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2016 - 2018 Community Service Plan

INTRODUCTION

Blythedale Children's Hospital is a specialty children’s hospital located in Westchester County  dedicated to the diagnosis, care and treatment of children and adolescents with complex medical and rehabilitative needs. Blythedale is a leader in developing innovative, multi-disciplinary programs.

This Community Service Plan was prepared to meet the requirements of Section 2803 of the NYS Public Health Law, in accordance with updated guidance provided by the NYS Department of Health, as well as the Internal Revenue Service’s Section 501 (r) requirements for a Hospital Community Health Needs Assessment.  

As directed by the State Health Department, Blythedale’s 2016-2018 Community Service Plan addresses health improvement priorities from the State’s Prevention Agenda, including those selected by a coalition of local community hospitals and other community representatives convened by the Westchester County Department of Health.  As a specialty hospital serving only children and adolescents, one of the priorities identified by the Westchester County Department of Health was not within Blythedale’s mission and scope.  Therefore, we have selected another priority from the State’s Prevention Agenda which addresses an issue of concern to Blythedale’s community of referring hospitals.

MISSION STATEMENT

Blythedale Children’s Hospital is dedicated to improving the health and quality of life of children. We improve the lives of children with complex medical illnesses and disabling conditions through superb multi-disciplinary care, teaching, research and advocacy programs.

We are the only specialty children’s hospital in New York State that provides the highest level of medical care and comprehensive rehabilitation for children with complex medical illnesses and conditions. Working collaboratively in an environment that fosters excellence, our goal is to improve each patient’s overall health, independence and quality of life and provide hope to patients and families through superior outcomes—without regard to religion, race or ability to pay.

HOSPITAL SERVICE AREA

As a specialty children’s hospital, Blythedale’s service area is widespread, with patients coming from the greater metropolitan region, as well as adjacent areas of New Jersey and Connecticut.  

61% New York City

28% Hudson Valley

 8% Long Island

 3% Out of State

Since the vast majority of admissions to Blythedale come from other hospitals, particularly the major medical centers in the metropolitan New York and Hudson Valley area, Blythedale’s sense of need for services largely emanates from its community of referring hospitals and their physicians.  

Blythedale’s patient population reflects the ethnic and racial diversity of its large service area, as illustrated by its 2015 inpatient population:

 4% Asian

19% Black or African-American

25% Hispanic or Latino

45% Caucasian

 7% Other

To address this diversity, the Hospital provides staff training in cultural diversity, interpreter services, and varied dietary needs. We also offer other accommodations to support families from different cultural backgrounds while their children are patients at Blythedale.

COLLABORATIVE PLANNING PROCESS

In addition to its referring hospitals, Blythedale also works with the Westchester County Department of Health to identify community health priorities relevant to Blythedale’s mission and services.  

In April 2016, the Westchester County Department of Health convened a workgroup of local hospitals to select two priorities from the State’s Prevention Agenda and collaboratively develop plans to address these priorities as part of the Westchester Department of Health the assist local hospitals with the development of the Community Service Plans. The Westchester workgroup disseminated community and provider surveys to gather data about the greatest health care needs within our community and reviewed the progress to date of the agenda items that were chosen in 2013. 

IDENTIFICATION OF PUBLIC HEALTH PRIORITIES

Based on discussions at the Westchester workgroup meetings and the data collected from the community, the following goals were selected as county-wide priorities:

  • Prevent Chronic Diseases
  • Promote Mental Health and Prevent Substance Abuse

As noted above, the second priority initiative identified by the coalition, related to promoting mental health and substance abuse prevention, is not within Blythedale’s mission and scope of practice. Therefore, Blythedale has selected another priority from the State’s Prevention Agenda which addresses an alternate State Prevention Agenda goal, "Prevent Healthcare Associated Infections”. 

PLANS OF ACTION

#1 Prevention Agenda Goal:  Reduce Obesity in Children and Adults

According to data referenced on the NYS Prevention Agenda website, on a national level 17 percent of American children and adolescents aged 2-19 years are obese and obesity prevalence among adults exceeds 35 percent. According to the NYS DOH, obesity among children and adolescents has tripled over the last three decades. Currently, a third of NYS children are obese or overweight (2014) In NYS, medical expenditures attributed to obesity are totaled in the billions. 

Blythedale Children’s Hospital has partnered with Kohl’s Eat Well Be Well Nutrition Outreach Program with the goal to provide education to children and their families on the importance of nutrition and health eating, as well as to provide them with the necessary tools to establish lifelong healthy habits.

