pioneer medical center – big timber, mthealthinfo.montana.edu/morh/pmc_implementation plan_2018...

Pioneer Medical Center – Big Timber, MT 2018

IMPLEMENTATION PLAN

Addressing Community Health Needs

Pioneer Medical Center ~ Big Timber, MontanaAugust 2018

1 Disclaimer: The Montana Office of Rural Health strongly encourages an accounting professional’s review of this document before submission to the IRS. As of this publishing, this document should be reviewed by a qualified tax professional. Recommendations on its adequacy in fulfillment of IRS reporting requirements are forthcoming.


Table of Contents

The Implementation Planning Process........................................................................................................................................................3

Prioritizing the Community Health Needs...................................................................................................................................................4

Pioneer Medical Center’s Existing Presence in the Community.............................................................................................................5

List of Available Community Partnerships and Facility Resources to Address Needs...........................................................................5

Sweet Grass County Indicators...............................................................................................................................................................6

Public Health and Underserved Populations Consultation Summaries..................................................................................................7

Needs Identified and Prioritized..................................................................................................................................................................9

Prioritized Needs to Address...................................................................................................................................................................9

Needs Unable to Address.........................................................................................................................................................................9

Executive Summary....................................................................................................................................................................................11

Implementation Plan Grid.........................................................................................................................................................................14

Needs Not Addressed and Justification.....................................................................................................................................................27

Dissemination of Needs Assessment..........................................................................................................................................................28



The Implementation Planning Process

The implementation planning committee – comprised of Pioneer Medical Center’s leadership team participated in an implementation planning process to systematically and thoughtfully respond to all issues and opportunities identified through a community health needs assessment (CHNA) process. The facility conducted the assessment process in conjunction with the Montana Office of Rural Health (MORH).

The community health needs assessment was performed in the Spring of 2018 to determine the most important health needs and opportunities for Sweet Grass County, Montana. “Needs” were identified as the top issues or opportunities rated by respondents during the secondary data scan or during focus groups (see page 9 for a list of “Needs Identified and Prioritized”). For more information regarding the needs identified, as well as the assessment process/approach/methodology, please refer to the facility’s assessment report, which is posted on the facility’s https://pmcmt.org/about/overview.

With input from a community steering committee, the implementation planning committee identified the most important health needs to be addressed by reviewing the CHNA, community demographics, and input from representatives representing the broad interest of the community, including those with public health expertise (see page 7 for additional information regarding input received from community representatives).

The implementation planning committee determined which needs or opportunities could be addressed considering Roundup Memorial Healthcare’s parameters of resources and limitations. The committee then prioritized the needs/opportunities using the additional parameters of the organizational vision, mission, and values, as well as existing and potential community partners. Participants then created a goal to achieve through strategies and activities, as well as the general approach to meeting the stated goal (i.e. staff member responsibilities, timeline, potential community partners, anticipated impact(s), and performance/evaluation measures).

The prioritized health needs as determined through the assessment process and which the facility will be addressing relates to the following healthcare issues:

1. Access to healthcare services2. Outreach and education



3. Community engagement and collaboration



In addressing the aforementioned issues, Pioneer Medical Center seeks to:a) Improve access to healthcare services;b) Enhance the health of the community;c) Advance medical or health knowledge

Pioneer Medical Center’s Mission: Sustainable Excellence in Patient and Resident Focused Care.

Pioneer Medical Center’s Vision:Grow to Become the Trusted Healthcare Provider and Employer of Choice in Sweet Grass County.

