Baton Rouge, LA, Healthcare Organizations Collaborate to Complete a Needs Assessment
Mr. Davidge is president and chief executive officer, Our Lady of the Lake Regional Medical Center; and Ms. Pearson is a healthcare consultant, Baton Rouge, LA.
Summary
Baton Rouge, LA, has in recent years seen rocketing rates of syphilis, alcohol abuse, and other health problems. In response, 10 local healthcare organizations met in 1993 to form the Baton Rouge Health Forum. The forum began its work by conducting a community needs assessment.
The forum organized three task forces. One compiled existing data on area demographics, public health, economics, and education. A second task force employed personal interviews and focus groups to gather residents' opinions on the area's top 10 healthcare needs. The third task force kept local media and community leaders informed about the assessment's findings.
As in other U.S. communities, Baton Rouge residents' top 10 needs centered around social issues with health implications. The number one perceived need, for example, was a central clearinghouse to provide information about healthcare to those who lack it.
Baton Rouge, the capital of Louisiana, still retains its small-town ambience. But it has not gone untouched by the state's poor health status. For example, Louisiana currently has the highest syphilis rate in the nation, with reported cases skyrocketing from 1,400 in 1987 to 6,445 in 1992, according to the Louisiana Office of Public Health. Alcohol abuse rose 15 percent between 1990 and 1991. In addition, the state has the highest rate of combined air emissions/surface water discharges/releases to land (as of 1992 — the most recent available data). Still, community members remember that not so long ago, Baton Rouge was a safer, better place to live. They want such a community to be more than a memory.
To help Baton Rouge again become the healthy community it once was, area healthcare organizations formed the Baton Rouge Health Forum two years ago. Members of the Health Forum (see "Baton Rouge Health Forum" at the end of this article) facilitated the completion of a community health needs assessment and continue to work together. Given the work of the Baton Rouge Health Forum and the support the group has received from other community groups, Baton Rouge's vision of a healthy community is becoming a reality.
Getting Started
Our Lady of the Lake Regional Medical Center, sponsored by the Franciscan Missionaries of Our Lady, planted the seed from which the Baton Rouge Health Forum grew. During the summer of 1993, the medical center's board of trustees asked staff to complete a community needs assessment. In late August, to enlarge the assessment's scope, Our Lady of the Lake President and Chief Executive Officer Robert C. Davidge invited counterparts from all Baton Rouge healthcare organizations to a breakfast where a community needs assessment was proposed.
The purpose of the assessment was to identify the most pressing needs of the vulnerable populations in East Baton Rouge Parish (county), which is coextensive with the city of Baton Rouge. East Baton Rouge Parish was chosen because it was well defined and served by all of the assessment's 10 sponsors. The sponsors wanted to do a good job in one area before expanding the assessment. The assessment's findings would be used to:
- Gain a better understanding of the health-related problems of the East Baton Rouge Parish community and the needs of its vulnerable populations
- Encourage the community to identify the problems and contribute to solutions
- Build relationships and increase the community's understanding of the appropriate roles of area healthcare providers
At the breakfast meeting, the healthcare leaders learned about various options for participating in the assessment. They could — at a minimum — provide input during the interview process or — at a maximum — allow staff to serve on one of the Health Forum task forces. Even though they were told they would receive the final needs assessment report in any event, all organizations decided to fully participate in the assessment.
Each organization assigned a staff person to act as its assessment representative. The representatives recruited persons from their organizations to serve on the Health Forum's task forces, which covered data gathering, interviewing, and communications.
Work Begins
It took seven months to train those who would be conducting interviews, develop a list of persons to be interviewed, refine interview questionnaires, conduct interviews and focus groups, and complete the final report and executive summary. During that time the task forces met regularly and updated the sponsoring organizations monthly. Healthcare consultant Virginia M. Pearson coordinated the assessment process.
Data-gathering Task Force The 11 members of this group gathered existing data to develop profiles and trends on demographics, public health, economics, and education for the Baton Rouge area. These data were included in the eventual assessment report to underscore the importance of the information obtained from respondents.
