2011– 2013

Community Health Needs Assessment

Thank you for taking time to read Advocate Good Shepherd Hospital’s Community Health Needs Assessment. Meeting the health needs of the patients, families and communities we are privileged to serve is at the core of our mission. Before we can support our community, we must first determine its needs. Outreach begins with a careful and comprehensive Community Health Needs Assessment. Every three years, we collect and analyze key data to strategically steer our efforts to the people, communities and health issues where they are most needed. Partnering with local, state and national organizations and through engagement with community leaders, we can enhance our effectiveness to create strong and dynamic systems to support the health of our community. Advocate Good Shepherd Hospital has community health programs that have been developed to address the unique health needs identified for our community. A few examples of our current programs include reducing childhood obesity, preventing falls, assessing cardiovascular disease and addressing mental health concerns. We also are collaborating with our schools and community to help teens develop safe driving habits at an early age. Our goal is for you to have as much information as possible readily available so that you can understand and perhaps be a partner with us as we address community health needs. At the end of the report, please find a link to connect with us to express any feedback or ideas you may have to address community health issues in our community. Whether you seek care through our hospital, physician group or home care, we are committed to partnering and to addressing your health needs. It is indeed a privilege to be entrusted with the health of our community. Sincerely,

Karen Lambert President Advocate Good Shepherd Hospital

Table of Contents I. Introduction/Mission 2 2 Mission 2 Values 2 Philosophy 3 MVP Integrated

II. Executive Summary 3 III. CHNA Process & Timeline 4 4 Community Health Councils Review Data & Set Priorities 4 Good Shepherd Hospital Community Health Council Members

IV. Community Definition 5 5 Service Area 6 Communities Served 9 Health Resources

V. Data Sources 9 10 Links to Selected Data Sources

VI. CHNA Findings 11 VII. Health Need Priorities 13 13 Prioritization Process 14 Health Needs Selected to Address 15 Ongoing Health Priorities 15 Health Needs Not Selected to Address

VIII. Overview of Planned Program Interventions 16 16 Primary Priorities 17 Secondary Priorities

IX. Vehicle for Community Feedback 18

I. Introduction/Mission Advocate Good Shepherd Hospital (Good Shepherd Hospital) is one of eleven hospitals in the Advocate Health Care system. Advocate is the largest health system in Illinois and one of the largest healthcare providers in the Midwest. It operates more than 250 sites of care, including 11 acute care hospitals, the state’s largest integrated children’s network, five Level I trauma centers (the state’s highest designation for trauma care), two Level II trauma centers, one of the area’s largest home healthcare companies and one of the region’s largest medical groups. Advocate Health Care also trains more primary care physicians and residents at its four teaching hospitals than any other health system in the state. Advocate is a faith-based, not-for-profit system, deeply rooted in its health system affiliations with the Evangelical Lutheran Church in America and the United Church of Christ. In January 1995, these two faith-based, values-driven organizations, joined together to establish Advocate Health Care. A common mission, values and philosophy (MVP) was developed from the similar mission-oriented histories of both organizations.

Mission Advocate’s mission is to serve the health needs of individuals, families and communities through a wholistic philosophy rooted in the fundamental understanding of human beings as created in the image of God. Advocate’s mission permeates all areas of its healing ministry. Advocate Health Care holds its employees, management and Board of Directors accountable to living five core values that guide behavior consistent with its mission.

Values The five values of Advocate Health Care serve as an internal compass to guide relationships and actions: Equality, Compassion, Excellence, Partnership and Stewardship. • Equality – We affirm the worth and spiritual freedom of each person and treat all people with respect, integrity and dignity. • Compassion – We embrace the whole person and respond to emotional, ethical and spiritual concerns, as well as physical needs in our commitment to unselfishly care for others. • Excellence – We empower people to continually improve the outcomes of our service, to advance quality and to increase innovation and openness to new ideas. • Partnership – We collaborate as employees, physicians, volunteers and community leaders to utilize the talents and creativity of all persons. • Stewardship – We are responsible and accountable for all that we are, have and do.

Philosophy Advocate’s philosophy is to provide wholistic care. This philosophy means that Advocate understands people have physical, emotional and spiritual needs, and their relationship to God, themselves, their families and society are vital to health and healing. The philosophy of Advocate is grounded in the principles of human ecology, faith and community-based health care. Through its actions, Advocate affirms the following principles. • We believe each person is created in the image of God. • We respect, include and serve people without regard to race, religion, age, disability, gender, sexual orientation or socio-economic status. • We seek to assure the spiritual freedom of all persons. • We extend our concerns for the whole person to our patients, employees, physicians, volunteers, trustees and their families. • We address clinical, business, corporate and social-ethical issues from a faith perspective and assist individuals, families and professionals in the resolution of these issues. • We are guided by the principles of justice in addressing our social responsibility as a corporate citizen in this society.

