetings sober. protocol. Anonymous® COMPASS DIABETES SELF-MANAGEMENT PROGRAM Compass Services is a free program that guides MetroHealth’s Diabetes Self-Management people living with HIV/AIDS along the path to Program is recognized by the American Diabetes wellness. Services offered include counseling Association for meeting the standards of diabe- for the newly-diagnosed, support groups, peer tes education. A series of group and individual navigation, special programming and a smart- classes, taught by certified diabetes educators phone app created by MetroHealth to retain (dietitians and nurses), is offered at MetroHealth youth and young adults (ages 13-34) in HIV care. Medical Center and MetroHealth Buckeye Health Compass Services programs and staff are funded Center. Sessions cover topics such as labs and through generous grants and other public and medications, nutrition, physical activity, stress private sources. management and how to prevent diabetes-related complications. Participants who complete the pro- Since the program’s 2008 inception, about 100 gram show improvement in blood glucose levels. individuals newly diagnosed with HIV receive Both sites also offer ongoing diabetes support individualized counseling, education and linkage group meetings. to care each year, for a total of nearly 800. In 2015, 197 individuals attended one or more of the 90 support groups. The multifaceted Peer Support DOULA VOLUNTEER PROGRAM Program is designed to encourage and help patients learn how to successfully live with HIV. MetroHealth offers the only free doula program in There are 45 trained HIV+ Navigators who provide the area. A doula assists a woman before, during support to other patients as needed. Some are and after childbirth by providing physical assis- paired with patients and others visit patients tance and emotional support. Studies show that who are hospitalized. A peer-written blog is also a labors with doulas are shorter with fewer compli- source of interaction and encouragement. cations, babies are healthier and they breastfeed more easily. MetroHealth’s doulas provide support In 2015, Compass Services assisted 10 local particularly for mothers whose partners are not families with creating quilt panels prior to participating in the birth. MetroHealth’s hosting its biennial display of the AIDS Memorial Quilt. Approximately 150 people attended the opening reception in December on HEALING HEARTS World AIDS Day. The Healing Hearts fund offers a grieving family financial help for burial or cremation of their pre- CUYAHOGA COUNTY PUBLIC LIBRARY AT mature or newborn child. In addition to alleviating METROHEALTH MEDICAL CENTER some stress for the family, the fund assures that the child’s remains are put to rest with dignity. Patients, visitors and staff of MetroHealth have The Healing Hearts fund is administered by easy access to resources of the Cuyahoga County MetroHealth’s Pastoral Care Department with Public Library through a MetroHealth Service Point support from MetroHealth’s neonatology staff. at MetroHealth Medical Center. In addition to books, DVDs and magazines, branch visitors can find a special section dedicated to pediatrics and parenting. The location also offers computers, a fax and copy machine and a dropbox for after-hours returns. The library is staffed by a librarian and a clerk.

CUYAHOGA COUNTY WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM WIC is a federally-funded food supplement and nutrition education program. It serves pregnant and breast-feeding women, and children up to the age of 5 who are at risk due to inadequate nutrition. Administered in Cuyahoga County by The MetroHealth System, the program operates 19 nutrition education program sites and serves more than 30,000 participants each month throughout the county. WIC provides nutrition education, breastfeeding education and support, nutritious foods, iron-fortified infant formula and referral to health care and human service programs.

26 METROHEALTH 2015 COMMUNITY REPORT Patient Education and Support 27 - - - MYCHART MYCHART TRAINING COMPUTER help communitynavigate members To patient portal, MyChart free com MetroHealth’s ten class. The stateThe of Ohio mandates that every ten class. birthing hospital ask every mom upon discharge A to sleep. the baby place for if she has a safe in a crib back should sleep alone, on their baby bed, on a or a portable crib, not in the parent’s hospitalsAll are required or air mattress. couch free cribs or portable site for a referral to have she does not that cribs when a mom answers to sleep. her baby place for a safe already have Women, County At MetroHealth, the Cuyahoga has a Cribs and Children (WIC) program Infants, a free for that provides grant Kids foundation for portable a crib when needed. Moms must view the crib, so their receiving sleep video before safe chance the hospital with a better can leave child survival.for puter classes were offered through a partnership through offered were puter classes of Community initiative Your with the Connect training helped Personalized One Community. manage secure, online seniors and other adults enabling them to access to medical records care online. Classes were manage their health access to tele- residents’ designed to improve of December 31, As health and tele-wellness. had 88,642 MyChart enrollees. MetroHealth 2015, SAFE SLEEP INITIATIVE child does a defined as when mortality, Infant has climbed to alarming a first birthday, not reach mor infant worst Ohio has one of the levels. tality at 47th and, ranking rates in the country, American babies. African at 49th for yet, worse rate in the County has the worst Cuyahoga rate in has the worst Cleveland state and, sadly, the county. sleep is part of the solution. Last year, Safe babies because of County lost 19 Cuyahoga to this as Some refer sleep environments. unsafe kindergar been an entire have losing what would - - -

feeding or have recently, serve as an encouraging recently, or have feeding moms. and new expectant women resource for and rate is 47th nationally, breastfeeding Ohio’s according to the Ohio Department of Health, infant to reduced is clearly linked breastfeeding mother and for of illness mortality and prevention peer support helpers are MetroHealth’s child. at their prenatal to meet with women available visits at MetroHealth Medical Center and offer individual education sessions on breastfeeding. deliver they after up with women follow Peers phone and at weekly by and remain available support groups. breastfeeding MOTHER NURTURE PROJECT PROJECT NURTURE MOTHER breast support helpers, who are currently Peer SUPPORT GROUP SUPPORT dealt with adults who have and other Parents in the the stress and anxiety a child of having Neonatal Care Unit (NICU) volunteer Intensive others going as advisors in a support group for group provides The through the same experience. or other adults parents for a calm environment care to share with the child’s closely involved connect with others concerns, voice experiences, is in their child and be supported during and after the NICU. METROHEALTH NICU FAMILY NICU FAMILY METROHEALTH ers and babies by volunteers at MetroHealth. The The at MetroHealth. volunteers ers and babies by can use the they how mothers show volunteers librarykit and new card to begin the important and continuing to of reading to their infants work grow. do so as their children LIBRARY CARDS FOR NEWBORNS CARDS FOR LIBRARY and the Cuyahoga Department Pediatrics The County Library partnered to Public (CCPL) have at MetroHealth with a babies newborn provide The the hospital. library leave they card before & “Baby library CCPL’s cards are inserted into moth to new early literacy kits and delivered Me” preters fluent in more than 200 languages. The The than 200preters fluent in more languages. services are free. LANGUAGE ACCESS AND AND ACCESS LANGUAGE CENTER SERVICES COMMUNICATION interpretation services provide patients Staff for hearing or sight English proficiency, with limited literacy and patients requiring impairments access to have and providers support. Patients support communications multilingual and cultural with interpretation, and translated translation are fluent in All staff patient education materials. access to inter and have English and Spanish SIBLING CLASSES Doula Providing emotional support and comfort mea- This free, one-time class helps children ages 2-11 sures to women during labor and delivery. Doula understand the important role they will play in the training offered by Doulas of North America family when their brother or sister is born. The (DONA) is required class eases a child’s anxiety by showing where Mom is going to have the baby and what a new Emergency Department baby looks like. Children 12 and older are invited Offering non-medical assistance to patients to attend a prenatal tour with their parents. and families in MetroHealth’s Level I Adult Trauma Center

