Ely-Bloomenson Community Hospital has taken another look at itself through the eyes of the community. As part of a required Community Health Needs Assessment (CHNA), EBCH shared the results at a series of public meetings.
Mental health and dental services were two of the most popular concerns along with access to specialists. There were also concerns over emergency medical services and being able to afford health care.
On Nov. 20, a meeting was held in Ely at The Hub with two dozen folks in attendance. EBCH CEO Patti Banks and communications team leader Jodi Martin shared the results.
“I wanted to ground everybody right now that the conversations tonight are going to be from the perspective of a critical access hospital,” said Banks.
She pointed out EBCH is an independent hospital not affiliated or managed by any health care system.
“As a critical access hospital, we are expected to provide access to essential, acute, emergency, and outpatient care to our patients in the communities and in the rural areas. So we are a healthcare anchor in our region because of our location. And because of the fact that on a good day, it can take, an hour and 45 minutes on a good day to get to a larger or the next higher level of care, which is one of the hospitals in Duluth,” said Banks.
EBCH, as a critical access hospital, is expected to have a 24/7/365 emergency department “where we can treat whatever comes through the door.” Governed by a nine-member volunteer board, the hospital shares its campus with the Essentia Clinic and the Boundary Waters Care Center, both independent of the hospital.
Banks gave an idea of the kind of business the ER receives, which has increased from 2,800 almost 12 years and is now closing in on 4,000 visits each year.
But an emergency department is only part of what the hospital offers. Banks said EBCH has specialty providers, an internal and retail pharmacies, along with 21 beds.
“With the CHNA, a lot of our focus and expectations are on the social drivers of health. Our goal is to be sure that the community stays healthy,” said Banks.
There are many “buckets” that make up health care from insurance to EMS, long-term care to mental health.
The CHNA does a lot of things for the hospital and it used as a tool by EBCH and its board of directors.
“It helps us promote collaboration. So we collaborated with some of you that are in this room that participated in focus groups or key informant interviews, it helps our board with strategic planning. We go through a retreat every year where we use some of this data to really help round us and to think about the strategic direction of the hospital as we move forward,” said Martin.
She said EBCH went above and beyond the requirements to interact with the community and even hired a third party vendor to assist to develop the 100page report.
Martin said the three most pressing health concerns were:
• Access to mental health
• Access to dental services
• Access to specialists “One thing I just want to make note of is, as a critical access hospital, mental health, dental services are two things that are not typically provided in a hospital,” said Martin, underlining the importance of collaboration.
The three items identified as essential to a health community were:
• Access to health care and other services
• Good jobs and a healthy economy
• Affordable housing “We’re really happy to see that people were thinking of health care and services that we provide in that study that it is important for us to be here and for the health of our community, to be here to provide services to you, but also in being here as an economic driver for 130 jobs in the community,” said Martin.
One of the questions asked who is your primary health care provider with 71% answering Essentia Health-Ely. For their hospital of choice, EBCH had a 52% response rate.
A follow up question asked why EBCH.
“Always, number one, it was an emergency, closest to my house, had to get there. But this time around our reputation and quality of care was also in the top three. So we were really happy to do that this time around.”
Martin said there were concerns about the health care data used in the survey from St. Louis County with many people saying that the large city of Duluth skews the numbers.
“People were very surprised by the high rate of suicide in our county. People felt like financial stability equaled healthier people. They thought that the thing, the people that might struggle
the most are your own families, those with mental health concerns, and uninsured and under insured. And that the community lacks knowledge of the available services and what kind of assistance that we can give to people,” said Martin.
Focusing on mental health, Martin said the hospital wanted to know what kind of mental health people were looking for.
“So we had a list of about 10, 12 different mental health issues, and depression and anxiety rose to the top quite frequently, but also all of the above. A lot of people just said we need more information about all these things,” said Martin.
One of the surprises was that 48% of people said they get their health care information from social media, above their health care provider and above friends and family.
Transportation was another hot topic.
One question was on the ability to get to a higher level of care whether that be from their home to EBCH or from EBCH to a Duluth hospital.
“Above 22% reported that no, they didn’t think that they could get to a higher level here in the event of a personal emergency,” said Martin.
The survey asked why is that with answers including concerns about emergency medical services.
“And a lot of people reported that they felt like they had, first of all, bad experiences with EMS, or that they lacked their own personal transportation to get to the hospital,” said Martin.
The survey shows 72% cited cost of care and insurance while 25% said they had a personal/bad experience with EMS transport.
The data in the report shows that St. Louis, Lake and Itasca counties have higher rates than Minnesota and the U.S. in:
• All cancer incident rate per 100,000
• Adult obesity
• Adults with chronic obstructive pulmonary disease
• Adult current smokers The counties also have:
• Less access to exercise opportunities
• Poorer ratio of population to dentists Martin said the hospital will use all of the data gathered to address the issues raised.
“We’re going to continue to develop and communicate EBCH’s role in local health care and that’s through branding awareness and connecting all of the dots and our collaboration,” said Martin. “Second thing is, the continuation of three years ago, we’re going to continue to collaborate to increase access to childcare, and that is really important to us for a workforce.”
Martin said in January EBCH opened an employee childcare program which is full with 14 children. Since then, employees have had 10 more children.
Banks pointed out with the new Family Medical Leave act that starts Jan. 1, an employee could take off for 20 weeks beyond the 1012 weeks they can take off already.
“When you’re a small hospital, we have small departments. So for us to be able to staff is going to pose some challenges maintaining access to care,” said Banks.
Martin said the hospital will follow up on the issues raised in the surveys.
“We’re going to continue to create sustainable solutions that meet our patient transfer needs, and that’s, working with EMS, that’s not our non-emergency transport, non-emergency surgeries, just transportation in general because we know it’s a need,” said Martin.
Information from the survey is on the hospital’s website at ebch.org.
Banks said people should know the hospital has learned to be flexible and resilient in the last five years.
“We are trying to communicate outwardly how we can maintain and drive down the cost of care without impacting quality and access,” said Banks.
“I can say that with a lot of confidence that about 50% of the work that we are doing nowadays, for those of us, especially that are not direct patient care, is community facing. It is outside of the hospital. It’s doing things like this. And I think we’re going to do more of this,” said Banks.
