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Community Health Needs Assessment

Cochise County CHA 2017 Report 

Cochise CHA Appendix A 2016 2017

Cochise CHA Appendix B Community Survey 2016

Cochise CHA Appendix AHCCCS utilization heat maps

 

A.   A definition of the community served by the hospital facility:

Benson Hospital defines their service area as the entire San Pedro Valley Hospital District (SPVHD), and areas within a 25 mile radius of the hospital that extend into Pima and Pinal counties. The SPVHD is a geographical area of approximately 1,100 square miles in the northwest corner of Cochise County. It contains the communities of Benson, St. David, Pomerene, Cascabel and Dragoon. Two main areas fall within the 25 mile radius, but outside the boundaries of the District. The J-6/Mescal area extends into Pima County. It is visualized as an area along I-10 going west some 20 miles from the Cochise County line. Another area extends north of Cascabel along the San Pedro River into Pima County, then into Pinal County. Collectively, the SPVHD and the J-6/Mescal and Cascabel extensions comprise the Benson Hospital service area. This region was founded as a mining and transportation center in the late 1800’s. It is high desert, with mountains, grasslands and native succulents predominating. Spread over the entire district the population density is about 17 persons/square mile. The City of Benson has a population density of about 135 persons/square mile. This is a rural setting. The Benson division in the map below approximates the SPVHD.

CHNA

 

An additional consideration of the community served by Benson Hospital involves input received from Mrs. Ashley Dickey, HR/PR Director of Benson Hospital. Mrs. Dickey indicates that ER usage has increased by 3% due to usage by patients coming from Whetstone, Huachuca City and Tombstone. This increase is in addition to a 15% general increase in ER visits over the previous two years. It is assumed that Benson Hospital’s service area is expanding, possibly due to a net positive effect of television advertising, website improvements, goodwill garnered from the Service Recovery program and resulting increased customer satisfaction.

 

B.   Demographics of the Community:

The SPVHD area has been estimated by the Benson Hospital Strategic Planning Committee to contain approximately 16,500 people. The J-6/Mescal and Cascabel extensions are estimated to add 1,500 people for a total of 18,000. Although the U. S. Census gives a population of 12,500 for this area, the Committee’s estimate includes winter visitors who are not counted by Census methods. The City of Benson estimates that winter visitors swell the local population by around 30%. Ephemeral traffic on I-10, SR 90 to Sierra Vista and US 80 to Tombstone and Bisbee comprise an unknown impact on the service area population. Previous proprietary demographic studies of the Benson Area (e.g. Claritas) have estimated service populations to be as high as 22,000 – 25,000. It is assumed that the unknown impact of traffic is responsible for the higher numbers.

The racial makeup is comprised of 91% White, 1% American Indian, 1% Black, 1% Asian/Pacific Islander, 6% Other. The U. S. Census Bureau considers Hispanic an ethnicity, not a race; for this reason there is no separate racial classification for Hispanics. If there were, the Hispanic portion of the area would be around 30%. The SPVHD population is expected to grow approximately 2%/year into the indefinite future.  As development of the El Dorado project picks up, population growth in the area may considerably surpass the 2% projection.

The SPVHD age distribution is 21.4% under 20 years of age, 21.4 % between 20 and 44, 30.1% between 45 and 64, and 27.1% over 65. Almost one third of the population is Medicare age, which has implications for health care planning. The median age of the area is approximately 50. This is rather higher than both Cochise County (37), and the State (34). Males and females are approximately 50/50%.

graph

In 2012, according to the Center for Economic Research, Cochise College (CER), SPVHD median household income was $38,290. This was considerably lower than that for the County ($44,000), the State ($53,000), and the Nation ($55,000) at the time. Not surprisingly, unemployment in the area was higher than in other localities. CER estimates showed unemployment hovering around 13%.

Cost of living data (100% = parity with reference cost of living), also from the CER, showed economic trends in the SPVDH over the 4 year period previous to 2011:

Grocery items                   100.5 %
Housing                             100.3 %
Utilities                                97.5 %
Transportation                 102.9 %
Health Care                         97.8 %
Goods/Services                   95.5 %
Composite Index          99.1 % (overall)

In 2015, The CER reports that median household income for the SPVHD has risen to $41,371, and that unemployment has fallen to 9.4 %.

