Determining the Big Picture The Results of the Discovery Zone Community Health Needs Assessment Determining the Big Picture The Results of the Discovery Zone Community Health Needs Assessment The Results of the Discovery Zone Community Health Needs Assessment Acknowledgements Many thanks to the people of the Discovery Region and Eastern Health staff, physicians and volunteers for their participation in the needs assessment process. In particular, we acknowledge: • Advisory Commiee – Lisa Browne (facilitator), Bernice Clements, Cal Cole, Janet Fisher, Gerald Giles, Barbara Ann Humby, Susan Khaladkar, Wayne Miller, Camilla O’Shea, Daphne Smith, Rev. Don Stiles • Steering Commiee – Michelle Abbo, Lisa Browne (chair), Pat Coish-Snow, Tammy Greening, Joan Linthorne, Wayne Miller, Natalie Moody, John Picke, Mona Romaine-Ellio, Collee Smith, Evelyn Tilley • Facilitators and Recorder – Lisa Browne, Pauline Chatman, Janet Fisher, Troy Mitchell • Administrative Support – Pauline Chatman • Photography – Cynthia Farrell, Janet Fisher • Graphic Design – Angela Lawrence I Determining the Big Picture Executive Summary Eastern Health Eastern Health is the largest health services organization in the province of Newfoundland and Labrador and provides the full continuum of health services, including community, acute and long-term care. It has both regional and provincial responsibilities. The organization has approximately 13,500 employees, over 700 medical staff and 2,000 volunteers. Community Health Needs Assessment As per the Government of Newfoundland and Labrador’s Regional Health Authorities Act and the Board of Trustees’ Strategic Plan, Eastern Health has been assessing the health needs of its geographic catchment. A community health needs assessment gathers information about the health of a particular area from both a factual and an opinion perspective. The Discovery Zone The area assessed for this report is referred to as the Discovery Zone, named aer John Cabot’s discovery of the New World. The zone has a population of 28,300 and includes the area from Bonavista to Port Blandford to Swi Current to Chapel Arm. The assessment was launched in January 2010. The Determinants of Health A number of influences and their interaction have major impacts on the health and well-being of a population. These determinants, such as social, economic, cultural and physical environment play a role -for beer or worse- in the health of a community. Determining the Big Picture looks at the health of the Discovery Zone from a determinants of health perspective, and paints a picture of the health of the people in the area. II The Results of the Discovery Zone Community Health Needs Assessment Methodology A Steering Commiee, made up of Eastern Health staff, oversaw the needs assessment process, and an Advisory Commiee, made up of people in the community who applied to sit on the commiee, provided guidance and support on the process. It is through the Advisory Commiee that this report tells the story of the people of the Discovery Zone. To ensure a wide variety of opinions and aitudes regarding the health needs of the area, a number of primary research methodologies were used: telephone survey, focus groups, key informant interviews and wrien submissions. Feedback was received from February to August 2010. This information was supplemented by existing secondary and utilization information. A blog and Facebook site were used to communicate information about the needs assessment process. Hurricane Igor On September 21, 2010, Hurricane Igor hit the province of Newfoundland and Labrador. It had a major impact on the communities within the Discovery Zone, the area covered by this community health needs assessment. While it is likely that the impact of Hurricane Igor will be felt for a long time, it is impossible to be able to speculate on what that impact will be in this report. All primary research and findings related to this needs assessment were completed prior to Hurricane Igor. Summary of Findings Within the Discovery Zone, there is a strong sense of place and volunteerism and community groups are lauded for their contributions to III Determining the Big Picture society. The region is one of disparity with some parts of the region doing quite well economically and others doing quite poorly. The lack of employment and consequently, lack of income, impacts on people’s ability to afford healthy food, appropriate housing and transportation. This in turn impacts on mental health and well-being of people and communities. People are very interested in health promotion activities, particularly for school aged children. People want to see increased personal responsibility for one’s own health but want to be supported through education sessions. The navigation of the health system continues to be a challenge, particularly for those with lower education and literacy levels. The lack of child care options is a problem for many families. People worry about youth and the isolation of living in aging communities and the impact of technology. From a health services perspective, the main themes were around health promotion, intervention and prevention, the primary health services, mental health and addictions, secondary health services and healthy aging. Recommendations The recommendations developed to address the issues that have arisen during the needs assessment process are: Health Promotion, Intervention and Prevention 1) Communicate the results of this assessment to members of the Eastern Region Wellness Coalition to discuss the findings of the needs assessment. As part of this commitment, the organization IV The Results of the Discovery Zone Community Health Needs Assessment will also develop a practical handbook for community groups to outline how they can address some of the issues, such as transportation barriers, raised in the needs assessment. 2) Develop a communications plan for Eastern Health. This plan will include topics brought up in the findings, including promotion of local clinics and hospitalists, taking personal responsibility for your health, customer service training for front-line employees and developing a listing of credible sources of internet health information. 3) Work with the existing Eastern Health-Eastern School District Liaison Commiee to strengthen the relationship between the two entities at a local level. 4) Work in consultation with the Eastern School District to communicate to the public the contribution schools have made and continue to make in the promotion of health and wellness among the school population. Mental Health and Addictions 1) Develop a local community advisory commiee to review the identified mental health issues and develop an action plan to address same. V Determining the Big Picture Primary Health Care 1) Organize a symposium in the Discovery Zone to discuss physician recruitment and retention issues with key partners. This symposium will provide a comprehensive look at the challenges around recruitment in the Discovery Zone and provide an indication of what efforts have worked in other parts of the province. 2) Establish an annual meeting between family physicians and Eastern Health. This meeting will help to provide an opportunity to share information about Eastern Health services. 3) Implement fully the Client Centred Waitlist Management Strategy of Eastern Health as per the Northeast Avalon Community Health Needs Assessment (See Appendix III). 4) Initiate mechanisms to electronically track Emergency Department wait times in Clarenville and Bonavista. 5) Develop a handout regarding ambulance services for patients detailing the costs and use of the service. 6) Develop a strategy aimed at increasing interest and awareness of health and community services sector careers to high school students. VI The Results of the Discovery Zone Community Health Needs Assessment Healthy Aging 1) Initiate the age-friendly concept throughout the organization. Emphasizing this concept throughout the organization will increase awareness of the needs of that population (e.g. the issue of oral health as raised in the primary research). As part of this initiative, Eastern Health will develop a guide/manual around preparing to be admied to a long-term care home. 2) Review the number of long-term care and protective care beds in the area to determine appropriateness of bed numbers. 3) Conduct an assessment on Golden Heights Manor to determine any security issues. 4) Establish a Working Group to co-ordinate palliative care services for the Peninsulas region with the newly appointed Co- ordinator for Palliative Care. 5) Work with partner agencies and government to build on communication messages regarding elder abuse and how to report it. Build Regional Capacity 1) Work with partner organizations to enhance collaboration and discussion of issues of mutual concern. These include: a. the Eastern School District to advocate for a Community School Model; b. Municipalities Newfoundland & Labrador (MNL) to discuss the health and well-being of communities; c. the Department of Tourism, Culture and Recreation to build VII Determining the Big Picture regional capacity and identify opportunities to address physical activity and recreation, healthy eating and tobacco control; d. the Family Resource Centres to advocate for increased child care services in the area; e. the local detachment of the RCMP to focus on mental health and addictions issues; f. the Pharmacists Association of Newfoundland & Labrador to build relationship as a resource in the community.