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• We are responsible and accountable in the spirit of stewardship for all the resources under our management to assure the accomplishment of our Mission. • We believe in effective collaboration with those individuals and entities interested in addressing the health care needs of our region.

MVP Integrated Advocate’s MVP is integrated into every aspect of the organization, strengthening its cultural foundation. The MVP calls for Advocate to extend its services into the community to address access to care issues and to improve the health and well-being of the people in those communities. As an Advocate hospital, Good Shepherd Hospital embraces the system MVP as its own. Good Shepherd Hospital, located in Barrington, Illinois, is an acute care facility with 169 licensed beds and more than 700 physicians representing 50 medical specialties. For over three decades, Good Shepherd Hospital has provided quality, compassionate health care to its patients and communities. Good Shepherd Hospital treats more than 220,000 patients each year and provides a variety of health education, community-based prevention programs and community collaboration.

II. Executive Summary Good Shepherd Hospital has strong commitment as a faith-based community hospital to fulfill our mission of meeting the health needs of patients, families and community members. This work begins with a broad understanding of the assets, needs and challenges facing the communities we serve. Good Shepherd has had a long history of working closely with community stakeholders to accomplish this task. By building lifelong relationships and partnering with organizations we can gain a deeper understanding of needs and create solutions that are comprehensive and inclusive. This report explains the process, data sources and strategy used to help bring improved health and vitality to the communities we are privileged to serve on a daily basis. The hospital has had a Community Health Council in place for some time and has developed an annual community health plan in the past. For this assessment, the group developed a longer range, three-year plan. For purposes of the assessment process, the group defined the community as the hospital’s total service area which includes the surrounding seventeen zip codes. This geographical area includes four counties; however the majority of the hospital’s service area is split equally between Lake and McHenry counties. In order to be more comprehensive, Good Shepherd was able to successfully leverage community partnerships through health coalitions established in Lake and McHenry Counties as well as through the Healthier Barrington Coalition which the hospital helped create in 1995. Through these partnerships, the hospital participated in three comprehensive community assessments: Lake County Mobilizing Action through Planning and Partnership (MAPP)-2012, McHenry County Healthy Community Study-2010, and the 2011 Healthier Barrington Needs Survey. Through the use of this data, as well as additional hospital data, the Community Health Council was able to determine areas of need for the community. The Community Health Council put significant thought into determining how to select priorities that were meaningful to the well being of community members as well as having the potential to show actual health improvements. Priorities such as obesity, fall prevention among seniors, teen safety, cancer prevention and cardiovascular health were the main areas selected for focus. Once priorities were determined, specific tactics and measureable targeted outcomes were established including a hospital budget to be sure specific resources were allocated toward addressing specific needs. The final CHNA document was presented for approval by the hospital Governing Council and included a three year plan beginning in January 2012 and continuing through December 2014. The Community Health Council meets quarterly to review the progress of the interventions and outcomes and engages in an annual strategic discussion to evaluate any modifications that might be necessary in the plan. Although the CHNA is a three-year plan; the Council

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wants to keep the plan somewhat fluid to address any pressing needs that might surface in the community. By doing this, we are able to address needs that may arise between assessment intervals. It is the hope of Good Shepherd Hospital that you will find this report a valuable tool and gain a greater understanding of how communities can be improved through collaboration and partnership.

III. CHNA Process & Timeline In 2011, Good Shepherd Hospital and nine other Advocate Health Care hospitals each convened a hospital-specific, hospital-based Community Health Council to conduct a comprehensive community health needs assessment (CHNA). The following chart describes the vision for a three-year process that when completed would result in the hospital’s having met the CHNA requirements of the Patient Protection and Affordable Care Act (PPACA).

Long Term Goal – Vision Phase I (2011) Site teams assess data, prioritize needs and establish plans.

Phase II (2012) Strengthen assessment through community engagement.

Phase III (2013) Assessment process in place to address needs and direct programming support, and metrics introduced to measure impact of programming.

Community Health Councils Review Data & Set Priorities In support of this vision and in alignment with Advocate Health Care’s standardized approach, Good Shepherd Hospital convened its Community Health Council to conduct its comprehensive CHNA. The Community Health Council is chaired by a Governing Council member of the hospital. The hospital’s community health leader provides leadership to the group which is comprised of representatives from the executive team, mission and spiritual care, trauma, cardiac center and business development and strategy. Community members serving on the hospital’s Governing Council were also recruited as active participants in the Community Health Council. Additional hospital staff and community representatives were added as the process evolved to fill in any Community Health Council gaps in expertise. The titles and affiliations of the Community Health Council’s members are provided below.