Cost of living data for the 4 year period previous to 2015:

Grocery items                       94.7 %
Housing                                 93.6 %
Utilities                                102.8 %
Transportation                   102.6 %
Health Care                           96.5 %
Goods/Services                    98.1 %
Composite index          98.0 %   (overall) 

 

The economic picture for the SPVHD has improved. The cost of living has been reduced by 1.1 percentage point over the past few years, while the median income has risen 9 percentage points.  Additionally, unemployment has decreased 3.6 percentage points.  Healthcare spending, however, has decreased slightly.

Local traffic counts are impressive.  Around 28,000 vehicles pass by SR 90 daily.  About 10,000 vehicles exit at 302 on to SR90, 2,000 exit daily at 303 into Benson, 2,000 exit daily on to Ocotillo St. and 1,000 exit daily on to 306 going to Pomerene and beyond, along the previously mentioned Cascabel extension.  About 16,000 vehicles travel through Benson daily.

In general, the area is poised for economic growth once the state and national economies improve.  Developers have long viewed the area as a vital link between Tucson to the west, Sierra Vista/Ft. Huachuca to the south and San Manuel/Mammoth/Oracle to the north.  The availability of land,   major transportation corridors (I-10, SR90 and US80), and industrial potential at the Benson Municipal Airport, make the area attractive for both residential and commercial development.  The portion of I-10 that traverses the SPVHD is the most heavily travelled segment of highway in the County.

Housing development in the Benson area has been slow.  Since 2012, eight new housing units were started – two single family homes and six manufactured homes. The median home price is $73,000, down from $151,000 in 2009.  Benson has a higher rate of foreclosures than does Cochise County generally.  Data from Benson City Planning suggests that in spite of positive economic indicators, housing has remained stalled.  However, housing may well improve dramatically with the impending development of El Dorado’s “Villages at Vignetto”, a proposed 20-year, 28,000 housing unit project to be built along SR90 within Benson city limits.  El Dorado expects to begin housing construction in 2016, building 2,000 units/year, according to demand.

 

C.   Existing health care facilities and resources within the community that are available to respond to the health needs of the community:

Benson Hospital: Benson Hospital was built with Hill Burton funds in the early 1970’s. Benson Hospital is a Rural Critical Access Hospital intended to serve the population of the SPVHD. The hospital is licensed to operate 22 acute care beds, all of which are designated as swing beds. In 2007, the emergency room was expanded to 3,000 square feet to include eight beds, secured admitting and an isolation room with separate entrance. The emergency room is continuously staffed with a physician and ancillary personnel. Approximately 23 patients/day are seen in the emergency room.

Benson Hospital houses a full service medical laboratory, radiology services that include CT, MRI, Ultrasound, Mammography and Densitometry, and rehabilitation services that include Physical Therapy, Occupational Therapy and Speech Therapy.

Other services include extensive outpatient infusion therapy, wound care, blood transfusions, anticoagulation therapy, antibiotic therapy, therapeutic drug monitoring, skilled nursing swing beds, hospice care, and nutritional counseling. Four of the 22 beds are equipped with cardiac monitors. Benson Hospital has an average inpatient census of five – six patients/day.  The Laboratory, Imaging, Rehabilitation, Occupational Medicine, Respiratory Therapy and Outpatient Treatment departments combined see around 90 outpatients/day. Benson Hospital has 145 employees.

Benson Hospital has recently moved Rehabilitation Therapy into a newly renovated, 5,000 square foot facility approximately one mile from the hospital at 500 S. Highway 80, Suite B, Benson AZ. This facility is newly furnished and represents over twice the previously available space for rehabilitation services.

The vacated rehabilitation space is being considered for gastroenterology service, one of the prioritized strategic elements identified by community survey and hospital planning as an important need in the area.