Interviewing Task Force Two months were spent developing the interview instrument with the aid of a pair of university professors. The 17 members of this task force faced a challenge, especially since most of them had no interviewing experience. Pearson conducted the members' training.
This aspect of the needs assessment was time consuming because — with travel time — each interview took about two hours to complete. Despite this, most of the interviews and focus groups were completed within a two-and-a-half-month period.
The task force wanted to interview persons representing diverse groups in the community. Task force members listed more than 200 persons they believed should be interviewed — from community leaders to members of vulnerable populations. The group then decided to conduct 140 personal interviews and 26 focus groups.Two-person teams conducted one-on-one interviews. One task force member led the discussion and asked questions while the other recorded the information. Focus groups included 6 to 10 people who had similar interests such as elderly services or drug abuse treatment.
In addition, the task force mailed short surveys to 65 persons who had access to important information, including members of local government bodies, such as the school board and parish council, or service organizations. By using written surveys, the task force could get more input without being encumbered by "open meeting laws," which would have threatened confidentiality.
After all was said and done, more than 300 people provided direct input to the needs assessment.
Questions focused on the overall health status of the Baton Rouge population. Participants listed what they saw as the three most critical health problems in East Baton Rouge Parish. They also listed their three top social and environmental concerns. Finally, participants had the opportunity to offer solutions to these pressing problems and their definition of a healthy community.
Communications Task Force Communications Task Force members sent Baton Rouge media and selected community leaders an initial news release that described the goals of the needs assessment and a fact sheet that described the Health Forum and how it would meet these goals. The group decided it would develop a comprehensive communications plan once assessment results were available.
During the assessment process, staff members of the participating healthcare organizations were kept informed of progress through their in-house newsletters. The Baton Rouge Business Report published an article that described the assessment process and the partnership formed by the sponsoring healthcare organizations.
Assessment Findings
As in many other U.S. communities, Baton Rouge residents' top 10 needs center around social issues that have health implications (see "Baton Rouge's Top 10 Needs" at the end of this article). Most persons interviewed and those who participated in focus groups say they are quite satisfied with the level of acute care available to Baton Rouge residents. They believe that most, if not all, needed services are already available for persons who are knowledgeable about available healthcare services and who have the money or insurance to cover the cost of healthcare or have access to governmental assistance. But what about community residents without access to a central information clearinghouse? They have no way of knowing what services are available.
Moving Forward
Once members of the Baton Rouge Health Forum approved the final assessment report, persons who had been interviewed received a copy of the executive summary, along with a note of thanks and an invitation to attend a two-hour workshop.
At the workshop, participants began planning community activities to address the issues raised by the assessment. Workshop participants also responded to a questionnaire that helped Baton Rouge Health Forum members identify persons interested in convening work groups to begin planning a half-dozen community projects. Although the assessment had identified 10 community needs, limited resources compelled the Health Forum to target only six of them.
The Baton Rouge Health Forum does not oversee the work groups. Each group determines its own goals, schedule, funding resources, and other specifics. For example, one group decided to help fill the community's top healthcare need, a central clearinghouse for information. The group, working with the local United Way, has created a phone information service called InfoLine.
Health Forum Continues
Once the needs assessment was completed, members of the Baton Rouge Health Forum decided to keep the collaborative effort going. The group adopted the following mission statement:
The Baton Rouge Health Forum is dedicated to measuring and building awareness of the community's health status through on-going assessment, dialogue and continuing partnerships. The Forum provides an opportunity to communicate, promote and actively achieve health-related goals. As members, we come together in a spirit of cooperation for the common good of the citizens of Baton Rouge.
The Baton Rouge Health Forum maintains two subcommittees.
Health and Wellness Education
Through the Health and Wellness Education Subcommittee, the forum — in collaboration with the Children's Coalition of Baton Rouge — has a goal of keeping at least one school in each neighborhood open from 6 am to 10 pm, seven days a week. When school is not in session, services such as tutoring, life-skill instruction, recreational opportunities, healthcare services, and health and wellness education are offered to anyone interested.