Good Shepherd Hospital Community Health Council Members • Senior Pastor, Lutheran Church of Atonement/Chairperson and Member, Good Shepherd Hospital Governing Council • Director, Community Relations, Good Shepherd Hospital • Vice President, Ambulatory Services and Operations, Good Shepherd Hospital • Soft Computer-IT Consultant (Hispanic Community) 4

• Education Consultant, Regional Office of Education, Lake County/Member, Good Shepherd Hospital Governing Council • President, Cornerstone Bank/Member, Good Shepherd Hospital Governing Council • Senior Pastor, First Congregational Church, Crystal Lake/Member, Good Shepherd Hospital Governing Council • Vice President, Mission and Spiritual Care, Good Shepherd Hospital • Fitness Director, Fitness Center, Good Shepherd Hospital • Director of Oncology, Oncology Department, Good Shepherd Hospital • Trauma Coordinator, Trauma Department, Good Shepherd Hospital • Dietician, Good Shepherd Hospital • Cardio-Pulmonary Manger, Cardiac Center, Good Shepherd Hospital • President, JMS-Marketing Consultations/Member, Good Shepherd Hospital Governing Council • Executive Director, Citizens for Conservation • Director, Population Health, Lake County Health Department • Public Information Officer, McHenry County Health Department • Director, Business Development, Good Shepherd Hospital Three of the hospital’s Community Health Council members attended two CHNA workshops hosted by the Advocate system that were designed to launch the process by educating them on how to conduct an assessment and how to find reliable data sources. Using both primary and secondary community health data, the team identified the hospital’s total service area key health needs and then employed a priority-setting process to determine key health needs on which to focus. This process included an examination of both the hospital’s and the community’s issues/challenges and assets, and discussions with external key informants to determine the potential for partnerships with other organizations and for sharing resources to address community need. The Community Health Council engaged in a comprehensive data review and strategic planning process to develop a three-year community health plan for 2012 through 2014 with the intent of conducting an annual review of community needs and making adjustments to the plan if necessary. Good Shepherd Hospital’s CHNA results and selected priorities were shared with the hospital’s Governing Council during each of the first two years of the three-year process, with full endorsement of the hospital’s community health plan by the Governing Council on July 15, 2013.

IV. Community Definition Service Area The hospital’s Community Health Council ultimately sets the direction for the community health initiatives within Good Shepherd Hospital’s total service area. For planning purposes, the Council defines the hospital’s community as the total service area (both the primary and secondary service areas combined), including the following zip codes: 60010, 60047, 60013, 60021, 60084, 60014, 60102, 60042, 60156, 60051, 60050, 60021 (primary) 60073, 60110, 60098, 60062, and 60067 (secondary). At times, the community of interest may be defined in different ways in order to evaluate more specific needs.

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Exhibit 1 – Good Shepherd Hospital Total Service Area Map

Communities Served Primary Service Area In 2012, the population of Good Shepherd Hospital’s Primary Service Area (PSA) totaled 309,151, which includes the following communities: Barrington

60010

Lake Zurich

60047

Cary

60013

Fox River Grove

60021

Crystal Lake

60014

Island Lake

60042

Wauconda

60084

McHenry

60050

McHenry

50051

Palatine

60067

Algonquin

60102

Lake in the Hills

60156

This population growth rate has been slowing in the past few years. The Council is currently awaiting the updated data from the census bureau. The Primary Service Area (PSA) has a high overall socio-economic level with a median household income of $91,118, which is 39% greater than the median household income for the six-county metropolitan Chicago area. Of the PSA total population, 4.2% is uninsured and 4.7% is on Medicaid as compared to 12.8% and 14.7% respectively for the six-county area. The community with the highest percent population that is uninsured and on Medicaid is Wauconda with 7.7% and 9.46%, respectively.

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Good Shepherd’s PSA is fairly homogenous with 86% of the population Caucasian, 8% of the population Hispanic and 4% Asian. Hispanics, however, comprise 10% of Crystal Lake’s population, 11% of the 60050 McHenry zip code population, 13% of Island Lake’s population and 18% of Wauconda’s population. While increases in minority populations will account for about 33% of the total population growth, the overall racial mix of the market will remain largely unchanged.