SMOKING CESSATION CLASSES Greenhouse Watering and misting plants The American Lung Association’s Freedom From Smoking® Program is offered at MetroHealth Greeters Medical Center and MetroHealth community Greeting patients and visitors, escorting patients health centers. This 8-session program provides and providing directions the skills, tools and support needed to success- Hospitality Rounds fully stop smoking. Classes are free and open Visiting hospitalized patients and offering to all adults 18 years of age and older. Nicotine comfort items such as playing cards, lip balm, replacement products are available for class puzzle books participants and are free to those who qualify. In Infant Comforter 2015, 71 individuals completed the classes. Providing nurturing support by holding and rocking infants in the Neonatal Intensive Care Unit and TRAUMA SURVIVORS NETWORK Newborn Nursery The Trauma Survivors Network is a community Loving Paws at MetroHealth of patients and families who connect with one Bringing dogs to visit patients and families. another and help to rebuild their lives after a Dogs must be certified through Therapy Dogs serious injury. It was established at MetroHealth’s International or Pet Partners Level I Adult Trauma Center in 2013 and is associ- No One Dies Alone ated with the American Trauma Society, a national Providing a reassuring presence at the bedside of organization committed to trauma care and pre- dying patients who would otherwise be alone at vention for more than 30 years. Trauma recovery the end of life services include: nurse and provider debriefing, community/first-responder presentations, peer Pastoral Care volunteer and mentorship training, recovery Assisting chaplains in meeting spiritual needs of service consultation and individual patient and patients of all faith backgrounds family coaching. Programming has expanded to include support groups for individuals and families affected by brain injury and amputation and programming for those experiencing time in the neonatal intensive care unit (NICU) and infectious disease unit.

VOLUNTEER SERVICES Aamoth Family Pediatric Wellness Center Assistance with nutrition and fitness classes for children Burn Center Support Burn survivors trained for visiting with patients and discussing the recovery process, and participating in support group for patients and families Child Life Interacting with and providing activities for infants and children in a playroom and at the bedside Clothing Distribution Labeling and sorting clothing for distribution to foster care, the emergency department and inpatient floors

28 METROHEALTH 2015 COMMUNITY REPORT Patient Education and Support 29 -

Ronald McDonald Family Room at at Room Family Ronald McDonald MetroHealth room of this special as the host or hostess Acting relaxing and sup a friendly, provide and helping support group meeting Center Surgery Greeting patients and visitors in ambulatory escorting patients to changing surgery center, on patients in recovery area, checking Network Survivors Trauma survived a have peer visitors who Trained traumatic injury injured visiting with newly support patients and offering Roundup Wheelchair from various wheelchairs Recovering hospital locations portive environment for families that are dealing that are families for environment portive child with the illness of their Senior Forum participants at monthly Greeting and registering seniors presentations for Shop Snack with sales Assisting Support Peer Spinal Cord successfully peer visitors who have Training injuryadapted to a spinal cord to visit with the recoverypatients and discuss process of Music at MetroHealth Spirit by Making music part of the healing process talent or instrumental with patients sharing vocal and visitors Group Support Stroke monthly Greeting and helping facilitate Patient and Family Advisor Program Advisor Family and Patient information offering members and family Patient patient experience the to improve Rounding Safety Patient safety and explaining hospitalized patients Visiting falls measures to prevent – Therapy and Occupational Physical Inpatient & Outpatient assistance by as directed non-technical Providing in wheelchairs therapist, pushing patients and Read Out Reach waiting in pediatric children to young Reading the importanceareas, demonstrating that reading development has in a child’s and Read Plus Out Reach outpatient for waiting aloud to children Reading how parents and children appointments, showing smartphone apps to promote and to use iPads literacy skills Rehabilitation Activities Patient with activities at MetroHealth Assisting of Ohio under the direction Institute Rehabilitation of art, music and recreation therapists Reiki Clinic, Hands to Heart Reiki In MetroHealth’s Reiki appointments volunteers offering qualified in need of a healing to patients and employees is required through the second Training touch. Master Level preferably and of Reiki level Resident Activities Enrichment Engaging long-term care residents in a variety friendly visits, hour, of activities including coffee and more special events 3 Research and Training

In an affiliation since 1914 with Case Western Reserve University School of Medicine, MetroHealth furthers global medical science through research and education.

30 Research and Training 31 ------

800 medical students and nurse practitioner, and nurse practitioner, 800 students medical assistant, anesthesia assistant,physician bioethic, podiatry students and informatics rotating from other400 residents/fellows institutions 380 MetroHealth residents/fellows • • • institutional partner in the Cleveland Clinical and Cleveland partner in the institutional and has a collaborative Science Translational both inpatients and to care for unit clinical research studies. participating in research outpatients Partner Community ogy. The Center for Health Care Research and Policy and Policy Research Health Care Center for The ogy. Health Disparities Reducing and the Center for on finding more cost-effec efforts research focus treatment and management of to approaches tive diseases. chronic MetroHealth trained: In the last year, Case Western Reserve University Western Case CENTER SIMULATION Simulation (Sim) Center provides MetroHealth The individuals and teams toprograms designed for andrefine critical decision-making, apply knowledge practice important high-fidelity skills using simula By creating realistic scenarios tors and techniques. tools, the Sim Center opti and using all available a multidisciplinary for experience the learning mizes the Sim Center conducted In 2015, of learners. array A variety of of training. learner-hours 17,000 over and including adult, child simulators are employed a birthing simulator, simulators, computerized infant ultrasound models and a long list of procedure-spe cific task-trainers. Standardized patients/profes sionals are incorporated in programs to achieve Sim CenterThe communication goals. high-value and trainees asdiligently serves MetroHealth staff care programs and as numerous regional health well Center team Sim multifaceted The professionals. coordinators full support to assist program provides programs and courses that and faculty to develop support their learning objectives. WITH CASE AFFILIATED HOSPITAL TEACHING SCHOOL OF UNIVERSITY RESERVE WESTERN MEDICINE School with CWRU affiliation During the 101-year of Medicine, MetroHealth has trained thousands in their of them renowned many of physicians, All world. and the fields throughout Cleveland hold faculty physicians active of MetroHealth’s of Medicine. School appointments at CWRU in key with CWRU work MetroHealth researchers areas of scientific discovery and biomedical technol

METROHEALTH RESEARCH METROHEALTH at MetroHealth, physicians By centralizing research been able to initiate have and other researchers manner. in a more efficient and cohesive studies in EPIC, developed that was system A tracking improved for the electronic medical record, allows participants. Often, continuity research of care for other therapies gain exhausted patients who have help. In 2015, medications that may access to new and approved, reviewed were studies new 179 there are 753 opened, and 30 clinical trials were approximately MetroHealth receives studies. active million annually from the National Institutes $12 programs focus of Health (NIH). Major research health care qualityon improving and outcomes, reducing health inequalities, restoring neurological treating heart mortality, health, decreasing infant tests novel and developing disease and arrhythmias 6,973 diseases. In 2015, kidney and treatments for protocols. in clinical research involved patients were to research, approach to bedside” “bench The from the laboratorytaking to the clinical research directly benefits patients. setting, Review Institutional MetroHealth has executed Agreements withBoard (IRB) Authorization in the state Boards Ohio of Review Institutional Clinic, University Hospitals,including: Cleveland Ohio StateThe Reserve University, Western Case University Children’s, Nationwide University, These of Cincinnati and Cincinnati Children’s. one IRB to rely on the review for agreements allow the developed staff MetroHealth of another. permits all which HUB, Review electronic Reliant on a to do their reviews participating institutions MetroHealth). (hosted by single electronic platform chosen institutions MetroHealth is one of four can studies nationally to help determine how MetroHealth is an a single IRB. by be reviewed METROHEALTH INSTITUTE METROHEALTH ETHICS OF BURN Ethics, John Biomedical for Center MetroHealth’s and Burn Care Center Comprehensive A. Gannon Reserve Department of University Western Case of partnered to create the Institute Bioethics have serves the international Institute The Burn Ethics. communities throughburn and biomedical ethics a multidisciplinary on research, focusing team and clinical practice. education, policy development will be presenting their the Institute During 2016, and international conferences. at national work to care Burn Care Center provides MetroHealth’s in its inpatientmore than 1,200year patients per treating patients withunit and outpatient clinic, MetroHealth wounds. burns, scars and complex inis one of two adult and pediatric burn centers American Burn by the the state of Ohio verified American College of Surgeons and the Association Committee on Trauma. 4 MetroHealth in the Community

With a commitment to everyone in the region, MetroHealth initiates and runs a variety of programs aimed at improving everyone’s health and opportunities for better living.