Pioneer Medical Center’s Values: Teamwork Responsibility Understanding Safety Talent Excellence Dedication

Implementation Planning Committee Members:

Gary Hamilton- CEO, Pioneer Medical Center TBD-Director of Nursing Mary Parker- Director of Business Operations Amy Schilling- HR Director Hannah Pauli- Director of Marketing/PR/Fundraising Edward Tu- Director of QI and Risk Management Brian Washburn- Director of Clinic and Outpatient Services

Prioritizing the Community Health Needs



The implementation planning committee completed the following to prioritize the community health needs: Reviewed the facility’s presence in the community (i.e. activities already being done to address community need) Considered organizations outside of the facility which may serve as collaborators in executing the facility’s implementation

plan Assessed the health indicators of the community through available secondary data Evaluated the feedback received from consultations with those representing the community’s interests, including public health

Pioneer Medical Center’s Existing Presence in the Community Ambulance Services-Boat Float Ambulance Services-School Sporting Events Ambulance Services-Rodeo BLS Trainings Community Flu Vaccination Clinics Diabetes Prevention Program High School Sports-Athletic Trainer HS Home EC Student/Resident Project Impact Testing

It’s your Choice Exercise Parade of Lights Senior Center Blood Pressure Checks SGCHS Yearbook Sponsorship Sports Physical Clinics Student Job Shadowing Sweet Grass Fest Visiting Specialists

List of Available Community Partnerships and Facility Resources to Address Needs Billings Clinic Affiliates Big Timber Cancer Alliance(SGCF) Big Timber Food Bank Billings Clinic Hospitality House Local EMS Local Mental Health Services Local Newspaper Local Police/Sheriff’s Office

Local Schools Local Transportation Services Montana Health Network Montana Hospital Association Montana Nonprofit Association Mountain-Pacific Quality Health Sweet Grass Community Foundation Sweet Grass County Public Health Sweet Grass Healthcare Foundation

Sweet Grass County Indicators

Low Income Persons6 Disclaimer: The Montana Office of Rural Health strongly encourages an accounting professional’s review of this document before submission to

the IRS. As of this publishing, this document should be reviewed by a qualified tax professional. Recommendations on its adequacy in fulfillment of IRS reporting requirements are forthcoming.


9.8% of persons are below the federal poverty level

Uninsured Persons 14% of adults less than age 65 are uninsured 11% uninsured children less than age 18

Leading Causes of Death in Montana: Primary and Chronic Diseases Heart Disease Cancer Chronic Lower Respiratory Disease

Elderly Populations 22.9% of Sweet Grass County’s Population is 65 years and older

Size of County and Remoteness 3,623 people in Sweet Grass County 2 people per square mile

Nearest Major Hospitals Bozeman Health in Bozeman, MT is 60.8 miles from Pioneer Medical Center Billings Clinic in Billings, MT is 82.1 miles from Pioneer Medical Center St. Vincent Healthcare in Billings, MT is 82.3 miles from Pioneer Medical Center

Public Health and Underserved Populations Consultation Summaries

Public Health Consultation [Jennifer Chappell, RN, Sweet Grass County Public Health Nurse; Daniel Thomasson, City Commissioner; Alan Ronneberg, Lieutenant, Sweet Grass County Sheriff’s Office - May 02, 2018 and May 25, 2018]

I think it would be nice to have a walking path around the community that is easily assessable. 7 Disclaimer: The Montana Office of Rural Health strongly encourages an accounting professional’s review of this document before submission to



The community needs more mental health services/counselors and outreach on the current services that are available. Educating people on cancer prevention, smoking and tanning etc. would make the community a healthier place to live. Substance abuse is always an issue Mental health. That’s a big one that the sheriff’s office deals with all the time. And it increases in the summer because of

the transient populations that come through. It is hard to get people into services because the demand is so high One thing that is really hindering getting quality staff at PMC is housing and childcare. If you look at the average income

in this town and what rent costs in this town, it is not right. We need more economical hosing options. I have heard of teachers turning down jobs because the cost of living is too high. They can’t find a place to live here.

Overall, we need to educate and communicate with the community better. There really isn’t one resource to get the word out there. The computer isn’t always the best way because this is an aging community and a lot of people do not use computers. There is no coordination with services, and it would really add a boost.

Underserved Population – Low Income, Underinsured [Cheri Fjare, Big Timber Food Bank; Bobette Johnson, Big Timber Senior Center – May 02, 2018]

- It’s not just the bus, people also don’t know about the food bank. There are a lot of services here, but people just don’t know about them.