Secondary Service Area Good Shepherd’s Secondary Service Area (SSA) consists of the following communities: Crystal Lake

60012

Mundelein

60060

Round Lake

60073

Woodstock

60098

Carpentersville

60110

The SSA has a significantly lower overall socio-economic level than the PSA, with a median household income of $70,933 or 8.4% below the median household income for the six-county metropolitan Chicago area. Round Lake, Woodstock and Carpentersville all have median household income levels that are below the six-county levels. The SSA population includes 6.7% uninsured and 8.6% with Medicaid. Of the individual SSA communities, Woodstock has the highest proportion of the population who are uninsured at 8.6% and Carpentersville has the highest percentage of the population on Medicaid at 12.9%. Good Shepherd’s SSA population is more diverse than its PSA with 56% Caucasian, 35% Hispanic, 4% Asian and 3% African American. Carpentersville has the highest concentration of both Hispanics (49%) and African Americans (6%). Other diverse communities in the SSA include Round Lake for which 40% of the population is Hispanic and Mundelein with a 32% Hispanic and 10% Asian population. Exhibit 2 – Demographics – Good Shepherd Hospital Total Service Area Race/Ethnicity

2012 Population

% of Total

USA % of Total

White Non-Hispanic

414,680

73.6%

62.8%

Black Non-Hispanic

11,223

2.0%

12.3%

Hispanic

97,230

17.3%

17.0%

Asian/Pacific Is.

31,574

5.6%

5.0%

8,572

1.5%

2.9%

All others

Source: The Nielsen Company, 2012, Thomson Reuters, 2012

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Exhibit 3: Projected Population Trends 2012–2017 – Good Shepherd Hospital Total Service Area 300,000

Current Projected 250,000

Population

200,000

150,000

100,000

50,000

0

Ages 0–17

Ages 18–54

Ages 55–64

Ages 65+

Source: The Nielsen Company, 2012, Thomson Reuters, 2012 The hospital’s total service area has a higher population with college degrees than that of the U.S. average. (See exhibit 4 below.) Exhibit 4 – Education Level – Good Shepherd Hospital Total Service Area 2012 Adult Education Level

Pop. Age 25+

% of Total

% of Total – USA

Less than High School

17,941

5.0%

6.3%

Some High School

18,182

5.0%

8.6%

High School Degree

87,219

24.1%

28.7%

Some College/Assoc. Degree

100,231

27.7%

28.5%

Bachelor’s Degree or Greater

138,297

38.2%

27.8%

Source: The Nielsen Company, 2012, Thomson Reuters, 2012 The hospital’s total service area has a high overall socio-economic level with a significant number of households making over $100K annually. (See exhibit 5 below.) Exhibit 5 – Household Income Distribution – Good Shepherd Hospital Total Service Area 2012 Household Income

HH Count

% of Total

% of Total – USA

< $15K

9,357

4.7%

13.0%

$15-25K

10,273

5.2%

10.8%

$25-50K

35,703

18.1%

26.7%

$60-75K

40,960

20.8%

19.5%

$75-100K

34,041

17.3%

11.9%

Over $100K

66,817

33.9%

18.2%

Source: The Nielsen Company, 2012, Thomson Reuters, 2012 8

Health Resources Good Shepherd Hospital’s total service area has multiple health service providers, including hospitals, free clinics, federally qualified health centers (FQHC) and other private entities (not listed). Exhibit 4 shows the various types of providers and their location within the total service area.

Exhibit 6 – Healthcare Resources within Good Shepherd Hospital Total Service Area Name of Facility

Type of Facility

Location

Primary/Secondary Service Area

Advocate Good Shepherd Hospital

Hospital

Barrington

Primary

Centegra NIMC Hospital

Hospital

McHenry

Primary

Centegra Woodstock Hospital

Hospital

Woodstock

Secondary

Advocate Sherman Hospital

Hospital

Elgin

Secondary

St. Alexius Medical Center

Hospital

Hoffman Estates

Secondary

Northwest Community Hospital

Hospital

Arlington Heights

Secondary

McHenry County Health Center

FQHC

McHenry

Primary

Family Health Partnership Clinic

Free Clinic

Woodstock/ Crystal Lake

Primary

Mid-Lakes Community Health Center

FQHC

Round Lake Beach

Secondary

HealthReach Inc.