32 MetroHealth in the Community 33 - -

population health and health equity for minority health and health equitypopulation for the these priorities, approach To communities. In geographic zones. divided into four county was specific community emerged projects zone, each to engage with residents through collaboration health their own them to improve and empower behavior. and neighborhood health Zone 1: and Westlake as west suburbs as far Western and southern suburbs including Olmsted Falls and North Royalton Strongsville Berea, Zone 2: Parma Brooklyn, including Lakewood, West Near West up the that make and the neighborhoods 25th Street Corridor Zone 3: Buckeye East Cleveland, Village, Slavic Broadway, and the eastern suburbs including Cleveland east as Heights, University Heights and as far Euclid and Highland Heights Zone 4: Southeastern and eastern suburbs including Pike Solon, Pepper Independence, Brecksville, Heights and Mayfield Community Health The Four hood in the immediate vicinity of MetroHealth’s hood in the immediate vicinity of MetroHealth’s engagement with local Through main campus. non-profit (schools, residents and institutions restaurants and other organizations, churches, retailers), food strategies are being developed of the importance to increase the awareness for alternatives food eating; healthy of healthy traditions; obesity and its chronic ethnic/cultural illness propensities; and stronger nutritional and attitudes. skills, behavior knowledge, Advocacy Initiatives: Advocacy (Zone 1) Quarrytown Engage Engage Quarrytown seeks to engage residents Authority Metropolitan Housing of the Cuyahoga (CMHA) Quarrytown property in a resident-driven increase process to decrease social isolation and community greater social connectedness to drive project relies The and individual health outcomes. building their of residents and is on the voices of a Health leadership skills through the formation residents who by Council led primarily Leadership leadership This with communitywork partners. group has identified health priorities, creating strategies, directing action and building opportu in ways healthier lives residents to live nities for one communityThrough to them. that matter Campus University’s Wallace partnership, Baldwin monthly meal to CMHA a provides Kitchen meal is made from The Quarrytown residents. as an and supplies nutrition as well surplus food, intergenerational social opportunity. (Zone 2) VIDA! on the Hispanic/Latino neighbor focuses VIDA! ------

ities are violence, healthy aging, access, food ities are violence, healthy out Cuyahoga County where all residents have an County where all residents have out Cuyahoga their full health potential.” to reach opportunity prior community health advocacy overall The ADVOCACY INITIATIVES ADVOCACY are Initiatives Advocacy Community The Health on addressing health disparities and focused of the residents of the health status improving The County through community change. Cuyahoga communities through “to create healthy vision is COMMUNITY HEALTH HEALTH COMMUNITY cates to become certified Amigas volunteers, Amigas cates to become certified free for program to the BREAST connects women mammograms and other community resources, breast cancer small-group bilingual and organizes education sessions held in homes, churches, beauty salons or community centers. More than about breast learned 35,000 individuals have health, screening guidelines and where to get Community mammograms in their community. additional tests and screenings offer health fairs sickle cholesterol, blood pressure, glucose, HIV, for and health consultations men. cell, pap exams for gram for Latina women to educate other women educate other women to Latina women gram for The in their communities about breast cancer. mission is to reduce health disparities, program’s by uninsured minority especially for women, cancer through early detection of breast providing and screening, education, community outreach patient navigation. health advo program trains bilingual breast The AND SUPPORT TOGETHER (BREAST) (BREAST) TOGETHER AND SUPPORT UNIDAS AMIGAS United) is Amigas Unidas (Friends MetroHealth’s pro grassroots volunteer a bilingual peer-to-peer BRINGING EDUCATION, ADVOCACY ADVOCACY BRINGING EDUCATION, tion and fitness classes at local schools and schools classes at local tion and fitness teen and children Medical Center, MetroHealth living.agers learn about healthier Established five participants to program teaches ago, the years of Pediatrics Academy American incorporate the healthier living for daily recommendation 5-2-1-0 servings is to eat five That of fresh into their lives. spend less than two hours and vegetables, fruits game videos, computer, looking at a screen (TV, at least one hour of vigorous console, phone), get sugar-sweetened and drink zero exercise physical in children result has been that The beverages. their center program are improving the wellness of body fat (BMI), a measure body mass index are acquiring and based on height and weight, skills. life healthy AAMOTH FAMILY PEDIATRIC PEDIATRIC FAMILY AAMOTH CENTER WELLNESS nutri hands-on center’s the wellness Through Vida!-led dinners are one of the many social net- Corporation and the Third Federal Foundation. working strategies that are furthering awareness This project will also include a mentoring compo- and leading to culturally competent programs for nent that will allow youth an opportunity to part- healthier eating. ner with adults who are interested in supporting the development of future goals and aspirations. Let the Youth Lead the Way (Zone 3) The mentors will include local business owners Based in the Slavic Village neighborhood of the and other community stakeholders. city of Cleveland, Let The Youth Lead The Way uses the community engagement process to Falls Prevention Project (Zone 4) engage youth. In partnership with the already Falls are the leading cause of both nonfatal and existing P16/MyCom initiative, a Youth Advisory fatal injuries for those 65 and older. Based in Council has been formed with students from the Brecksville community, the Falls Prevention three high schools. The youth have developed Project facilitates the training of self-identified and implemented activities that have reduced the community stakeholders and residents to deliver likelihood of participation in high risk behaviors. multiple, targeted and peer-led falls prevention The focus has been on projects that have bene- training programs. This pilot project partners with fited residents of their community. They held an a local agency to deliver the nationally recog- education fair for younger students and distrib- nized “A Matter of Balance” Program. Through uted clothing in their neighborhood. Anticipated collaboration and replication, the Falls Prevention outcomes are an increase in community and Project is increasing awareness and educating the adolescent connectedness and increased partic- public in order to prevent and reduce falls among ipation from youth who have been disengaged. older adults. Students have created a mission statement and plan to engage more with local business owners and other community stakeholders. DIVERSITY RECRUITMENT Partners for this project include the Boys and Girls In line with the established MetroHealth value of Club of Cleveland, Slavic Village Development Inclusion and Diversity, there is a focus on attract- ing a diverse applicant pool. MetroHealth Human Resources staff have reached out to more than 100 leaders at educational institutions and other organizations to help build a diverse applicant pool. All applicants are considered on their individual merits, and the most qualified candidates are selected. An immediate goal for 2014 was to increase racial and ethnic diversity of candidates interviewed for management positions (manager, director and VP) to 20 percent. In actuality, 37 percent of those interviewed were racially and ethnically diverse. The result was that 38 percent of the hires were diverse. For calendar year 2015, the goal expanded to include underrepresented gender (considering labor market statistics), and reached for 40 percent of the interviewed candidates to be diverse. For all management positions, more than 79 percent of the candidates interviewed satisfied the new goals and 71 percent of the hires fit the new diversity standards. Physician recruitment achieved similar success, with 68 percent of the candidates interviewed being diverse (with the addition of gender) and 67 percent diversity hires. In nursing, the 2015 goal was that at least 25 percent of the candidates interviewed were racially/ ethnically diverse, veterans and/or men. Diversity candidates accounted for 40 percent of the nursing interviews and 32 percent of the hires.