Objectives

  1. By 2018, Blythedale will reach 20,000 students each school year through on site classroom instruction
  2. By 2018, Blythedale we anticipate our education campaign will reach 400,000 people through our Eat Well Be Well website and 5,000 people through off site events. In addition, advertising of the Eat Well Be Well program on WCBS program (bimonthly frequency) will reach 35 million people and a Facebook ad campaign will reach 500,000 people

Interventions and Activities

1. Promote awareness of benefits of healthy eating habits by:

  • Providing nutrition content such as nutrition guidelines, Tips & Tricks, recipes, well-researched articles, video content and more through Blythedale’s new online newsroom. Dissemination through this vehicle will ensure the materials are seen by more parents and caregivers within our community
  • Outreach will be made to children K-8 in school districts in Westchester which will include lesson plans and nutrition curricula for each grade level and handouts given to the children to take home. There will also be outreach to local preschools and child care facilities to distribute nutritional materials for teachers and parents
  • Kohl’s Eat Well Be Well nutritionists and hospital clinicians will have a presence at local health fairs to provide health screenings and fun activities to engage both the parents and children. Nutritional materials will be distributed to all participants

Performance Measures

  • The number of visits to the BCH website to review posted materials
  • The number of attendees at the health fairs
  • The amount of nutritional materials distributed 
  • The number of classrooms visited
  •  Analytics related to Facebook advertising

#2 Prevention Agenda Goal: Prevent Healthcare- Associated Infections and Activities by Sector

Healthcare associated infections are the focus of many initiatives at the federal, state and hospital level.  According to data referenced by NYS Prevention Agenda website the state is making initiatives to reduce the number of device-associated infections within the ICU and has just begun to address the infection rate outside the ICU through a Partnership for Patients.

Blythedale has an aggressive infection control program to address all causes of healthcare associated infections.  This program has been extremely successful in controlling the incidence of such infections, critically important with Blythedale’s population of children with complex medical conditions. However, it requires constant vigilance to maintain this low rate.  Blythedale will continue to seek ways to improve our ability to reduce health care associated infections.

Objective: By 2018, Blythedale will maintain hospital acquired infection rates less than 1.1 per 1,000 central line days and 1.7 per 1,000 catheter days.

Interventions and Activities

1. Revision in policy and procedures to facilitate reduction in central line infections such as modifying dressing kits to include transparent antimicrobial dressing and adding use of disinfection caps to the accessible ports on IV tubing

2. Education of all medical staff via Power Point presentations and skills labs

3. Strict guidelines to determine when it is appropriate to use indwelling urinary catheter

4. Nursing staff update policies/procedures for care of indwelling urinary catheter and provision of  education to medical team

Performance Measures

  • The Director of Infection Prevention and Control monitors cultures for any patient with a central line and/or catheter. 
  • If an infection is detected a root cause analysis is conducted to see if there were any breaches in procedures and if so, this is addressed with education. 
  • Hand hygiene compliance rate = 90% or above
  • Quarterly reports will be made to the Infection Prevention and Control committee and information on HAIs will be posted on the Hospital’s Intranet

DISSEMINATION OF THIS REPORT TO THE PUBLIC

Details on Blythedale’s community health programs and other hospital services are regularly featured on the Hospital’s website and in the Hospital’s newsletter.  This Community Service Plan will be posted on Blythedale’s website.

OTHER BLYTHEDALE COMMUNITY SERVICE HIGHLIGHTS

Blythedale has provided a significant amount of community benefit programs, as evidenced through a variety of programs and services, including:

Injury Prevention: As part of its injury prevention activities, Blythedale sponsors fitting and installation checks for both regular and special-needs car seats on site at the Hospital, and Hospital staff have served as instructors in car seat technologist training courses in the lower Hudson Valley. 

CPR Training Center: Blythedale has been a Community Training Center for the American Heart Association, providing training in Heartsaver CPR (cardio-pulmonary resuscitation), Heartsaver AED (automated external defibrillator) and Heartsaver First Aid.  In addition to Blythedale staff, those trained include health care professionals, members of local police and fire departments, students at area schools and staff from various community agencies.  Blythedale has also offered Pediatric CPR training for the community and health care professionals, and is a certified Pediatric Advanced Life Support (PALS) Training Center.  

First Responder Training Program: Blythedale, in coordination with the Westchester Regional EMS Office, Westchester County Department of Environmental Services, and the NYS EMS for Children Program, has developed a special pediatric CME series for first responders of the Westchester EMS region.  The series covers subjects vital to first responders, including traumatic brain injury, autism, technology and care of the infant or child, child abuse/neglect and child/infant safety during transfer. The courses are presented by Blythedale clinical experts, including physicians, nurses, therapists and other clinical experts.

MEDICAID SERVICES, CHARITY CARE AND OTHER HOSPITAL FINANCIAL ASSISTANCE

As a major funder of services for children with special health care needs, Medicaid is a significant (75%) source of primary or secondary coverage for the majority of Blythedale’s patients.

Consistent with its mission and federal and State requirements (Public Health Law 2807(k)(9-a)), Blythedale has developed guidelines that delineate the circumstances and procedures under which free or reduced cost care is available.  These guidelines are made available to all families upon registration, and Hospital staff provides counseling as necessary.  Patients are also notified of Blythedale’s Charity Care policies through notices on the Hospital’s website and posters in English and Spanish in the Hospital’s lobby and in patient registration and waiting areas.  Interpretation services are available for patients needing information in languages other than English. 

All patients having difficulty paying their bills are directed to Hospital staff who assists the family in completing a financial assessment and try to qualify the patient for assistance.    Blythedale’s Patient Assistance Fund and other special funds are also used to help children with various items where family resources are limited and insurance does not cover.  

Click here to view Community Health Planning Meetings, the Planning Committee and the Stakeholders Health Planning Summit Participants.

Click here to view the Charity Policy and Procedure.

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