Free Clinic

Mundelein

Secondary

V. Data Sources Although Good Shepherd Hospital is located in Lake County, it resides approximately .25 miles from the McHenry County border. The majority of Good Shepherd Hospital’s patients originate from Lake and McHenry Counties; however, there are portions of Cook and Kane County in the hospital’s total service area. In order to more accurately reflect the hospital’s total service area, the hospital participates in and supports three community health assessments, all of which are conducted every three years at varying intervals. These health assessments include the McHenry County Health Coalition Assessment, the Healthier Barrington Coalition Assessment and the Lake County Health Assessment. The hospital sponsors and leads the Healthier Barrington Coalition which has conducted a household survey specific to the 60010 zip code area every three years since 1995. It has been administered in collaboration with Epidemiologist, Joel Cowen, MA, who specializes in community need assessments for health and human service organizations and who retired in 2011 from Health Systems Research, a Division of the University of Illinois, School of Medicine, Rockford. The household survey is comprised of questions relating to the perceptions of overall quality of life in the greater Barrington area as well as questions regarding specific health and social-emotional issues by household. Additionally, the hospital is on the steering committees for the McHenry County and the Lake County Health Coalitions; both of which conduct county-wide need assessments every three years. These two assessments include both primary data sources as well as secondary sources. Below is a list of all data sources used for Advocate Good Shepherd Hospital’s 2011–2013 Community Health Needs Assessment. Both the McHenry County and Lake County studies included data from the Behavioral Risk Factor Surveillance System (BRFSS), the Centers for Disease Control (CDC), and Census.

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Both counties utilized the MAPP (Mobilizing Action through Planning and Partnership) process for the development of the county-wide health need assessments and community health improvement plans. These assessments included a community analysis which was comprised of health behavior and disease prevalence data, focus groups, key informant interviews and household surveys. The steering committees of these groups engaged in lengthy strategic planning processes to evaluate data and determine priorities for health improvement for each of the counties. Good Shepherd Hospital is very much engaged in these county initiatives with several associates involved in work teams and program tactics. In addition, Good Shepherd Hospital also conducted its own Community Health Needs Assessment in 2013. This assessment looked at key health issues affecting members of its total service area. The information generated through this assessment and through the community studies and MAPP processes noted above generated a list of priority areas that will guide Good Shepherd Hospital’s community health strategies over the next three years. Data Sources Used in the Community Health Needs Assessment Source

Year(s)

Type of Data

McHenry County Healthy Community Study

2010

Primary and Secondary data

Lake County IPLAN

2009

Primary and Secondary Data

Healthier Barrington Needs Survey

2011

Primary Data

Advocate Good Shepherd Hospital Trauma Registry Data

2011–2012

Primary Data

Hospital Discharge Data

2010–2011

Primary Data

County Health Rankings

2011

Secondary Data

Hospital Transition Systems (TSI) (unidentified hospital patient data)

2010

Secondary Data

© 2013 The Nielsen Company, Truven Health Analytics Inc.

2012

Secondary Data

Centers for Disease Control (CDC)

2010

Secondary Data

Behavioral Risk Factor Surveillance System (BRFSS)

2010

Secondary Data

Links to Selected Data Sources 2010 McHenry County Healthy Community Study http://www.co.mchenry.il.us/home/showdocument?id=2837 (click here) Lake County IPLAN www.lakecountyil.gov/publications (click here) County Health Rankings, University of Madison School of Public Health http://www.countyhealthrankings.org/ (click here) Lake County MAPP Assessment Reports http://health.lakecountyil.gov/Population/Documents/Community%20Themes%20and%20 Strengths%20Assessment%20(CTSA)%20Report%20-%20version%208.1%20-%20FINAL%20 -%2008.30.2012.pdf (click here) 2011 Barrington Survey http://www.barrington-il.gov/Modules/ShowDocument.aspx?documentid=2192 (click here)

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VI. CHNA Findings The summary of findings is intended to provide some context for planning efforts, rather than comprehensive information on every relevant health indicator. This section provides an overview of the health status of Good Shepherd Hospital’s total service area based upon the primary and secondary data sources evaluated. As the hospital’s Community Health Council evaluated findings from the above sources, they also gave great consideration to priorities being addressed by partnering counties. Below is a summary of top priorities identified at the county level as well as through the Healthier Barrington Coalition. Given the hospital’s role as a stakeholder in these three community assessments, the hospital also wanted to be a partner in addressing needs identified through these various community assessments.

McHenry County Community Study/Primary Priorities • Information and Referral system • Access to care for low-income population • Access to mental health and substance abuse services • Obesity and nutrition

Lake County MAPP Strategic Priorities Vision: Achieving the highest level of health for all in Lake County • Coordination of Care: Access to a medical home, and behavioral health and coordinated network of care • Adequate and diverse public health system workforce • Emphasis on prevention and wellness • Reduction in health disparities; increase health equity

Healthier Barrington Coalition Priorities 2011 • Information and referral (connecting people with resources) • Access to dental services • Unemployment/economic pressures • Local transportation • Coordination of care for behavioral health services In addition to the key priorities identified in the community surveys, the Community Health Council also evaluated data within the surveys in relation to disease prevalence, hospitalizations and trauma data. The group felt this would help broaden the scope of data being evaluated. Below are some of the key findings.