34 METROHEALTH 2015 COMMUNITY REPORT MetroHealth in the Community 35

Department (Q1, 2016) Medical Offices MetroHealth Bedford (Q2, 2016) Medical Heights MetroHealth Cleveland Offices (Q2, 2016) Medical Offices and MetroHealth Parma Ambulatory Surgery Center (Q2, 2016) Medical Offices River MetroHealth Rocky (Q2, 2016) Health Center MetroHealth Brecksville (Q3, 2016) MetroHealth Middleburg Heights November November Middleburg Heights MetroHealth Health Center (2013) Family Center Independence Health MetroHealth (2014) Health Center MetroHealth Brunswick (2015) Center at Health Westlake MetroHealth (2015) Park Crocker Practice Family MetroHealth State Road (2015) Heights Mart, Parma MetroHealth at Drug (2015) Mart, Independence MetroHealth at Drug (2015) Mart, Olmsted Falls MetroHealth at Drug (2015) Emergency Heights MetroHealth Cleveland Department (Q1, 2016) Emergency MetroHealth Parma • • • • • • • • • • • • • • • - munity medical practices joining MetroHealth, care to where on bringing medical there is a focus creation of The learn and play. work, people live, impacts locations creates jobs and favorably new jobs or construction Whether it’s the community. both add staff, adding clinical and administrative spent in the taxes collected and dollars to payroll to MetroHealth locations also attracts Traffic area. most recent The other commerce into the areas. are: MetroHealth System The additions to EASIER ACCESS ACCESS EASIER FOR ALL that and quality are two factors Convenience when seeking choices people make influence the award-winning, health care. MetroHealth offers fulfill the mission To high-quality health care. a healthier community,” to “leading the way of With that health care must be easily accessible. of buildings, renovation of new the construction and com buildings, strategic partnerships existing DOCTORS ON THE STREETS (DOTS) STREETS THE ON DOCTORS spring, through doctors, fall nights from On Friday MetroHealth’s medical residents from nurses and at St. Medicine volunteer of Family Department Street in Cleveland 25th West on church Malachi to the homeless. Medical care is care to provide most vulnerable brought to some of Cleveland’s deal with a variety of whom populations, many the year, Throughout of illnesses and conditions. residents collect necessities MetroHealth medical medications, blankets, over-the-counter as such reading care products, canes, foot boots, socks, clothing, sleeping bags and tarpsglasses, warm who are and women to be distributed to men harsh weather. region’s to our exposed EIGHTH LARGEST EMPLOYER MetroHealth representatives also help patients IN CUYAHOGA COUNTY sign up for MyChart, MetroHealth’s personal As of December 31, 2015, MetroHealth reached electronic medical record, and explain how they a total of 6,759 employees, increasing city can take an active role in their health care. Making and state payroll tax revenue. That’s also 604 appointments, refilling medications, reviewing additional employees in the last three years to lab and radiology results and communicating with support the innovative programs that improve the physicians are just a few benefits of MyChart. health of the community. Through MetroHealth’s In 2015, the enrollment van went to 178 events. Tuition Reimbursement Program and collaboration Staff on the RV saw 1,220 patients, helped 277 with College Now, MetroHealth is encouraging patients complete applications for Medicaid and continuing education for its workforce, which 295 patients enroll in MyChart. supports local institutions of higher learning, enables employees to advance in their fields and FOOD SERVICE TRAINING increases earning potential. Funds that individuals save through both programs, and increased To help high school students with special needs earnings, create more disposable income to be become prepared for future careers, MetroHealth invested in Northeast Ohio. kitchen staff teach teens from Rhodes High School and Lincoln-West High School about hospital kitchen production. During the weekly visits to EMPLOYEE CAMPAIGN MetroHealth, students gain hands-on experience The MetroHealth Foundation’s annual Employee and the possibility of working independently or Campaign raises funds to support programs and with some assistance in a food service field. projects of The MetroHealth System. The 2015 campaign raised more than $1.2 million. The same FRIENDS OF MOTHERS AND INFANTS employees who tirelessly care for patients show their commitment to our community by gener- Established in 1972, the MetroHealth Friends ously donating from their paychecks. of Mothers and Infants is a volunteer organization dedicated to providing essential items for underserved mothers and infants who are clients EMPLOYEE SERVICE DAY of MetroHealth. Friends of M&I promotes health This is an opportunity for staff to help local and well-being of families by providing new infant residents and organizations by cleaning up and and toddler clothing, portable cribs, strollers and helping out in several of the West 25th Street other necessities. The program connects with neighborhoods. Generally, about 100 employees families through MetroHealth’s outpatient clinics and their family members donate their time on a and social work staff. The program serves 1,000 Saturday morning to participate in activities such families each year. as picking up trash, gardening/planting, making blankets for the No One Dies Alone program and HEARTS AGAINST HUNGER painting over graffiti. Employee volunteers have an opportunity to interact with neighborhood res- The MetroHealth System has participated in the idents who also come out to lend a hand, show Hearts Against Hunger drive since 1995. More support or just say thank you. than 100 internal coordinators lead employees in the charitable effort, which was recognized by Harvest for Hunger with its Bag of Hope Award ENROLLMENT VAN in 2014. The 2014 and 2015 annual food drives MetroHealth’s Enrollment Outreach RV drives each raised donations of more than $40,000 and throughout Cuyahoga County to make it easy approximately 3,000 pounds of food. for residents to sign up for health care. The van reaches residents in their local communities, HOLIDAY GRANTS and staff assists them in applying for coverage in the appropriate health care programs. The RV Every year, MetroHealth awards matching grants is equipped with multiple work stations and is to employee groups from various departments staffed by financial representatives certified by that donate cash and/or goods to provide gifts the Centers for Medicare & Medicaid Services. and food to those in need during the winter These Certified Application Counselors (CACs) holidays. In 2015, the value of items distributed help patients enroll in publicly-funded health care was more than $40,000. Numerous organiza- programs and then schedule medical appoint- tions throughout the community are recipients ments. The goals are to remove financial barriers including Fairhill Partners, Malachi Center, Norma to preventive and continuous care, and to pro- Herr Women’s Center, Providence House and St. mote a healthier community through Augustine Hunger Center. improved access.