Underserved Population – Senior Citizens [JoAnn Fuller, Big Timber Senior Center– May 02, 2018] At the senior center there is a hospitality bus and its accessible, but we are trying to get more people to use it. We try to get

the word out, but it’s been difficult. A lot of people here could use home health. I don’t know if its lack of awareness about its availability, or the cost.

Underserved Population – Youth [Jennifer Chappell, RN, Sweet Grass County Public Health Nurse; Susan Sondeno, RN, Big Timber Schools; Alan Ronneberg, Lieutenant, Sweet Grass County Sheriff’s Office– May 02, 2018 and May 25, 2018]

There is nothing for the kids to do here. There’s no bowling alley or anything so I feel like we need to build something so the kids have other things to do to keep them from getting into trouble.

I work a lot with the schools and a see a lot of mental health needs there. More prevention activities for the younger generations are needed.



There are not very many people who are licensed to do mental health in the community. We have had a lot of mental health issues in the schools in the last five years.

Needs Identified and Prioritized

Prioritized Needs to Address

1. A statewide MT rural/frontier communities assessment found ‘Access to healthcare and other services’ was the top component of a healthy community.

2. A statewide MT rural/frontier communities assessment found ‘More primary care providers’, ‘More specialists’ and ‘Improved quality of care’ were the top three ways to improve access to healthcare.



3. Focus group participants reported access to clinic appointments could be difficult.4. A statewide MT rural/frontier communities assessment found on average, 27.9% of MT rural/frontier residents reported

delaying or not receiving needed healthcare. Common reasons for the delay were: ‘Too long to wait for an appointment’ (22.3%) and ‘Could not get an appointment’ (20.4%).

5. Focus group participants reported a desire for increased utilization of tele-medicine services.6. Focus group participants indicated the availability of visiting specialist was appreciated and they valued not having to travel

for services.7. Focus group participants expressed an interest in expanding specialty services available locally to include: mental health,

ultrasound, eye care, foot care, home health).8. 22.9% of Sweet Grass County residents are aged 65 or older.9. Focus group participants noted a need for healthcare services for seniors in the community.10. Focus group participants indicated a need for increased community knowledge of available services and better community

coordination of resources.11. Focus group participants felt a need for enhanced referral coordination and follow up care post discharge.12. In MT, over 1 in 3 adults report having 2 or more chronic conditions. Rates among adults living in frontier communities are

higher with 41% reporting having 2+ chronic conditions.13. Top three leading causes of death in Montana are ‘Heart disease,’ ‘Cancer,’ and ‘Chronic Lower Respiratory Disease

[CLRD].’14. Montana has a 24.4 per 100,000 mortality rate from Diabetes Mellitus compared to 23.9 in the U.S.15. Focus group participants felt the community would benefit from more education on prevention of diseases.16. Alcohol and drug abuse was a concern identified by focus group participants.17. 26.2% of MT students and adults reported not wearing a seatbelt and 2.7% of Montana adults reported drinking and driving. 18. 20% of Montana adults reported unhealthy drinking behaviors (binge and heavy drinking).19. Sweet Grass County’s death from motor vehicle crashes rate is 43 per 100,000 compared to 19 in Montana.20. A statewide MT rural/frontier communities assessment found ‘Cancer’, ‘Alcohol abuse/substance abuse’ and

‘Overweight/obesity’ were the top three health concerns.21. A statewide MT rural/frontier communities assessment found 55.8% of respondents felt their community was ‘Somewhat

healthy’ (55.8%).22. 21% of Sweet Grass County residents reported they had ‘No leisure time for physical activity’ and Sweet Grass County has a

26% Obesity rate.23. Focus group participants reported a desire for more opportunities to be more physically active.24. Focus group participants indicated a concern regarding sedentary lifestyles and obesity.