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The ten leading causes of death in Good Shepherd Hospital’s total service area are: • Cancer • Heart Disease • Accidents (unintentional injuries) • Stroke • Chronic respiratory disease • Alzheimer’s disease • Kidney disease • Diabetes mellitus • Influenza and pneumonia • Suicide Sources: Mortality, Illinois Dept. of Public Health Vital Statistics: Lake County, 2003 – 2007; Lake County Health Assessment, 2010; McHenry County Health Assessment, 2010; Centers for Disease Control and Prevention, National Center for Health Statistics, 2009

The five leading causes of hospitalization in Good Shepherd Hospital’s total service area are: • Normal newborn deliveries • Gastroenterology related disorders • Orthopedics (lower extremities) • Infectious diseases • Dermatology (cellulitis) Source: Hospital Transition Systems, Inc. (TSI) Data, 2010

The four leading causes of trauma hospitalizations in Good Shepherd Hospital’s total service area are: • Falls • Motor vehicle accidents • Other • Burns Source: Good Shepherd Hospital Trauma Registry, 2011–2012

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Self-Reported Health Data for McHenry and Lake Counties: Condition

McHenry County

Lake County

High cholesterol

31.2%

33.6%

High blood pressure

28.1%

24.5%

Arthritis diagnosis

23.8%

2.2%

Asthma

15.5%

12.7%

Diabetes

5.4%

4.9%

Overweight adults

35.7%

35.1%

Obese adults

23.5%

19.8%

Smoker

19.8%

14.4%

Binge drinker

20.7%

15.4%

Source: Illinois Behavioral Risk Factor Surveillance System (IBRFSS) Lake County, McHenry County, 2007 (Note: All data and website links within this document were verified as of December 15, 2013.)

VII. Health Need Priorities Prioritization Process In addition to reviewing the data above, community experts were invited to present additional data. For example, the Lake and McHenry County Health Departments presented their IPLANs for addressing community health needs and the hospital trauma coordinator presented data on trauma admissions at Good Shepherd Hospital to the Community Health Council. The presentations led to a discussion related to falls among seniors age 65 and older. The Council agreed it was important to include community collaboration and partnerships as part of its priority-setting process. Many of the conditions that surfaced on the assessment are complex in nature and multifaceted, and would be best addressed by partnering with other community organizations. It would also be difficult to show impact if the hospital attempted to address these priorities on its own. In order to assist the strategic discussion, the criteria below were established and agreed upon to help narrow the focus. In its work to reach consensus, the Council brainstormed what potential needs might be addressed (top ten priorities) given the information reviewed and presented. Through brainstorming, the group first identified the top ten overall health needs and then applied the criteria below to select the top three priorities for the hospital to address. As mentioned earlier, the criteria below were established to help bring consensus and to establish a plan that could be more impactful. Criteria for selection: • Focus on a vital few priorities rather than many • Must be able to show measurable results • Must have available resources to address the issue (may include community partnerships) • Have three-year horizon for goal setting The Community Health Council developed the following list of priorities based on information presented, experiences in the community and the data sources evaluated by the Council.

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Top Ten Priorities 1. Cholesterol and heart disease 2. Dental health 3. Falls among seniors 4. Diabetes 5. Mental health 6. Bilingual literacy 7. Obesity (childhood, adult) 8. Motor vehicle accidents (youth focus) 9. Cancers (prevention, education) 10. Substance abuse Following application of the criteria for selection and significant discussion and consideration as part of the selection process, the Community Health Council agreed on the following primary and secondary community health priorities (below). Falls among senior was relatively new and a very significant risk to the elderly population especially over the age of seventy. The hospital had been working with area schools for some time and the group felt that obesity was a leading indicator of many diseases and therefore the hospital should remain focused on this priority. In addition, cancer continues to be a leading cause of death and a health priority the group felt could be addressed through ongoing education and awareness.

Health Needs Selected to Address The top three priorities for Good Shepherd Hospital to address are: • Falls among seniors • Obesity • Cancer (prevention and early detection) The Community Health Council used the following rationale in determining the top health needs to address.

Falls Falls among seniors (age 65+) is by far the most common risk factor for trauma hospitalization at Good Shepherd Hospital. Falls in many cases are preventable. The hospital was already involved in initiatives to address falls with the Lake County Health Department but felt a greater emphasis on this program would help expand the scope and reach more seniors living in the community. Addressing falls was well-aligned with the above criteria and the Council was confident the hospital could make a positive impact in this area.