36 METROHEALTH 2015 COMMUNITY REPORT MetroHealth in the Community 37 MetroHealth Department of Public Safety/ Department of Public MetroHealth Emergency ManagementOffice of the continues to support MetroHealth byOhio Healthcare Coalition Northeast public health, with partners in working and public safety emergency management, to build a moreother health care organizations of a disaster. resilient community in the event with patients with EbolaPlans include dealing diseases, and with or other highly infectious disaster, a natural a patient surge due to has act. MetroHealth pandemic or terrorist as a such exercises participated in disaster and a community- simulated airplane crash It also supported a outbreak. wide infection (NDMS) System National Disaster Medical Many disaster. simulation of a natural trained with have MetroHealth employees Agency Emergency Management the Federal types multiple (FEMA) to be prepared for of emergencies. MetroHealth also is working partners in with local, state and federal medical support and information planning for National the Republican sharing for Convention. • • - Safety To Go, sponsored by the Division of by Go, sponsored To Safety kindergarten teaches interactively Trauma, Metropolitan School in 20 Cleveland children that rules about safety District schools accidents, injuries childhood help prevent and deaths. messages are presented at safety Trauma through the distributioncommunity events fliers and resources to activities, of safety prevention. address everyday The Save a Life Tour travels to area high travels Tour a Life Save The teen and is dedicated to preventing schools driving. Presentations deaths due to unsafe of awareness provide and driving simulations the dangers of drinking and driving, texting and driving and other distracted driving. • • • INJURY PREVENTION INITIATIVES PREVENTION INJURY hoods surrounding MetroHealth Medical Center. Center. MetroHealth Medical hoods surrounding conducted a survey to see how committee The in moving be interested would employees many and are discussing options to the neighborhood, based on the survey results. HOUSING COMMITTEE HOUSING is charged committee internal MetroHealth This plan to encourage an incentive with developing neighbor Side West to the move to employees THE METROHEALTH FOUNDATION METROHEALTH SELECT The MetroHealth Foundation, Inc. is a 501(c) MetroHealth offers an integrated network option (3) charitable organization. Founded in 1954, it for employers throughout Northeast Ohio. It is supports The MetroHealth System’s mission by focused on providing high-quality, personalized funding programs and projects in patient care, sci- health care solutions that are more affordable, entific and clinical research and medical education. with access to the entire MetroHealth network. The Foundation heads up the annual Employee With lower co-pays, deductibles and other Giving Campaign, which in 2015 raised more than costs, it has become the option of choice for $1.2 million for those programs and projects, and Cuyahoga County, Cleveland State University, oversees a half dozen community fundraising Discount Drug Mart, many local municipalities events. The Foundation also has raised more than and others. Established in 2009, MetroHealth $1.8 million for the first phase of the campus trans- Select also is offered to MetroHealth employ- formation, the addition to the Critical Care Pavilion. ees. As of December 31, 2015, there were 22,000 members.

METROHEALTH PRIME REACH OUT AND READ MetroHealth Prime is a free membership program specifically designed to meet the needs of adults This national program was co-founded by 55 and older. Membership provides access to MetroHealth pediatrician Robert Needlman, a variety of programs and services for seniors MD, in 1989, in Boston. The program has been to maintain a healthy lifestyle. In a partnership adopted nationally by 5,000 pediatric practices with the Cleveland Metroparks, Prime mem- and most pediatric residency programs, reaching bers can hike and take free yoga classes in the more than 4.5 million children each year. Reach Metroparks. Other offerings include discounts Out and Read gives young children a foundation for golf, restaurants and parking, health talks, for success by incorporating books into pediat- other exercise opportunities at MetroHealth’s Old ric care and encouraging families to read aloud Brooklyn Health Center and grandparents/grand- together. MetroHealth employees donate books kids days at the Cleveland Metroparks Zoo. As of to the program and volunteers read to children in December 31, 2015, there were 22,379 members pediatric waiting areas of the hospital, and Child enrolled in MetroHealth Prime. Life professionals provide critical operating support for the program.

38 METROHEALTH 2015 COMMUNITY REPORT MetroHealth in the Community 39 - VIOLENCE TASK TASK VIOLENCE FORCE contributes Force Task Violence MetroHealth The of com and well-being the health to improving munity residents by assisting in development and assisting in development munity residents by implementation violence strategies to address of taskThe force health. and its impact on public and internal staff constituencies engages external meet the needs of patients and families to better violence and trauma and through impacted by at risk. those primary activities for prevention - - - bilitation facilities with a new Functional Electrical Functional with a new bilitation facilities addition of two The Stimulation (FES) Center. 100,000feet, to the Critical Care square floors, ICU is underway and will produce 85 new Pavilion rooms. MetroHealth will be spending $82 million prior that will be completed on this construction in July National Convention to the Republican The addition alone will create 330 jobs. This 2016. will create hundreds more buildings that follow that more people will seek jobs and a likelihood 25th Street neighborhood, West residences in the impacted. and businesses will be favorably eral new buildings: an outpatient clinic, inpatient buildings: an outpatient eral new hospital, offices, central utility administrative plant transformation The and other support buildings. reha of Old Brooklyn’s will include the renovation TRANSFORMATION of MetroHealth’s campus transformation The 25th Street main campus will result in sev West TRAINING WITH FOR ADULTS DISABILITIES DEVELOPMENTAL and Nutrition Servicesto trainFood has a program in the hospital’s adults with disabilities to work are hired well who perform Those as interns. kitchen program began permanent positions. Since the for MetroHealth has hired three interns to in 2014, equipment and clean carts, sanitize transport food program earned MetroHealth anThe the kitchen. County Board from the Cuyahoga Award Inclusion along April 2015, Disabilities in of Developmental the same high standards expecting with praise for dignity and and conveying other employees as for theWith this success, the goal is to expand respect. program to other departments. mittees in the areas of medical preparedness, of medical preparedness, in the areas mittees and relations, community outreach government with the region’s Along community involvement. MetroHealth is other health care systems, with the city in conjunction of Cleveland working all and any is prepared for to ensure the region MetroHealth will be the medical emergencies. officials in need of hospital high-level for “go to” care, and the addition to the urgent or emergency ICU rooms, will new with 85 Critical Care Pavilion, space be needed. be ready should the REPUBLICAN NATIONAL CONVENTION CONVENTION NATIONAL REPUBLICAN ENGAGEMENT (RNC) COMMUNITY hospital across the are employees MetroHealth servingcurrently com on a number of RNC 5 Partnerships with Community Organizations

By working together, needs are met and enhancements provided so Cuyahoga County citizens can live their healthiest lives.