Southeast Arizona Behavioral Health Services Psychiatric Health Facility (PHF): SEABHS/PHF was built next to Benson Hospital in the 1990’s to meet the mental health needs of southeast Arizona. The inpatient facility is no longer in operation, and the outpatient branch has moved to 610 Union St. in Benson, operating as a day program for mental health and wellness.  They see about 20 – 25 patients/day and employ 35 people.

Community Bridges: Community Bridges has taken on an expanded role in the community, operating inpatient and outpatient programs out of the old SEABHS/PHF complex adjacent to Benson Hospital. They provide mental health services which include detoxification for inpatients and medication assistance, stabilization and maintenance for outpatients. CB is dedicated primarily to substance abuse and detoxification with 24 beds, 30 employees and a census of around 15 patients/day.

Arizona Counseling Treatment Services: A mental health organization which provides crisis services, group treatment and other outpatient services. The Benson branch has 15 employees and sees approximately 30 patients per day.

Healthcare Innovations (HCI) is the local ambulance service located adjacent to the Benson Hospital. This facility houses three fully-equipped ambulance units operated by emergency service technicians, half of whom are Emergency Medical Technician (EMT’s) and half paramedics. Each emergency run involves one ambulance with two technicians, typically an EMT and a paramedic. The facility receives over 345 calls/month. About 260 of those calls result in a run. Approximately 67 of the monthly runs are to deliver patients to Benson Hospital’s Emergency Room. HCI has 33 employees.

Good Samaritan Society-Quibiri Mission Nursing Home: This is a 60-bed skilled nursing center dedicated to long-term health care and offering supportive medical services to its clients. Such services include inpatient therapy, skilled care, respite care, rehabilitation, memory care, and other modalities. Quibiri Mission has 80 employees and an average census of 50 patients/daily.

Cochise County Health Department: Cochise County operates a health department in Benson intended to serve the local population. The office has services that offer teen pregnancy prevention, health education, tobacco prevention, nutrition, active adult services, Healthy Start, immunizations and nursing. There are four staff members in the Benson office, servicing around eight people per day.

 

Additional ambulance services: Whetstone Ambulance has 16 employees and conducts around 76 runs per month, about eight of which come to Benson Hospital.  Elfrida Ambulance has 17 employees and conducts around 29 runs per month, about one of which comes to Benson Hospital.  Sunsites Ambulance  has 22 employees and conducts around 21 runs per month about two-three of which come to Benson Hospital.

 

Local Chiropractors:

  • Dr. Lalond – this office sees 20-30 patients per day and has three employees.
  • Dr. Burdett – this office sees 10-15 patients per day and has two employees.
  • Dr. Judd – this office sees five-ten patients per day and has three employees.

These local chiropractors have but a small impact on Benson Hospital. Review of referrals to radiology shows only one or two patients per month having been sent from chiropractors.   The rate of referral to rehabilitation from local chiropractors is nil.

 

Local area physicians include:

Progressive Healthcare Group:
This practice includes two MD’s and a mid-level provider. The practice sees approximately 50 patients/day. There are 15 employees at Progressive Healthcare.

San Pedro Medical:
This practice includes two MD’s and three mid-level providers. The practice sees about 60 patients daily. There are 18 employees at this practice.

Dr. Barbara Hartley:
Dr. Hartley practiced in Benson for several years.  She now serves as a hospitalist at Benson Hospital approximately two weeks/month.

Dr. Thomas Pettinger:
Dr. Pettinger is the sole provider in his practice. He sees around 15 patients a day, three days per week. There are three employees at this practice.

Rex Heaton:
Rex Heaton is a Family Nurse Practitioner doing occupational medicine at Benson Hospital.  He sees around two to three patients daily and assists in the ER as needed.  Rex manages outpatient services, overseeing wound care and IV infusion therapy, and serves as a back-up provider to patients who do not have primary care physicians.

 

Local Dentists:

Benson Dental:  This practice has two dentists, 12 employees and sees about 35 patients/day.

Brett Clerc:  This practice has one dentist, five employees and sees about 27 patients/day.

 

Specialty Physicians:

 There are nine specialty physicians who travel to Benson to hold clinics:

 

Dr. Klein, Orthopedic:                 Clinic twice monthly, with two employees and ~15 patients/ day.