Obesity Obesity trends in both Lake and McHenry counties continue to rise. Good Shepherd began addressing childhood obesity through school partnerships with outcomes demonstrating effectiveness in increasing nutrition knowledge and improving fitness. The hospital had been working with schools since 1998 to address obesity and this issue was also in alignment with the criteria set by the Council. The hospital had already been showing impact through improved nutrition scores and fitness testing and the Council felt strongly the hospital should continue to expand its programming and partnerships in this area.

Cancer Cancer is the top cause of death in the Good Shepherd Hospital total service area and often a preventable cause of death. Many cancer deaths can be avoided or delayed through lifestyle changes and early detection. Initiatives around the most common causes of cancer (lung, breast, colon, skin) were selected as being top priorities for implementation. The Community Health Director also consulted with the Cancer Committee at Good Shepherd Hospital to confirm that these, in fact, were areas that would be beneficial to community members. Again, these initiatives aligned with the rationale and criteria determined by the group. 14

Ongoing Health Priorities Although the Council was in agreement that the three priorities above would receive significant resources, the hospital has existing programs and partnerships that have addressed mental health, heart disease (diabetes and cholesterol) and teen health.

Mental Health Data also identified mental health needs as a continuing health issue for the service area. Although Good Shepherd Hospital does not offer direct services for mental health patients, the hospital will continue to be involved in collaborative efforts with community organizations as well as providing support for preventative efforts.

Diabetes/Cholesterol/Cardiovascular Disease Diabetes and cardiovascular disease continue to be a major concern for the community. The hospital has developed a strong community outreach program offering free and reduced screenings. The Community Health Council has decided to continue to offer screenings, targeting follow-up with individuals whose diabetes screening results show risk factors.

Teen Health Due to the fact that the major cause of death and injury for young adults is motor vehicle accidents, the Council wanted to also continue to educate youth regarding safe driving habits. Other teen health issues that will continue to be addressed through outreach and prevention education are appropriate use of bike helmets and skin cancer prevention.

Health Needs Not Selected to Address The Council used the established criteria to help decide what issues could best be addressed through the hospital’s efforts. Issues affecting health which were not chosen as priorities include literacy, substance abuse and dental needs. Although literacy is a significant quality of life indicator, the hospital does not have adequate resources or expertise in addressing this need. Substance abuse surfaced as a need as well but it was determined that several community groups had been formed to address this issue at a very local level. For example, several Behavioral Health agencies had initiatives to address substance abuse as did many area schools. The Council felt that it would be difficult and not within the scope of the hospital to address dental health. The hospital has no direct services and all agreed resources could be used more appropriately on other initiatives. There were also some existing tactics at both the Lake and McHenry County level to address dental needs. The group also felt that some of the identified needs did not fall into the framework established by the Council. For example, the hospital does not have the resources or expertise to address transportation or joblessness. In addition, many of the needs are being served by other community groups or government agencies. It was thought that through the hospital’s partnerships and coalitions, they could support some of the community initiatives addressing these needs. For example, the hospital would be willing to partner and support the local career center and work with the local United Way organizations on securing the 2-1-1 information and referral system for the area. Good Shepherd is specifically working with the Barrington Area United Way to fund 2-1-1 for the 60010 zip codes and also is working collaboratively with McHenry County United Way for 2-1-1 McHenry County. This system will help link local human services with people in need. Through the Healthier Barrington Coalition, the hospital is trying to partner with local dentists and the Illinois Dental Society to address the growing dental needs in our area. These are all vital aspects to having a healthy community and the hospital wants to collaborate as much as possible in improving the health status of the hospital’s community.

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VIII. Overview of Planned Program Interventions Good Shepherd Hospital is a vital part of the community, serving the health needs of individuals, families and communities through a wholistic philosophy of care. The hospital’s dedication to community health continues through its partnerships with community-based organizations, community leaders, government officials, health departments and the faith community. Good Shepherd Hospital has been leading healthier community initiatives since 1995 in the Barrington area through the Healthier Barrington Coalition and since 2000 in Wauconda through the United Partnership for a Better Community. In addition, the hospital participates in and supports efforts by both the McHenry County Health Department and the Lake County Health Department through leadership and financial support in order to assess and address community health needs through their Mobilizing Action through Planning and Partnership (MAPP) efforts. The following is the specific plan developed by Good Shepherd Hospital’s Community Health Council which outlines the programs and efforts the hospital will implement to help address the selected needs. Programs selected to address each initiative are evidence-based and include input from clinicians and/or experts in the appropriate field. In addition, each initiative has specific goals, targeted outcome measures, a dedicated budget and designated internal hospital resources.