40 Partnerships with Community Organizations 41 - -

MetroHealth System has a representative serving System MetroHealth Roundtable.on the CHNA CENTER FOR sion, kidney disease and transplantation. Center sion, kidney role in the Community an active faculty also play Core of the NIH-funded Partnership Research Science Collaborative, Translational Clinical and Reserve Western Case a partnership involving Clinic University Hospitals, Cleveland University, and Daryl Sehgal, MD, Ashwini and MetroHealth. co-direct the Center. MD, Thornton, REDUCING HEALTH DISPARITIES REDUCING HEALTH was Health Disparities Reducing Center for The The created in 2004 a collaboration between as Reserve Western Case and MetroHealth System mission of the Center is to reduce The University. on root (a) research health disparities through and interventions, (b) edu causes, mechanisms and policy makers providers cation of students, communityand (c) partnership with organizations faculty Center’s The agencies. and government in a number of research, are involved and staff education and community activities collaboration Greater designed to address health disparities in more received have They and beyond. Cleveland of million from the National Institutes than $10 Health, the Department of Health and Human Services and other agencies to understand and address health disparities related to hyperten ------nity and other essential stakeholders to share support to one another best practices, provide The collaboration. for and discuss opportunities THE CENTER FOR HEALTH AFFAIRS, AFFAIRS, THE CENTER FOR HEALTH NEEDS HEALTH COMMUNITY (CHNA) ROUNDTABLE ASSESSMENT created Affairs Health Center for The In 2015, for the CHNA Roundtable to spur opportunities shared learning and collaboration in Northeast the Roundtable brings Ohio. Meeting quarterly, together individuals from the hospital commu ing program, “Engaging the Community in New “Engaging the Community in New ing program, is one of eleven Housing,” to Healthy Approaches to receive nationwide programs recognized Advisory the grant is funded by The funding. Colorado Kresge Foundation, Company, Board and Foundation de Beaumont Health Foundation, MetroHealth is Foundation. Johnson Wood Robert the $250,000 in-kind providing grant by matching results. services including tracking munity health. This initiative targets initiative deteriorating This munity health. & Brooklyn Clark-Fulton housing in the Stockyard, high Centre neighborhood, where residents have These of lead poisoning, and COPD. asthma levels can be easily illnesses with long-term effects BUILD The are improved. when homes prevented to Cleveland Health Challenge grant will allow hous healthy The Homes Zone. create a Healthy gram, awarded The MetroHealth System along MetroHealth System The gram, awarded the Cleveland Watch, with Environmental Health other local Health and Department of Public organizations, a $250,000 com grant to improve BUILD HEALTH GRANT BUILD HEALTH pro BUILD Health Challenge, a national The tering and costly. In 2015, Better Health launched Health launched Better In 2015, tering and costly. on childhood to focus Health Initiative a Children’s asthma and obesity. viders from nine health care systems including care systems viders from nine health insurers, community MetroHealth, employers, Health leverages Better groups and agencies. among primaryregion-wide partnerships care Northeast Ohio to establish in common providers metrics to measure goals and evidence-based care and outcomes of primary care patients with diseases, including diabetes and high chronic are all too common, life-al blood pressure, which BETTER HEALTH PARTNERSHIP HEALTH BETTER is a regional health Partnership Health Better to the committed collaborative care improvement and lower health care, better of better Aim Triple residents with common Northeast Ohio costs for medical conditions. MetroHealth was chronic when the organization, formerly a co-founder was Cleveland, Health Greater as Better known Health Partnership Better established in 2007. 900members include nearly health care pro CICLEVIA Together, families, friends, community groups, MetroHealth is a partner with the city of local organizations and businesses are working Cleveland and other community partners for to transform their neighborhoods into places that CiCLEvia, an initiative patterned after the inter- support healthy living, where options for healthy national open streets movement. The Cleveland food and exercise are widely available, affordable, version will embrace the Clark-Fulton and Ohio accessible and desirable. Guided by the leader- City neighborhoods along West 25th Street with ship of the HEAL Coalition, made up of residents, the street being closed the second Saturday local non-profits and other stakeholders, the of the month during the summer. The one and initiative focuses on local voices to build strate- a half mile closure, from MetroHealth Drive to gies for making health and well-being a part of Lorain Avenue, will open the street for walking, the everyday culture in the targeted communities. jogging, biking, dancing and many other activities. A Field Action Report on the HEAL Initiative was There will be healthy food for purchase and an published in the June 2015 issue of the American atmosphere of celebration during the vibrant city Journal of Public Health. street experience. HEALTHY CITIES CLEVELAND CUYAHOGA COUNTY In the summer of 2015, Morgan Stanley launched HEALTH CARE COUNCIL “Healthy Cities Cleveland,” part of a national MetroHealth participates in the quarterly meet- program to encourage wellness, play and nutrition ings of the Cuyahoga County Health Care Council, in underserved communities. MetroHealth’s which is organized by the Cuyahoga County School Health Program joined forces with the Department of Health & Human Services. This is Greater Cleveland Food Bank and other commu- an opportunity for health care providers to keep nity partners to support this initiative. The Greater abreast of major developments affecting patients Cleveland Food Bank hosts a school-based pantry and clients in the health and human services program at five Cleveland Metropolitan School arena, such as the changes to Medicaid, the District schools, one or two times a month. county budget process and prescription dis- MetroHealth will provide multiple health screen- count programs. ing events for students and community members at each of these school sites over the next two years. The schools are Adlai E. Stevenson, Case, FITNESS ZONE Garrett Morgan High School, Marion-Sterling and Willson. The Trust for the Public Land has installed more than 62 Fitness Zones in communities across the country and has now expanded to Ohio by launching a pilot program in Cleveland’s Buckeye Neighborhood. MetroHealth and the St. Luke’s Foundation will provide funding for the outdoor gyms designed to create a no-cost, supportive, accessible and social environment for getting fit. This pilot project, in cooperation with Healthy Eating and Active Living (HEAL), will place easy-to-use exercise equipment at three locations in the Buckeye neighborhood: East End Neighborhood House, Fairhill Center and the Woodhill Community Center.

HEAL In 2010, the Center for Reducing Health Disparities at MetroHealth and the Saint Luke’s Foundation partnered to create the Healthy Eating and Active Living (HEAL) program to address chronic illnesses (e.g., hypertension, diabetes) in the Buckeye-Shaker, Larchmere and Woodland Hills communities. The HEAL initiative invited local residents to design healthy eating and active living opportunities.

