Brigham and Women's Hospital
As one of the leading best hospitals in the U.S, Brigham and Women's Hospital is always committed to improving the health status of the surrounding neighbourhood residents. The hospital aims at promoting health equity and reducing health disparities for the vulnerable members of the surrounding Boston community. Alongside offering the best preeminent women's health services in the region, the hospital is known to provide some of the best surgical treatments in the country. BWH specializes in kidney, heart and lung transplant surgery. The essay will aim at identifying how the hospital incorporates the core public health functions to address/provide the essential health services as per the guidelines of the National Health Performance Standards (NPHPS).
To ensure that BHW's outreach activities and programs are in line with NPHPS policies and regulatory standards, the Centre for Community Health and Health Equity (CCHHE) formed a partnership with Health Resources in Action (HRiA) to undertake a Community Health Needs Assessment. The schedule for the assessment was between the period of 2012 through 2011 to 2013.
This CHNA work engaged a few residents and stakeholders in an interviewing process with the areas of focus for the research being the suburban neighbourhoods of Boston. The assessment informs the hospital's community outreach activities and programs that address the health needs of the neighbourhoods of Dorchester, Mission Hill, North and South Dorchester, Mattapan, Roxbury, and Jamaica Plain.
African-American and Latino communities
The population of the listed areas mainly consists of African-American andat Lino communities deep-seated in high levels of poverty, unemployment, and chronic diseases. It has always been my dream to do something good for the community, and therefore I was so glad when I volunteered as an informant interviewer for the assessment. The process was conducted in two phases:
A general community health needs assessment (CHNA) was carried out during this period to explore key issues like community health concerns, the magnitude of chronic illnesses and areas of opportunities across the city of Boston. The priority neighbourhoods chosen include Mission Hill, Roxbury, Dorchester, Mattapan, and Jamaica Plain.
The HRiA conducted 29 key informant interviews and ten focus groups engaging a total of 113 individuals in the process. After the end of the process, the research team managed to pool some key findings:
- Chronic illness, obesity, and gang-related violence as matters of great concern in both the neighbourhoods inhabited by African-Americans and Latinos.
- Engagement of the community was through interviewing and community outreach programs with no other known data collection method employed.
- Positive feedback from the BWH's priority neighbourhoods recorded.
- Social and economic influence the cause for most behavioural and health concerns.
- Most residents have health insurance cover with the primary concern being the under-utilization of primary care.
The 2011-2012 CHNA process reveals some of the key areas of concern in which BWH should deal consider matters of concern. The hospital engaged the residents in a series of public awareness campaigns aimed at pointing out the areas that need attention. The discussions proved to be helpful in implementing the key concerns under the CCHHE list. The findings recorded unemployment, poverty, and gang-related violence to be the key areas of concern.
2013 Community Health Needs Assessment
The spring 2013 assessment was to supplement the 2011-2012 evaluation. It is to assess and prove if the findings from the previous assignment were free of faults. It is a requirement for the hospitals to conduct community health needs assessments every three years by the Patient Protection and Affordable Care Act. The evaluation was to determine if there were any changes in the previous findings. It focused on issues such as the extent and severity of the problem, strength of partnerships, financial capacity of the hospital, and the potential impact of the matter of concern. BWH's alignment with its core principles, mission and vision were also an area of focus. Chronic diseases, obesity, gang related violence, trauma, unemployment, poverty, and income rate emerged as the top priority areas.
A total of 150 residents and stakeholders took part in the 2013 assessment process. The HRiA conducted 26 informant interviews and 13 focus groups. The CHNA also incorporated findings from the analysis of public health data. The sources include articles from the Massachusetts Department of Education and works from the U.S. Census and the Boston Public Health Commission.
A team from The Health Equity Research and Intervention department partnered with the local community organizations to bring scientists and health specialists from BWH to enlighten and bring scientific information to the residents of Boston. Other notable public awareness campaigns include the partnership between Brigham and Women's Hospital with Roxbury Community Alliance for Health to provide information on better nutritional and healthy eating habits. BWH also partnered with the Centre for Community Health, Education, Research and Service to sponsor an awareness campaign on prostate health for African American males.
The Passageway is a program based on the Violence Intervention and Prevention umbrella. The program has been there since 1997, and it is still operational. It provides necessary intervention, assistance, and prevention services to individuals subjected to domestic violence by their partners. Advocates for this program are available at multiple sites all over Boston. Some of the sites include Brigham and Women's Hospital, Southern Jamaica Plain Health Centre, Brookside Community Health Centre, Whittier Street Health Centre, and Brigham and Women's Health Faulkner.
As a result of the effort put by the advocates, a number of important goals were achieved. For example, over 1,000 residents, patients and employees received free, voluntary, and confidential services. At least 1500 healthcare providers and local community members received awareness on the impact of domestic partner violence.
In response to the recent increase in demand of more CHNAs, the advocates are forming partnerships with other community-based organizations to counter the rise. Examples of such groups include the Mission Hill Health Movement, Roxbury Tenants of Harvard, Higher Ground in Roxbury, and the Tobin Community Centre. Some of the services provided by Passageway advocates include:
- Intervention on issues relating to domestic partner violence.
- Direct follow up on the progress of victims of domestic partner violence.
- Provide training and education for healthcare providers.
- The passageway program provides legal representation and consultation to victims of domestic partner violence.
The Passageway Health Law Collaborative oversees partnership of the program with attorneys and students from the Wilmer Hale Legal Services Centre of Harvard Law School. The joint-pact is responsible for giving advice and representing clients facing legal issues divorce, custody, support, housing matters, among others. over 97 clients received services through the Passageway Health Law Collaborative. Through improved health outcomes initiated by BWH, educational success among the young people increased by a notable factor. The hospital achieved this through provision of academic support in the existing youth empowerment programs.
Consistent with its principles, vision, and mission, Brigham and Women's Hospital (BWH) will continue its efforts to delivering high-quality healthcare to our patients and their families while ensuring access to financial counsellors for patients experiencing economic difficulties. A team of professional financial advisors is available at BWH's main campus to assist patients with health insurance enrolment.
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