The Critical Role of School Nurses in Today’s Changing Healthcare Environment

Maine School Nurse Summer Institute July 23, 2014Bates CollegeLewiston, Maine

Lois Skillings, RN, MSPresident and CEOMid Coast Health ServicesBrunswick, Maine

Objectives:

• As national healthcare reform impacts the delivery and financing of healthcare, the role of school nurses is more important than ever. This presentation will highlight the goal of achieving the Triple Aim of improving healthcare, and the influence of school nurses in the transformation process.

Fixing Healthcare:

An Economic and Social Imperative

• It is a whole new world out there. Aside from political views, the way we finance and deliver healthcare has to change.

• Our current healthcare system is not sustainable.

• This is the work of our generation of healthcare leaders.

© Copyright Orlikoff & Associates, Inc. 2014

© Copyright Orlikoff & Associates, Inc. 2014

© Copyright Orlikoff & Associates, Inc. 2014

The U.S. Healthcare Environment

Trends: Demographics and Healthcare Costs

• 10,000 Baby Boomers turn 65 each day.

• Today, the elderly population utilizes hospital services five times as often as the non-elderly.

• Combine this with the fact that our healthcare system is already too expensive, and we are on a collision course for collapse.

Trends: Maine Healthcare Scene

• Very high hospital quality outcomes and pretty good population health when compared nationally.

• Small and aging population, and poverty, makes cost shifting greater burden in Maine.

• All Maine hospitals are not-for-profit.

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Per Capita Healthcare Costs

United Kingdom

Germany

Japan

Canada

United States

Maine

$3,647

$4,683

$4,752

$5,741

$8,895

$10,647

Source: The World Bank: Health expenditure per capita (current US$) 2012; Maine data estimated

Maine needs to reduce costs by 20% just to achieve the

U.S. average, and we would still be double

other countries

Free Care & Bad Debt – Mid Coast

$ 2.0Million

$ 4.4 Million

$ 2.8 Million

$3.3 Million

$ 3.8 Million

$ 5.4 Million

$ 4.9 Million

$ 5.1Million

$ 5.2 Million

$ 5.8 Million

2009 2010 2011 2012 2013

= Free Care

= Bad Debt

Hope, Solutions and Strategies

• The “Triple Aim”• Partnership and Collaboration• Patient Centered Medical Home• Critical Role of School Nurses

© Copyright Orlikoff & Associates, Inc. 2014

Source: Institute for Healthcare Improvement, Cambridge, MA

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Solutions: The Triple Aim to

Accountable Care

Improve the Healthof the Population

Enhance thePatient

Experience of CareIncluding Quality, Access

and Reliability

Reduce, or Control,the Per Capita Cost of Care

Improve the Healthof the Population

Enhance thePatient

Experience of CareIncluding Quality, Access

and Reliability

Reduce, or Control,the Per Capita Cost of Care

Prevention and Wellness

Our vision is to become an organization that

not only takes care of patients when they become sick, but also takes responsibility for the health and well-being of our community.

Strategic Vision for Population Health

Primary Care / Patient-Centered

Medical HomeCommunity

Health

Employee Health / Worksite

Wellness

Accountable Care

Integrated, Coordinated, Accountable & Aligned toward a Culture of Health and Wellness

© Steve Trockman 2012

United Way of Mid Coast Maine Success By 6: Early Childhood

Re-defining the “H”

Today

Future

HHOSPITAL

h ERor

If we are successful, the healthcare system in the future will necessarily need to look different. We can’t have it both ways (transformation and continue acute-care centric models.) Can we engage the community and employers to develop a culture of health and wellness? Can we integrate primary care, acute care, home care and elder care services to be more efficient and effective? Will all “hospitals” have inpatient beds? Can we afford as many hospitals? If we truly impact and improve the health of the population, will we need as many hospitals? We will need more community-based primary care and urgent care.

Patient-Centered Medical Home

• Coordinated care focused on prevention through Primary Care.

• Relationship between patient and their physician and the care TEAM.

• Integrated care…physical, social, spiritual, emotional.

Collaboration and Partnerships

• School Nurses are at the front line for the health of hundreds of thousands of children in our State. You have unique perspective and a critically important voice.

Transformation

• Growing, learning, improving

• Revolution, evolution, change, makeover

• Change.

References:

The Healing of America by T.R. Reid Copyright 2010

The American Health Care Paradox: Why Spending More Is Getting Us Less byElizabeth H. Bradley and Lauren A. Taylor Copyright 2013

Thank you!

Questions?

Mid Coast Health  

Our Community, Our HealthBrunswick, Maine