42 METROHEALTH 2015 COMMUNITY REPORT Partnerships with Community Organizations 43 ------vent unplanned pregnancies and improve unplanned pregnancies and improve vent spacing between births model to engage and Centering Pregnancy and health, wellness about women coach progress through as they parenting matters their pregnancy Long Acting Reversible Contraception Contraception Reversible Acting Long pre women to help childbearing-age (LARC) • • around the issue of human trafficking. The collab The issue of human trafficking. around the vices. Cribs and clothing were provided to families provided vices. Cribs and clothing were Women, Countythat needed assistance. Cuyahoga and Children (WIC) servicesInfants, and home – all promoting also offered nurses were visits by outcomes parent education and better awareness, babies.for Service High-risk Pregnancy and MetroHealth’s Neonatal Care Unit Intensive III (highest level) Level high-risk quality(NICU) continue to provide care for also health system The moms and their babies. understand how to better efforts supports research contribute to prema specific clinical conditions may issues. and pre-term birth weight turity MetroHealth partnered with the city of In 2015, County and other stakehold Cuyahoga Cleveland, to initiative Cleveland Year the First ers to launch a community mortality. advance response to infant MetroHealth will implement the following In 2016, mortality:to further combat infant orative secured a grant to create an educational to create an educational secured a grant orative County hospital Cuyahoga inform film to better to and how the signs of trafficking about staff intervene. has also MetroHealth effectively on recog and other staff updated social workers and the necessary nizing the signs of trafficking steps. next MORTALITY INFANT born alive baby defined as when a mortality, Infant critical concern, espe is a year, dies within the first health and well-being The cially in Northeast Ohio. mor of a community the infant by can be measured everytality deaths for rate - the number of infant sleep-related deaths 1,000 births. Prematurity, live are the leading causes of infant and birth defects the that in 2014 most recent dataThe shows death. state The of mortalitynational infant 5.3. rate was 45th in the countryOhio ranked its rate of 6.8. for their first birthday. dying before is 1,025 infants That mortality the infant rate is 8 County, In Cuyahoga White. races other than for and it rises to 11.6 the trend, MetroHealth to reverse In an attempt programs aimed at educating pregnant has several moms, their partners and families. new women, Camp for those programs included Boot In 2015, Classes, Sibling Dads, Childbirth Preparation New ser Classes and high-risk pregnancy management ------HUMAN TRAFFICKING County’s MetroHealth is a member of Cuyahoga The Trafficking. to End Human Collaborative collaboration with Fairview Hospital, MetroHealth Hospitalsand University created a subcommittee protocols from other local and national to study hospitals to identify victims of human trafficking A survey enter the health care system. as they at the three local hospitals of providers revealed practitioners needed further education that many ful homeownership. The homeowners program homeowners The ful homeownership. MetroHealth, Stockyard, is co-sponsored by & Brooklyn Centre Community Clark- Fulton Those Federal. Third Office and Development a be eligible for who complete the seminar may Federal. Third $2,000 from payment down HOMEOWNER CLASSES HOMEOWNER to help individ classes are an effort Homeowner County neighborhoods. It in Cuyahoga uals invest HomeToday™ Federal’s Third of uses the format communities one “strengthens with the tagline program, It is a comprehensive at a time.” owner combines group educational sessions and which the fundamental personal counseling to teach skills of good financial management and success bers who serve subcommittees. on various zation for HIP-Cuyahoga, providing strategic and providing HIP-Cuyahoga, zation for has System MetroHealth The operational support. Steering on the HIP-Cuyahoga a representative mem as a number of staff well as Committee, HIP-CUYAHOGA in 2009, the mission of Health Launched is to inspire, Partnership–Cuyahoga Improvement environmental and policy, influence and advance wellness health and that foster changes lifestyle learns and plays works, who lives, everyone for community More than 100 County. in Cuyahoga in this partners that care about health are involved priorityThe health issues being effort. collective Racism, addressed are: Eliminating Structural Systems, Health Linking Health Care and Public and Chronic Living Active Eating and Healthy County Cuyahoga The Disease Management. organi of Health servesBoard as the backbone tion to improve health outcomes and reduce ineq tion to improve Health Department of Public Cleveland The uity. Other members of this initiative. is the anchor represent local hospitals other agencies. and HEALTHY CLEVELAND INITIATIVE CLEVELAND HEALTHY the is to improve mission of this initiative The promoting by all Clevelanders for qualityof life being disease, chronic preventing wellness, communityengaged with collabora partners and • Nurse Family Partnership model to arrange corporations (CDCs), Hispanic Business Center, home visits by registered nurses to low-in- Hispanic Alliances, Julia de Burgos Cultural Arts come first-time mothers. The visits begin Center, MetroHealth, residents and the faith- during pregnancy and continue for two based community. years following birth to maximize maternal *placemaking: a people-centered approach to the and child health and to promote family use of public spaces to bring together and benefit economic security a community • Opportunities to engage employees and others in raising awareness about infant mortality and promoting solutions at the MENTORING PROGRAM WITH CLEVELAND neighborhood level METROPOLITAN SCHOOL DISTRICT (CMSD) MetroHealth and the CMSD have established an education program offering internships and men- LA VILLA HISPANA toring to students from Lincoln-West High School La Villa Hispana will be the cultural and eco- to introduce them to potential health care careers. nomic hub of the Hispanic/Latino community in Twenty-eight students began the two-year pro- Northeast Ohio. It is geographically centered on gram as juniors attending monthly lectures given the intersection of West 25th Street and Clark by MetroHealth clinical and non-clinical staff on Avenue and extends about a quarter mile in all various health care topics and careers. Funded by directions. La Villa Hispana is a cultural placemak- The Thomas H. White Foundation, the students ing* initiative with a concentration in two areas: had three-week internships at MetroHealth during 1) “La Plaza Central/Central Plaza” will host public the summer of 2015, to become more familiar gatherings that will include music, arts and cul- with specific jobs within the hospital. As seniors, ture and food, and will also be the home of “La the students meet monthly with their mentors Placita,” a Latino-themed festival and market. 2) and shadow in their chosen areas of interest. “The MarketPlace@ La Villa” will serve as a small Additional skills, including résumé building, inter- business incubator, creating unique opportunities viewing and basic CPR, are also taught. for local entrepreneurs to create and grow local businesses. The entire effort is led by a steering committee of community stakeholders including METROHEALTH SCHOLARS PROGRAM the local councilperson, community development MetroHealth launched a program with the Cleveland Metropolitan School District (CMSD) that enables incoming freshmen at James F. Rhodes and Lincoln-West high schools to explore both clinical and non-clinical health careers. Fifty 9th graders at Rhodes and Lincoln-West participated in the program, spending one day a month at the hospital getting an inside look at career opportunities available in the hospital system. They also had the chance to engage in active learning through shadowing and internships. These students will attend a newly-formed MetroHealth/CMSD School of Health & Science on the MetroHealth campus starting August 2016.

MI METROHEALTH AT LA PLACITA MetroHealth’s Mi MetroHealth family festival, formerly an annual summer event with activities for all ages, health screenings and food, will become part of the La Placita monthly summer series in 2016. La Placita is a pop-up open-air market near the intersection of Clark Avenue and West 25th Street. It celebrates the neighborhood’s Hispanic/ Latino culture and identity, with music and other arts, food, artisan vendors and community partner organizations. MetroHealth, a community partner, will integrate aspects of the Mi MetroHealth campus festival into each of the La Placita events.

44 METROHEALTH 2015 COMMUNITY REPORT Partnerships with Community Organizations 45 - - - - of the Executive, Ohio Department of Health, Ohio Department of the Executive, Cuyahoga County, Cuyahoga of Board ADAMHS Clinic Medical Free The of Health, County Board McCafferty F. Thomas Cleveland, of Greater of Public Department Cleveland Health Center, County Cuyahoga Health, Hispanic UMADAOP, Center. Corrections County in Cuyahoga launched was DAWN Project edu who later Papp Joan Dr. MetroHealth’s by dations for improvements. They also are edu They improvements. dations for and the community on cating parents, students to all could provide the SRTS the opportunities community members. PROGRAM DE PORRES MARTIN ST. from St. program, students In a work/study in a gain experience High School Martin de Porres areas includ in several work They hospital setting. human ing logistics, medical records, nursing and participated in 24 students resources. In 2015, the program. cated lawmakers about the life-saving aspects of about the life-saving cated lawmakers naloxone for passed and allows which HB 170, be in who may to be prescribed to individuals an experiencing a position to assist someone to carry enforcement law and allows overdose to victims of suspected and administer naloxone opioid overdose. SCHOOL (SRTS) TO SAFE ROUTES to enable state effort and local is a federal, This in grades K-8, including and encourage children to bicycle and those with disabilities, to walk to reduce childhood In part, it is an effort school. of the health and well-being obesity and improve cityThe of Cleveland, children. school Cleveland MetroHealth, ODOT Cleveland, Bike CMSD, the and other community partners are studying and making recommen routes to school current - - -