Dr. Goldfinger, Cardiology:        Clinic once monthly, with two employees and ~15 patients/ day.

Dr. Myer, Cardiology:                 Clinic once weekly with four employees and ~25 patients/ day.

Dr. Boyella, Gastroenterologist: Clinic twice monthly with two employees and ~15 patients/day.

Dr. Hamilton, Podiatry:               Clinic twice monthly with two employees and ~15 patients/day.

Dr. Montes, Podiatry:                  Clinic twice monthly with two employees and ~15 patients/day.

Dr. Walshaw, Nephrology:          Clinic twice monthly with two employees and ~15 patients/day.

Dr. Untch, Orthopedic:                Clinic twice monthly with two employees and ~15 patients/day.

Dr. Favre, General Surgery:       Clinic twice monthly with two employees and ~15 patients/day.

Among the above stated specialists, Drs. Myer, Montes, Walshaw, Untch and Favre hold clinics on the Benson Hospital campus.  The remaining specialists see patients at local practices.

Looking at the provider-to-population ratio, we see 11 local physician/mid-level providers and nine specialty providers available to provide for a population of about 18,000 in the SPVHD. Recalling that patients are coming to Benson Hospital from surrounding areas, we add 540 (the 3% cited earlier who are coming from surrounding areas to the Emergency Room) individuals to the population and estimate the provider-to-population ratio to be 20:18,540, or, approximately one provider for every 927 people.

In total, there are now about 483 health care workers and 600 people daily who have some type of healthcare encounter in the Benson area. Of those 483 healthcare workers, three are local chiropractors, six are local physicians, five are mid-level providers, nine are specialty physicians who come to Benson either bi-weekly or monthly and two are local dentists.

 

D.   How the Data was Obtained:

This assessment utilizes a Delphi approach to data collection/interpretation. Direct interviews of the people and organizations on the front lines of health care in the district were the primary sources of information. In some cases, public information such as the U. S. Census and other demographic sources have been used. Existing studies have also used. To a considerable extent, previous work done by the Benson Hospital Strategic Planning Committee has driven this assessment. Gary K. Maluf, Ph. D. is the principal author; he will gladly provide a list of sources upon request. Dr. Maluf also assumes responsibility for any omissions/inaccuracies.

The individuals and agencies selected for interview were calculated to provide a representative cross-section of the local medical field. By extension, they are also expected to represent the array of area patients and knowledge of their health care needs. Included in this group was the head of a local medical practice that has over 10,000 active charts. This individual is an MD, MPH with over 30 years practice experience. The practice sees approximately 30% Medicare, 30% Medicaid, 30% Private Insurance and 10% Self Pay patients. Another physician interviewee has a local practice in Family Medicine, a broad range of patient types and many years in the community. A former County Health Nurse, and current President of the hospital Governing Board, was interviewed to add longitudinal depth to the study. Professionals from the Southeast Arizona Behavioral Health facility and from Community Bridges were interviewed to provide the perspective for mental health. The Area Manager for the local ambulance service was interviewed for demographic information regarding emergency healthcare events. Overall, these resources have served to provide a useful reference panel to inform this needs assessment. As the study progresses, additional resources will be identified to strengthen this assessment and help frame implementation strategies.

 

E.   The Health Needs of the Community:

 

The health needs of the SPVHD population predominantly reflect those of a mature demographic. Recalling that the median age is around 50, health needs associated with chronic illness prevail. Health care needs are derived by historic demand, from previous studies and by expert opinion. Historic demand is reflected in the following lists.