25. Focus group participants reported a desire for a local dietician and weight loss clinic services.

Needs Unable to Address(See page 27 for additional information)

1. Sweet Grass County has a rate of 64.5 per 100,000 of pertussis comparted to 44.6 in Montana.2. Focus group participants felt there was a shortage of volunteers for the local ambulance services.3. Focus group participants noted affordable housing and childcare shortages.4. Suicide was the 6th leading cause of death among Montanans from 2011-2015. Montana’s frontier communities have an age-

adjusted mortality rate of 26.7, when compared to 12.8 in the U.S.

Executive SummaryThe following summary briefly represents the goals and corresponding strategies and activities which the facility will execute to address the prioritized health needs (from page 9). For more details regarding the approach and performance measures for each goal, please refer to the Implementation Plan Grid section, which begins on page 14.


Goal 1: Improve access to healthcare services in Sweet Grass County.


Strategy 1.1: Increase access to primary care services.Activities:

Develop new access model to expand availability of clinic services to include walk-in clinic. Develop and provide information for new clinic access model to PMC staff. Develop community marketing campaign to introduce inform community of available primary care services. Determine feasibility of implementing clinic online scheduling.

Strategy 1.2: Increase access to specialty care services.Activities:

Develop community education on currently available specialty care services at PMC (in-house and via tele-health). Explore opportunities to expand tele-health specialty services with Billings Clinic. Explore expanding available specialty services at PMC (ex. Speech therapy, MRI, ultrasound, mental health).

Strategy 1.3: Collaborate with existing resources in Sweet Grass County to enhance senior services. Activities:

Explore feasibility of providing nurse home visits through the rural health clinic. Meet with Hospitality House to discuss potential areas of collaboration and coordination of resources. Develop educational materials to inform community on available senior resources.

Strategy 1.4: Continue to enhance PMC efforts in care coordination.Activities:

Adopt and implement transitional care management program.


Goal 2: Enhance Pioneer Medical Center outreach and education efforts in the PMC service area.


Strategy 2.1: Investigate additional ways PMC could expand educational programs and outreach offerings. Activities:

Explore feasibility to expand diabetes management efforts through utilization of a certified diabetes educator. Participate in the Mountain-Pacific Quality Health project to provide additional services to diabetic and pre-diabetic

patients. Partner with Public Health to offer “It’s your choice” (driver behaviors and traffic safety program) for local youth. Explore developing monthly newspaper article/column on various health topics featuring PMC staff/provider expertise. Determine feasibility of developing an electronic mailing providing health topics and resources via a listserv.

Strategy 2.2: Promote health and wellness opportunities in Sweet Grass County.Activities:

Continue to host and promote community events/programs that provide health and wellness information (i.e. sports physicals at local school, community golf tournament, providing PT and ambulance staff at local sporting events).

Explore opportunities to partner or support new community events promoting health and wellness (ex. Fun run).

Strategy 3.1: Develop a Sweet Grass County Healthy Community Coalition.Activities:

Identify community partners/stakeholders (ex. Hospitality House, mental health services, police, cancer alliance, transportation etc.) in Sweet Grass County.


Goal 3: Strengthen PMC’s community engagement and collaboration efforts to enhance community partnerships and knowledge of available services.


Invite stakeholders to participate in a community health coalition to identify and share information related to efforts and resources.

With coalition, conduct environmental scan of available resources and create a resource directory to share with community (online, handout etc.).

Implementation Plan Grid


Strategy 1.1: Increase access to primary care services.

Activities Responsibility Timeline Final Approval Partners Potential Barriers

Develop new access model to expand availability of clinic services to include walk-

Med StaffClinic

6 Months Med Staff CEO

HRMarketing

Resource limitationsSupport staff



in clinic. Manager limitations

Develop and provide information for new clinic access model to PMC staff.

Clinic Manager 6 Months-1

YearMed Staff CEO

Marketing NA

Develop community marketing campaign to introduce inform community of available primary care services.