one. Eligible participants are given FREE naloxone FREE naloxone one. Eligible participants are given and other educational kits containing naloxone established materials. Since the program was nearly 3,000 been distributed kits have in 2013, resulting in DAWN, County Project Cuyahoga by reversals. opiate overdose more than 350 known County Office Cuyahoga Community Partners: ing rescue breaths and administering nasal nalox PROJECT DAWN PROJECT with Naloxone) Avoided (Deaths DAWN Project education and naloxone is an opioid overdose are distribution (OEND) program. Participants – individuals who are at risk of opioid overdose using opioids those in recovery actively and those someone who is at – and individuals who know participants are Program opioid overdose. risk for of opioid overdose, educated on the risk factors to and how an opioid overdose to recognize how giv calling 911, by respond to an opioid overdose ership development and community and substance ership development a has MetroHealth System The abuse prevention. Advisory Board. on the PHNR representative NORTH ROYALTON (PHNR) ROYALTON NORTH a healthy, mission of the PHNR is to promote The youth community empowering by drug-free With responsible decisions. and adults to make community different representation from 12 grant from the Drug-Free sectors and a federal the Partnership Communities Support Program, serves as the community youth catalyst for experiences, asset building (skills, developmental to become youth for relationships and behaviors lead successful and contributing adults), youth PARTNERSHIP FOR A HEALTHY A HEALTHY FOR PARTNERSHIP NORTHERN OHIO TRAUMA SYSTEM (NOTS) SYSTEM TRAUMA OHIO NORTHERN Clinic, founded along with Cleveland MetroHealth, to formed collaboration was This in 2010. NOTS in our patients care for the best trauma provide the right patients to transporting community by right care at the right time. Other the place for General, community are Southwest partners County of Health, Cuyahoga Board Cuyahoga Services, and Justice and County Safety Public Safety. Department of Public the City of Cleveland collaboration among that has proven Research trauma of levels different hospitals that provide Level MetroHealth is a verified lives. care saves Clinic Fairview Cleveland Center. Trauma Adult I II Hospital Hospital and Hillcrest are Level is a General Centers and Southwest Trauma Since the inception of Center. Trauma III Level County have trauma deaths in Cuyahoga NOTS, is more than 800 That 24 percent*. decreased by NOTS. through saved lives Registry Trauma to the Ohio *According STANCE These transit and infrastructure enhancements Since 2006, the Partnership for a Safer Cleveland are contributing to economic revitalization and has managed Standing Together Against improved quality of life along the West 25th Neighborhood Crime Everyday (STANCE), which Street/Pearl Road Corridor. was initially funded by the Department of Justice. *placemaking: a people-centered approach to the STANCE’s success in sustaining reductions in use of public spaces to bring together and benefit violent crime and reducing calls for police ser- a community vices reinforces an evidence-based approach of linking enforcement, outreach workers, prevention services, and reentry policies and programs. TRUE2U/CMSD The inclusion of reentry programming, linked to Recognizing that career readiness starts prevention and enforcement, has helped sustain early, True2U was created by the Cleveland violence reduction in three of Cleveland’s highest Foundation’s youth development program, crime neighborhoods. STANCE proposes to con- MyCom, and the Cleveland Metropolitan School tinue the reduction of violence and violent crime District for the fall 2015 semester to connect through the refinement and expansion of its 8th graders with 200 mentors to help students three program elements: strategic enforcement, explore their purpose, identify their strengths comprehensive prevention and targeted reentry and set personal goals for success. Its objective and intervention. is to begin raising career awareness for CMSD students who will soon be entering high school. MetroHealth is providing mentors for students TRANSIT AND INFRASTRUCTURE interested in a health career. IMPROVEMENTS MetroHealth participated in a multi-year placemaking* and Transit Oriented Development (TOD) VOTER REGISTRATION Study of the West 25th Street Corridor. In 2015, MetroHealth staff regularly provide voter registra- Cleveland City Planning Commission approved tion forms to patients who express an interest in the TOD and Implementation Plan recommenda- registering to vote. They also provide mail ballot tions. The West 25th Street/Pearl Road Corridor applications to patients who expect to be in the is ranked as the second highest in bus ridership hospital or long-term care during an election. among all Greater Cleveland Regional Transit Authority (RTA) routes. Recommended transit improvements include consolidation of bus stops, enhanced waiting environments for transit users and improved bus scheduling. Future plans call for dedicated transit lanes to increase service and reduce wait times for riders. Other roadway infrastructure and streetscape improvements around MetroHealth are planned or underway.

46 METROHEALTH 2015 COMMUNITY REPORT Partnerships with Community Organizations 47 - WINDOW OF HEALTH WINDOW of Mexico, with the Government In a partnership MetroHealth consulate in Detroit, through its (Window of de Salud” “Ventanilla began the program includes The in 2015. Health) Program enrollment health education, bilingual, bicultural it is Though and referrals. in insurance programs the and their families, nationals aimed at Mexican Spanish-speaking patients program assists other as well. UNLIMITED OPPORTUNITIES YOUTH SUMMER JOBS MetroHealth has worked more than 20 years, For to provide Unlimited Opportunities Youth with Youth about 30 teens. In 2015, summer jobs for in the Unlimited teens worked Opportunities gardened at the nursing MetroHealth kitchen, various home, filed in clinics and performed for 25 hours a week working After other jobs. hired permanently. two teens were six weeks, workforce provides Unlimited Opportunities Youth develop preparation, job placement and youth ment programs for at-risk youth, ages 14-19, who who ages 14-19, at-risk youth, ment programs for in poverty at or below that are with families live County. Cuyahoga - - ment being made include: The Lofts at Lion Mills at Lion Mills Lofts The ment being made include: Aragon housing project, – a $9 million affordable housing and million historic – a $1.5 Ballroom Hispana Villa La center renovation, event/banquet and economic hub – a plan to create the cultural of the Hispanic/Latino community in Northeast Dream Neighborhood – an initiative The Ohio and and help them refugees to Cleveland to welcome and affordable access to safe providing by thrive and opportunities housing, education, workforce into other assets that support their transition the community. to the *placemaking: a people-centered approach benefit use of public spaces to bring together and a community WEST 25TH STREET REVITALIZATION 25TH STREET WEST is help transformation MetroHealth campus The 25th West revitalization of the the ing to catalyze and institution anchor a major As Street Corridor. Side, West on Cleveland’s employer the largest 25th Street West in the MetroHealth is a partner planning effort collaborative – a Initiative Corridor assets existing on the area’s with the goal to build revitalizationand bring economic to the corridor MetroHealth and its adjacent neighborhoods. and future current and construction, renovation real estate public transportation projects, and and placemaking* improvements, infrastructure of to the growth enhancements will contribute and retailresidential, commercial development of the invest Some examples along the corridor. Serving you 90 28 9 at these locations 27 13 271 15 29 8

22 90 2 26 1 5 21 25 71 16 24 6 18 77

480 480 480 20 3 10 271 12 71 14 11 19

77 80 17 23

Emergency 4 Departments 71 MetroExpressCare 80 Pharmacy 7 Coming Soon

1 MetroHealth Medical 9 MetroHealth Cleveland 17 MetroHealth Middleburg 24 MetroHealth West 150th Center Main Campus Heights Medical Offices Heights November Family Health and Surgery Center 2 MetroHealth Beachwood MetroHealth at Health Center 25 MetroHealth West Park Health Center Discount Drug Mart 18 MetroHealth Old Brooklyn Health Center 3 MetroHealth Bedford 10 Independence Health Center 26 MetroHealth Westlake Medical Offices 11 Olmsted Falls 19 MetroHealth Parma Health Center at Crocker Health Center Park 4 MetroHealth Brecksville 12 Parma Heights Health Center (Coming Soon) 20 MetroHealth Parma 27 Parker Hannifin Downtown 5 MetroHealth Broadway 13 MetroHealth Hand and Medical Offices and YMCA (Coming Soon) Upper Extremity Center Ambulatory Surgery Center Health Center Operating in conjunction with the 6 MetroHealth Brooklyn 14 MetroHealth Independence 21 MetroHealth Pepper Pike Cleveland Department of Public Health Center Health Center Health Center Health (in partnership with the city of Cleveland): 7 MetroHealth Brunswick 15 MetroHealth Lakewood 22 MetroHealth Rocky River 28 J. Glen Smith Health Center Health Center Medical Offices Health Center 8 MetroHealth Buckeye 16 MetroHealth Lee-Harvard 23 MetroHealth State Road 29 Thomas F. McCafferty Health Center Health Center Family Practice Health Center

For a listing of health centers and physicians nearest you, please visit our website: metrohealth.org/locations