Top 5 reasons for seeking medical help:

San Pedro Medical:
1. Diabetes  2. Hypertension  3. Respiratory  4. Arthritis  5. Mood Disorder

Progressive Healthcare:
1. Hypertension  2. Diabetes  3. Respiratory  4. Arthritis  5. Mood disorder

Benson Hospital ER:
1.Bronchitis  2. Chest pain  3. Lumbago  4. Urine infection  5. Limb pain

Benson Hospital Admission
1.Pneumonia  2. Physical Therapy  3. Urine infection  4. Congestive heart failure             5. Chronic obstructive bronchitis

Benson Hospital Outpatient:
1. Atrial fibrillation  2. Anticoagulant therapy  3. Hypertension   4. Diabetes  5. Limb pain

SEABHS/PHF/Community Bridges
1. Schizophrenia  2. Schizoaffective disorder  3. Mood disorder  4. Psychotic Disorder 5. Depression

Quibiri Mission:
1. Dementia  2. Diabetes  3. Cardiac  4. Orthopedic  5. Stroke

Cochise County:
1. Immunization, child  2. Immunization, adult   3. WIC   4. Family planning  5. STD/HIV testing

Top Five Reportable Diseases Reported to County:

  1. Influenza
  2. Hepatitis
  3. STD
  4. C. Diff
  5. Campylobacter

In 2004, Benson Hospital commissioned a study done by FMR Associates of Tucson to determine Benson Area residents’ perceptions of health care quality and future needs.  The image of the hospital was mostly positive, with ER, Cardiac, Rehabilitation and MRI perceived as needing to be expanded.  Various hospital services were ranked, with Housekeeping, Nursing and Laboratory being the highest ranked services.  The hospital’s strengths were a convenient location and caring and concerned staff.  Weaknesses were dated equipment and inadequate community involvement.  A heart specialist was the type of doctor most residents wanted to have available, followed closely by orthopedic medicine.  It must be emphasized that the FMR study was primarily for image.  Moreover, the respondents were drawn from the Benson Area, not from the entire SPVHD.

In November-December, 2013, Benson Hospital arranged for a community survey to focus on perceptions of healthcare. This survey was conducted by Houston Partners International Inc., and was designed to more closely approximate the San Pedro Valley Hospital District population’s opinions. This survey identified several areas of concern: more specialists needed (cardiac, ob/gyn, orthopedic, gastroenterology, surgery, pediatrics), more primary care physicians, dental/hearing/vision services, senior care and urgent care. These concerns are being addressed by Benson Hospital and are being prioritized through the Strategic Planning process.  This survey showed a 20% higher rate of preference satisfaction for Benson Hospital than did the survey conducted by FMR in 2004. Moreover, familiarity with Benson Hospital increased by 13% over the 2004 survey.  In a concluding statement, the survey observed that the SPVHD is highly satisfied with healthcare generally and largely satisfied with hospital experiences.  Based on comments elicited during the survey process, there is clearly an opportunity to enhance the capabilities and image of Benson Hospital.

Expert opinion has been obtained from five health care professionals with extensive experience in the SPVHD.  Lois Turner, RN, is ER Supervisor at Benson Hospital. Ms. Turner cites the need for medication drips for inpatients at Benson Hospital. Cardizem and heparin are particularly important in this regard. She also states that more critical patients need to be admitted to increase utilization. Ms. Turner believes that increasing clinic specialties such as cardiology and gastroenterology would help with admissions. Turner indicates that difficulty admitting unstable patients to other facilities is a factor in physicians’ decisions to utilize Benson Hospital first.

Mrs. Amanda Osuna, RN, BSN is Charge Nurse at Benson Hospital. Mrs. Osuna has 6 years’ experience in the delivery of health care to the SPVHD population. She believes there are a limited number of primary care physicians in the area, many of whom do not accept AHCCCS. This results in more individuals seeking care in the emergency setting. She also feels there are limited resources of health education and preventative screenings such as mammograms and colonoscopies. Mrs. Osuna points out that appointments for immunizations at the Benson area County Health branch are limited to two days a week.

Regarding disease, “Many residents are admitted to the hospital with respiratory complications, such as COPD and pneumonia. The ER sees many dental problems, perhaps from lack of regular check-ups and poor hygiene. One reason the hospital sees adults with dental problems is that AHCCCS will not pay for fillings, only to have teeth pulled. There are also many elderly people with fractures from falls who end up needing rehabilitation for weakness. Many of these individuals live alone, or are cared for by an elderly spouse.