Clinic Manager

Marketing6 Months-1

YearMarketing

CEO NA NA

Determine feasibility of implementing clinic online scheduling and texting reminders.

Clinic Manager 1 Year

Clinic Manager Med

Staff CEO

ITMarketing

Billing ClinicFinancial limitations

Needs Being Addressed by this Strategy: #1: A statewide MT rural/frontier communities assessment found ‘Access to healthcare and other services’ was the top component of a

healthy community. #2: A statewide MT rural/frontier communities assessment found ‘More primary care providers’, ‘More specialists’ and ‘Improved

quality of care’ were the top three ways to improve access to healthcare. #3: Focus group participants reported access to clinic appointments could be difficult. #4: A statewide MT rural/frontier communities assessment found on average, 27.9% of MT rural/frontier residents reported delaying or

not receiving needed healthcare. Common reasons for the delay were: ‘Too long to wait for an appointment’ (22.3%) and ‘Could not get an appointment’ (20.4%).

Anticipated Impact(s) of these Activities: Increased availability to primary health care services Increased knowledge of available primary care services Improved health outcomes Decreased appointment no shows and cancelations

Plan to Evaluate Anticipated Impact(s) of these Activities: Track development of new access model Track development and distribution of community outreach/education materials on available primary care services Determine feasibility of implementing online scheduling and app usage

Measure of Success: PMC will expand access to primary care services by including a walk-in clinic by summer 2019.




Strategy 1.2: Increase access to specialty care services.


Develop community education on currently available specialty care services at PMC (in-house and via tele-health).

MarketingOut Patient

ServicesPMC Tele-health

CoordinatorMed/Staff

6 Months-1 Year

DON ClinicMarketing Scheduling limitations

Explore opportunities to expand tele-health specialty services with Billings Clinic.

Med/StaffCEO

Year CEODON

Billings ClinicOutpatient RN

Materials Manager

Space limitations, Volume limitations,

Workforce limitations

Explore expanding available specialty services at PMC (ex. Speech therapy, MRI,

Med/StaffCEO

Year CEO DONBillings Clinic

Financial limitations, Space limitations,

Workforce limitations16 Disclaimer: The Montana Office of Rural Health strongly encourages an accounting professional’s review of this document before submission to



ultrasound, mental health).



quality of care’ were the top three ways to improve access to healthcare. #5: Focus group participants reported a desire for increased utilization of tele-medicine services. #6: Focus group participants indicated the availability of visiting specialist was appreciated and they valued not having to travel for

services. #7: Focus group participants expressed an interest in expanding specialty services available locally to include: mental health, ultrasound,

eye care, foot care, home health).Anticipated Impact(s) of these Activities:

Improve community knowledge of available specialty services Improved access to specialty services Improved health outcomes

Plan to Evaluate Anticipated Impact(s) of these Activities: Track utilization of specialty services pre/post educational outreach efforts Track development of new specialty service offerings via tele-health Track development of new specialty service offerings on-site Review Referrals

Measure of Success: Serving more patients using Tele-health services. Increased patients seeing visiting specialists.Identifying meaningful specialty growth opportunities and developing the identified programs.




Strategy 1.3: Collaborate with existing resources in Sweet Grass County to enhance senior services.


Explore feasibility of providing nurse home visits through the rural health clinic.

Clinic DirectorMed/Staff

CEOYear CEO

DONCommunity Health

Worker (CHW)Business Office

Medicare Approval, Workforce limitations

Meet with Hospitality House to discuss potential areas of collaboration and coordination of resources.

MarketingCEO

Six months CEOClinic Director

CHW Hospitality House

Public Health RN

Resource limitations,Scheduling conflicts,

Identifying widely relevant needs

Develop educational materials to inform community on available senior resources.

MarketingCEO Year CEO

CHWPublic Health RN

Financial limitations, Timely information/

updatesNeeds Being Addressed by this Strategy:

#1: A statewide MT rural/frontier communities assessment found ‘Access to healthcare and other services’ was the top component of a healthy community.