Health Status Report This subcommittee, with the help of a group of Louisiana State University students, plans to compile and regularly release a series of reports on the community's health status, issuing them in a form that will be comprehensible to all Baton Rouge residents.
Communications Task Force
Once the assessment report was completed, the work of the Communications Task Force really began in earnest. The group helped plan the two-hour workshop for persons who had been interviewed.
In addition, task force members developed a communications plan for the community. For example, they planned a breakfast meeting at which presidents of local professional organizations were told the findings of the needs assessment and about how the Baton Rouge Health Forum was already responding to those needs. The Health Forum also makes speakers available for organizations' meetings and provides copies of the assessment report for professional groups to use in their own planning. Each of the area's public libraries has a copy.
A Healthy Community
The community is showing its support for the Baton Rouge Health Forum. A growing number of organizations have expressed a desire to work with the coalition to help address some of the needs identified in the assessment.
What began as one organization's invitation to help make Baton Rouge a healthier place to live has grown larger than most people expected. The community has even created a vision statement of what it means to be healthy:
A healthy community is one where every citizen has access to quality, affordable health and social services. There is an emphasis on illness prevention and wellness. The community is financially stable with a good economy, and jobs that allow everyone to be self supporting. This is a community of people cooperating and working together. This grassroots activity sees people taking responsibility for their own actions. It is a safe place with low crime and murder rates. It has a strong education system in place. This community has clean air and water. And when they need it, people have access to a system listing existing services and programs.
BATON ROUGE HEALTH FORUM
The Health Forum comprises the following organizations:
East Baton Rouge Parish Medical Society One of the state's first physician organizations, it now has some 750 members. The society provides a free physician-referral service, a speakers' bureau, medical care for area high school sports teams, and other services.
Earl K. Long Medical Center A 204-bed general acute care facility, it is affiliated with the Louisiana State University (LSU) Medical School and serves as a teaching hospital.
General Health, Inc./Baton Rouge General Medical Center
This community-owned, not-for-profit integrated healthcare system operates six primary subsidiaries, including its flagship, Baton Rouge General Medical Center. The latter is a 414-bed tertiary care, teaching facility.
Medical Center of Baton Rouge This for-profit, 233-bed, general acute care facility was recently acquired by the Columbia/HCA system.
Our Lady of the Lake Regional Medical Center Louisiana's largest private hospital with 1,022 beds, it is a not-for-profit, tertiary care hospital owned by the Franciscan Missionaries of Our Lady Health System.
Pennington Biomedical Research Center Affiliated with LSU, it is well known for its research in nutrition and heart disease.
Mary Bird Perkins Cancer Center This is a freestanding, not-for-profit, community-owned research facility that also provides cancer education and radiation treatment.
South Louisiana Rehabilitation Hospital This 80-bed physical rehabilitation hospital concentrates on patients with stroke, brain injuries, spinal cord injuries, and musculoskeletal problems.
Rehabilitation Hospital of Baton Rouge
Owned by Continental Medical Systems, it is an 80-bed physical rehabilitation hospital with four outpatient centers.
Woman's Hospital This not-for-profit, 225-bed facility for infants and women of all ages was one of the first women's specialty hospitals in the country.
BATON ROUGE'S TOP 10 NEEDS
Although the Baton Rouge assessment revealed many healthcare and social needs, respondents most often cited the following needs (in order of importance):
- Create a clearinghouse that identifies existing health and social service programs.
- Address the growing rates of crime, violence, and murder.
- Improve the public education system and literacy rates.
- Add support systems for drug abusers and counteract the growing illegal drug business.
- Add mental health programs and counseling services.
- Increase employment opportunities.
- Address pollution issues with increased controls.
- Provide a more accessible system for the delivery of wellness and primary care services and reduce duplication of health and social services.
- Support and stabilize the family unit.
- Increase available support systems for alcohol abuse.