Mrs. Teresa Vincifora, RN, BSHCA is Chief Clinical Officer at Benson, and brings a deep understanding to this assessment process following many years in positions of responsibility in health care. She points out that rural residents are poor, with less access to health care. Some of these people may have lesser insurance coverage than the usual big contractors such as United Healthcare, Blue Cross/Blue Shield, etc. Benson Hospital would do well to increase contracts with other insurance carriers to reach out to these people.

Mrs. Vincifora also believes that Benson Hospital needs to educate staff to current needs and trends important to patients and health care delivery. She suggests the hospital devote more resources to education and training of staff. This is an important aspect of meeting the needs of the health care population. Additionally, she would increase the quality of care to patients as measured by performance indicators. This would improve Benson Hospital’s reputation for quality care and serve to attract more health care personnel as well as attract insurance contracts which cover the local population. Her observations are based on studies published in “The Internet Journal of Allied Health Sciences and Practice” and “Health Care Financing Review”, both peer-reviewed journals; and on a working paper from the University of Minnesota Rural Health Research Center.

Dr. Barbara Hartley, MD was in family practice in Benson. She is also the Chief of Staff of the Medical Staff at Benson Hospital. Dr. Hartley brings a profound level of experience and understanding of health care to this assessment. She thinks that the health needs assessment process should be looking more to the short-term than long-term. Dr. Hartley observes that several department heads at Benson Hospital are approaching retirement. Of the physicians in practice now in the Benson area, three are in their 60’s and will probably not be practicing much longer. This, of course, impacts physician recruiting efforts, and Dr. Hartley observes that Benson Hospital may be the only entity with sufficient resources and motivation to pursue recruitment.

Dr. Hartley also believes that a clinic, such as the one recently discontinued, may be an issue to arise again.

The following is a verbatim reproduction of some of Dr. Hartley’s recommendations: “A major challenge in continuing to meet the health care needs of this community, and a limiting factor in how much the hospital has to invest in primary care and expansion of its services, is the declining reimbursement from both Medicare and AHCCCS. The majority of the hospital’s income comes from these programs, and it remains to be seen how the health care reform issue is going to play out, politically, and what the final landscape looks like.”

Dr. Hartley continues: “As far as the needs of the uninsured, low-income people and minorities, this community is more in need all the time of a true community health center.” Dr. Hartley goes on to suggest that the Benson Hospital may wish to align with an existing community health center.

Ann Cook, RN, is a retired County Health Nurse, and is President of the Benson Hospital Governing Board. Mrs. Cook is pleased that the rehabilitation department has been expanded in size and scope, citing the many needs of orthopedic, occupational, speech, and other patients in the SPVHD.  She states that wound care and other services provided by outpatient nursing personnel are invaluable to the community

 

F.   Primary and Chronic Disease Needs and Other Health Issues of Uninsured and/or Low-Income Persons and Minority Groups:

 

The SPVHD serves residents who are uninsured, low-income and members of minority groups.  The demographics of the community identified a significant age distribution, with “almost one third of the population being Medicare age.”  In the adult population, obesity, cholesterol monitoring, blood pressure, diabetes, substance abuse, and mental health issues are prominent.  Among young residents, substance abuse, obesity, mental health issues and sexually related issues are prominent.  Among children in the area, child abuse, obesity and mental health issues are prominent.  To some extent, dental care issues can impact all ages.

 

G.   The process for identifying and prioritizing community health needs and services to meet community health needs.

 

The Strategic Planning Committee uses information gleaned from, among other sources, Medical Staff minutes, Long-Range Planning Committee findings, patient survey results, Quality Assurance Committee minutes, Department Head meeting minutes and community surveys to identify and prioritize community health needs and services.

In April of 2013, the Strategic Planning Committee (SPC) hosted two retreats. The first retreat included the Department Heads at Benson Hospital, and the second retreat convened the Governing Board, the Medical Staff and other interested community members. A summary of this needs assessment was presented to these groups to obtain suggestions and recommendations for prioritizing the health needs and services to the community. Several such suggestions and recommendations were garnered and studied at a subsequent meeting of the SPC.

The SPC is presently in the process of identifying and prioritizing these community health needs, and expects to prepare a list for future development and implementation. In a future iteration of this assessment, the committee will give a prioritized description of the health needs, along with a description of the processes and criteria used in their development. Potential measures and resources to address these needs will also be identified.