#8: 22.9% of Sweet Grass County residents are aged 65 or older. #9: Focus group participants noted a need for healthcare services for seniors in the community. #10: Focus group participants indicated a need for increased community knowledge of available services and better community

coordination of resources.Anticipated Impact(s) of these Activities:

Improved access to nurse home visits Improved knowledge of available senior services18 Disclaimer: The Montana Office of Rural Health strongly encourages an accounting professional’s review of this document before submission to



Improved collaboration with community partners Increased clinic visits Decrease ED visits Improved health outcomes Identification of acute exacerbation

Plan to Evaluate Anticipated Impact(s) of these Activities: Determine feasibility of providing nurse home visits Track meetings with Hospitality House Track re-admission rates Track outcome(s) of collaboration efforts with Hospitality House Track utilization of PMC senior services post educational outreach efforts

Measure of Success: Clinic visits trending up and re-admission rates trending down. Increased use of identified services.


Strategy 1.4: Continue to enhance PMC efforts in care coordination.

Activities Responsibility Timeline Final Partners Potential Barriers19 Disclaimer: The Montana Office of Rural Health strongly encourages an accounting professional’s review of this document before submission to



Approval

Adopt and implement transitional care management program.

Clinic DirectorMed Staff

3 months Med StaffBusiness Office

BC ITCHWDON

IT Development



quality of care’ were the top three ways to improve access to healthcare. #11: Focus group participants felt a need for enhanced referral coordination and follow up care post discharge.

Anticipated Impact(s) of these Activities: Improved patient transitional care Improved health outcomes Improved standard of care Increased patient and family satisfaction

Plan to Evaluate Anticipated Impact(s) of these Activities: Track adoption of transitional care program Track patient outcome pre/post implantation of care program Decreased readmissions

Measure of Success: PMC implements a transitional care management program in 3 months.


Strategy 2.1: Investigate additional ways PMC could expand educational programs and outreach offerings.




Explore feasibility to expand diabetes management efforts through utilization of a certified diabetes educator.

CEODieticians

1-3Year(s) CEO DONMed Staff

Patient volume limitations,

Space limitations, Workforce limitations

Partner with Public Health to offer “It’s your choice” (driver behaviors and traffic safety program) for local youth.

DONPublic Health

NurseEmergency

Preparedness Leadership

3 Months CEO Med Staff Marketing

Clinic DirectorPublic Health

Work flow logistics

Explore developing monthly newspaper article/column on various health topics featuring PMC staff/provider expertise.

CEO Marketing

6 months-2 years

CEOMed Staff

PMC Managers

Local Newspaper

Financial/Insurance riders,Staff bandwidth

limitations

Determine feasibility of developing an electronic mailing providing health topics and resources via a listserv.

MarketingBC IT

Two years CEOMed Staff

Clinic DirectorPMC IT

Reception Staff

IT/Information/ software limitations




healthy community. #10: Focus group participants indicated a need for increased community knowledge of available services and better community

coordination of resources. #12: In MT, over 1 in 3 adults report having 2 or more chronic conditions. Rates among adults living in frontier communities are higher

with 41% reporting having 2+ chronic conditions. #13: Top three leading causes of death in Montana are ‘Heart disease,’ ‘Cancer,’ and ‘Chronic Lower Respiratory Disease [CLRD].’ #14: Montana has a 24.4 per 100,000 mortality rate from Diabetes Mellitus compared to 23.9 in the U.S. #15: Focus group participants felt the community would benefit from more education on prevention of diseases. #16: Alcohol and drug abuse was a concern identified by focus group participants. #17: 26.2% of MT students and adults reported not wearing a seatbelt and 2.7% of Montana adults reported drinking and driving. #18: 20% of Montana adults reported unhealthy drinking behaviors (binge and heavy drinking). #19: Sweet Grass County’s death from motor vehicle crashes rate is 43 per 100,000 compared to 19 in Montana. #20: A statewide MT rural/frontier communities assessment found ‘Cancer’, ‘Alcohol abuse/substance abuse’ and ‘Overweight/obesity’

were the top three health concerns. #21: A statewide MT rural/frontier communities assessment found 55.8% of respondents felt their community was ‘Somewhat healthy’