Primary Priorities At each Community Health Council meeting, these initiatives and outcomes are discussed and evaluated. Good Shepherd Hospital’s implementation plan includes the following:

Falls among seniors Matter of Balance, another evidence-based program, was selected to address falls—particularly in the senior population. Matter of Balance was developed by Maine Health and has been proven to be an effective tool in addressing fall risks among senior populations. Initially Good Shepherd Hospital implemented a professional trainer model, however, the hospital experienced some implementation challenges. In 2011, the hospital moved to a lay coaching program which has been more effective. By using trained volunteer coaches, the hospital has been able to offer more classes in the community and reach a greater number of seniors. Participants are measured on their perception of decreasing their fall risk (controlling their environment) and increasing their physical stability through exercise. To date, over 15% of all participants improve in these two areas after taking the class.

Obesity The Coordinated Approach to Childhood Health (CATCH) program will be implemented to address childhood obesity. This is an evidence-based program developed by the University of Texas. The CATCH curriculum is paired with Fitness Gram; another evidence-based program from Human Kinetics. Together these programs address nutritional education and habits along with fitness testing for students twice per year. Data will be collected on both nutrition and fitness levels in the fall and spring and results will be compared to monitor improvements.

Cancer Cancer continues to remain a leading cause of death in the Good Shepherd community with breast, colon, lung, prostate and skin cancer being most prevalent. Lung cancer is still the leading cause of cancer deaths and is preventable in most cases. With input from the hospital cancer committee and consulting oncologists, the Council felt the hospital could have impact through continued education and awareness on prevention of these cancers, as well as screening recommendations. The Council also felt that screening guidelines should be in alignment with the U.S. Preventive Services Task Force (USPSTF) which is an independent group of health experts conducting research and making recommendations on health screenings.

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Secondary Priorities Diabetes (heart disease) The Council endorsed a new approach to addressing cardiovascular disease which involves diabetes screenings at the community level and would focus on regular screenings (quarterly) rather than episodic screenings. In the past, the hospital offered glucose and cholesterol screenings to the general public but there was no follow up on whether patients were improving their risk factors. By implementing quarterly screenings, patients could consistently check their progress toward improvement. The goal would be to target and measure the return rate of those individuals with risk factors. This would require a database of patients’ risk factors so results could be logged and measured over time to track improvement. This database would be built by the hospital and allow health educators to secure and track the patients’ results over time. The hope is to help those who have high risk factors for developing diabetes to manage those factors early enough so the disease does not progress. The long-term plan is to incorporate cholesterol along with glucose and A1C levels into the screenings in year two. Because both diabetes and cholesterol are significant risk factors for heart disease, the Council wanted to take a very specific approach where patients return for follow up to re-check results and address any barriers to successfully managing their risk factors. These screenings would be offered at a very affordable rate and promoted to the general community.

Youth Mortality Mortality among youth remains a health risk for young persons in the community and the Council wanted to remain committed to addressing this need. Operation Click is an example of a community partnership program which addresses the risk for youth motor vehicle fatalities. This program has been expanded from 3 schools to 33 schools through the commitment and support of Good Shepherd Hospital. Peer-topeer education focuses on increasing seat belt compliance and reducing both texting and driving, and driving under the influence. Good Shepherd has been working with Operation Click since its inception in 1998 and the Council felt that support for this program should continue at this time. Operation Click has been impactful and has documented improvement in seat belt compliance with average compliance rates moving from 79% to 98% in pre and post surveys. The Council felt this remains an important initiative in addressing mortality among our community’s youth. The hospital has been active on the board of directors, provides funding for their annual banquet and recently provided funding so the organization could hire a part-time program coordinator for 24 months. The seed funding will allow the coordinator to develop a funding stream for sustainment of Operation Click in the future.

Mental Health The Community Health Council set targets for collaboration and integration with community groups to help address behavioral health needs. The Healthier Barrington Coalition developed a Mental Health Task Force to help determine the most pressing needs and how the community might better collaborate to meet those needs. Good Shepherd Hospital will be developing a ‘well-being’ community survey to assess some of the most pressing behavioral health needs in the community. In addition, the hospital is providing complimentary space at two Advocate facilities to two behavioral health providers in the community.

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IX. Vehicle for Community Feedback Thank you for reading this CHNA Report. If you would like to provide comments to us related to the contents of this report, please click on the link below. http://www.advocatehealth.com/chnareportfeedback If you experience any issues with the link to our feedback form or have any other questions, please click below to send an email to us at: [email protected] A paper copy of this report may be requested by contacting the hospital’s Public Affairs and Marketing department.

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450 West Highway 22 Barrington, IL 60010 847.381.0123 advocatehealth.com/gshp