The strategic planning process has identified five areas of focus: 1. Physician collaboration, 2. Marketing, 3. Quality and value initiatives, 4. Expansion of current services and adding services, 5. Capital formation.  These areas of focus have been adopted by the Board of Directors and include a number of tactical initiatives included in each category.  Several times each year, the plans are updated and reviewed by the Strategic Planning Committee.  It is anticipated that a completely refreshed Strategic Plan will be in place for October of 2015 through mid-2016.

 

H.   The process for consulting with persons representing the community’s interests:

 

We are expecting to hold several community briefings to seek community input.  In addition, we are working with the Chamber of Commerce and the Economic Development Committee of the City Council to establish avenues of communication.  Finally, our key staff are involved with the County Health Department, which conducts regional needs assessments.

 

I.   Information gaps that limit the hospital facility’s ability to assess the community’s health needs:

 

The lack of an accurate and reliable population in the SPVHD is an information gap. Also, lack of a true understanding of the extent to which I-10 and SR 90 traffic impact hospital services is another. Lack of understanding of the population beyond the borders of the SPVHD that travel into the district for care is another. And finally, perhaps the greatest information gap, is there has been no previous SPVHD-specific needs assessment available for reference.

 

J.   Implementation of Strategic Plan:

 

The implementation of a strategic plan is owned by the CEO; however, each incentive is reviewed and recommended for action by the Strategic Planning Committee, which serves at the pleasure of the Governing Board of the hospital.  Moreover, alignment with the local healthcare provider community informs and affects ongoing implementation dynamics.

As a sole community provider, Benson Hospital leads the execution of a community-wide health benefit plan.  The hospital is involved in all facets of community well-being through local and regional community events, educational offerings, and other venues as appropriate.

The Strategic Planning Committee will set the position for addressing health needs of the community.  This occurs after a retreat is held which includes hospital managers, medical staff, hospital board members and interested members of the community. Information garnered from retreats, and from other venues and sources is organized and prioritized by the strategic planning process.  Implications for planning will be developed into action plans documented in the strategic plan as key strategic objectives.

Input analysis is being incorporated into all business planning and will be considered part of the operational planning of the hospital.

The FY2016 budget includes supporting the development of all community well-being initiatives identified in the planning/operating process.  As needs are identified, budget allocations will be made and placed in the budget.  Alternatively, grants or other sources of capital will be sought to promote wellness in the community.

 

The Southern Arizona Hospital Alliance:

 

This alliance was formed in the summer of 2015.  Tucson Medical Center and Benson Hospital, Copper Queen Hospital, Mount Graham Regional Medical Center and Northern Cochise Hospital comprise the alliance, with TMC at the center.  The alliance is expected to help improve care and cut costs.  It will also add an important strategic dimension to planning at Benson Hospital.  Conditions for rural health care are difficult in Southern Arizona, as they are elsewhere.  Rural facilities continue to fail.  Physicians are difficult to recruit.  Proprietary organizations are acquiring not for profits and challenges mount for facilities such as Benson Hospital to remain independent.  The alliance is intended to address this constellation of difficulties and strengthen its member’s ability to care for their populations.

 

Implications for planning:

  • Prepare for possible population increase due to El Dorado development.
  • Recruit and retain primary care providers.
  • Establish strategic and beneficial relations with specialty providers.
  • Establish/maintain strategic relations with ambulance services.
  • Work with local physicians and ER physicians to maximize admissions.
  • Develop medical services needed to support admitted patients.
  • Develop medical services needed to support outpatient needs.
  • Maximize yield from healthcare payers.
  • Establish wellness committees/initiatives/activities in the community.
  • Consider symbiosis with chiropractors/dentists/naturopaths.
  • Align “top five” reasons with hospital operations.
  • Work with county to promote wellness.
  • Work with county to reduce number of reported diseases.
  • Seek sources of capital support.
  • Commence master planning with partner.
  • Coalesce/balance implications with strategic planning/operations.

These implications for planning, and others that develop, will be subsumed into the strategic planning process as need imposes and resources permit.