(55.8%).Anticipated Impact(s) of these Activities:

Expanded access to diabetes and pre-diabetes management services Enhanced collaboration with community partners Improved community knowledge and awareness of various health topics Increased community awareness of available health resources Increase health literacy

Plan to Evaluate Anticipated Impact(s) of these Activities: Track development and expansion of diabetes/pre-diabetic management offerings Track programs offered at local schools Track number of articles/columns published in local paper Track development of electronic listserv

Measure of Success: PMC improves community engagement through the creation and distribution of a monthly electronic listserv newsletter by end of 2020.




Strategy 2.2: Promote health and wellness opportunities in Sweet Grass County.


Continue to host and promote community events/programs that provide health and wellness information (i.e. sports physicals at local school, community golf tournament, providing PT and ambulance staff at local sporting events).

MarketingMed staff

DON

Year CEO Clinic DirectorLocal Schools Space limitations,

Scheduling conflicts, Staffing limitations

Explore opportunities to partner or support new community events promoting health and wellness (ex. Fun run).

Marketing 2-3Years CEOClinic Director

Med StaffHR

Community Partners

Resource limitations, Scheduling conflicts,

Identifying Community Partners

Needs Being Addressed by this Strategy: #10: Focus group participants indicated a need for increased community knowledge of available services and better community

coordination of resources. #12: In MT, over 1 in 3 adults report having 2 or more chronic conditions. Rates among adults living in frontier communities are higher

with 41% reporting having 2+ chronic conditions. #13: Top three leading causes of death in Montana are ‘Heart disease,’ ‘Cancer,’ and ‘Chronic Lower Respiratory Disease [CLRD].’ #14: Montana has a 24.4 per 100,000 mortality rate from Diabetes Mellitus compared to 23.9 in the U.S. #15: Focus group participants felt the community would benefit from more education on prevention of diseases. #20: A statewide MT rural/frontier communities assessment found ‘Cancer’, ‘Alcohol abuse/substance abuse’ and ‘Overweight/obesity’

were the top three health concerns. #21: A statewide MT rural/frontier communities assessment found 55.8% of respondents felt their community was ‘Somewhat healthy’

(55.8%). #22: 21% of Sweet Grass County residents reported they had ‘No leisure time for physical activity’ and Sweet Grass County has a 26%

Obesity rate. #23: Focus group participants reported a desire for more opportunities to be more physically active.



#24: Focus group participants indicated a concern regarding sedentary lifestyles and obesity. #25: Focus group participants reported a desire for a local dietician and weight loss clinic services.

Anticipated Impact(s) of these Activities: Increased community engagement Increased community collaboration Improved knowledge and visibility of available services Increased access to health and wellness opportunities Improved health outcomes

Plan to Evaluate Anticipated Impact(s) of these Activities: Track number of community events/programs PMC hosts/co-sponsors Track number of participants in community events Track service utilization or new patient services post community events Track number of new health and wellness events offered

Measure of Success: Increased community events and participation.




Goal 3: Strengthen PMC’s community engagement and collaboration efforts to enhance community partnerships and knowledge of available services.Strategy 3.1: Develop a Sweet Grass County Healthy Community Coalition.


Identify community partners/stakeholders (ex. Hospitality House, mental health services, police, cancer alliance, transportation etc.) in Sweet Grass County.

MarketingCEOBOD

3 Years CEOBOD

Med Staff Stakeholder engagement,

Availability limitations

Invite stakeholders to participate in a community health coalition to identify and share information related to efforts and resources.

MarketingBODCEO

3 Years CEOBOD

Med StaffHospitality House,

Mental Health, Police, EMS, Transpiration,

Cancer Alliance

Stakeholder engagement,

Scheduling conflicts

With coalition, conduct environmental scan of available resources and create a resource directory to share with community (online, handout etc.).

MarketingSGC CHCC Committee

3 Years CEOHospitality House,

Mental Health, Police, EMS, Transpiration,

Cancer Alliance, Med staff, Clinic Director, BOD, CHRN, CHW

Participation, Timely information, Resource

limitations

Needs Being Addressed by this Strategy: #10: Focus group participants indicated a need for increased community knowledge of available services and better community

coordination of resources. #15: Focus group participants felt the community would benefit from more education on prevention of diseases. #21: A statewide MT rural/frontier communities assessment found 55.8% of respondents felt their community was ‘Somewhat healthy’

(55.8%).Anticipated Impact(s) of these Activities:

Increased community engagement Increased community collaboration Improved knowledge and visibility of available services

Plan to Evaluate Anticipated Impact(s) of these Activities: Track number of community partners interested in participating in a community health coalition Track number of meetings held Track development of community resource directory Track distribution of the directory

Measure of Success: A community health coalition is formed, and first meeting is held by End of 2020.


Needs Not Addressed and Justification

Identified health needs unable to addressby Pioneer Medical Center Rationale

1. Sweet Grass County has a rate of 64.5 per 100,000 of pertussis comparted to 44.6 in Montana.

Upon further consultation and examination of current pertussis case data (post completion of CHNA), it was determined the DPHHS data source reflected an outbreak from 2015 and it not currently a high concern in Sweet Grass County.

2. Focus group participants felt there was a shortage of volunteers for the local ambulance services.

The ambulance team has many volunteers. The Ambulance manager is working on schedule development to better utilize the abundant volunteer base.

3. Focus group participants noted affordable housing and childcare shortages.

Though this is a valid concern in our community and neighboring communities alike, it is not one that PMC can



effectively address based on mission, vision, and values.4. Suicide was the 6th leading cause of death among Montanans

from 2011-2015. Montana’s frontier communities have an age-adjusted mortality rate of 26.7, when compared to 12.8 in the U.S.

The community and PMC are both making efforts to address this important issue in the community. PMC is addressing this through resource developed in other area on the implementation plan.



Dissemination of Needs Assessment

Pioneer Medical Center “PMC” disseminated the community health needs assessment and implementation plan by posting both documents conspicuously on their website https://pmcmt.org/about/overview as well as having copies available at the facility should community members request to view the community health needs assessment or the implementation planning documents.

The Steering Committee, which was formed specifically as a result of the community health needs assessment (CHNA) process to introduce the community to the assessment process, will be informed of the implementation plan to see the value of their input and time in the CHNA as well as how PMC is utilizing their input. The Steering Committee, as well as the Board of Directors, will be encouraged to act as advocates in Sweet Grass County as the facility seeks to address the healthcare needs of their community.

Furthermore, the board members of PMC will be directed to the hospital’s website to view the complete assessment results and the implementation plan. PMC board members approved and adopted the plan on August 16, 2018. Board members are encouraged to familiarize themselves with the needs assessment report and implementation plan, so they can publicly promote the facility’s plan to influence the community in a beneficial manner.

PMC will establish an ongoing feedback mechanism to take into account any written comments it may receive on the adopted implementation plan document.

[Please remove the following statement and the disclaimer in the footer once the planning document is finalized]*Please note that you will need to include information specific to these requirements:- You must post your community health needs assessment (CHNA) and your facility’s implementation plan publicly – both

“conspicuously” on your website as well as have a hard copy available at your facility should someone request to view either/both documents.

o Your documents must remain on the web until two subsequent CHNA reports have been postedo An individual must not be required to create an account or provide personally identifiable information to access the

reporto A paper copy must be available for public inspection without charge

- Your facility’s implementation plan must be approved and the plan must document the date upon which the plan was approved/adopted


pioneer medical center – big timber, mthealthinfo.montana.edu/morh/pmc_implementation plan_2018...

Documents