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Hospital survey uncovers health disparities throughout community

Assessment IDs five most pressing health needs

Mike Easterling
Farmington Daily Times
Visitors to the San Juan Regional Medical Center's 2017 A Fair of the Heart in Farmington learn about weight differences between fat and muscle. The event is just one of the initiatives the hospital has mounted to address the issues identified in its Community Heath Needs Assessment.
  • The hospital does a new Community Health Needs Assessment every three years.
  • The COVID-19 pandemic impacted the hospital's information-gathering process this year.
  • Hospital officials used input from community members, physicians, community surveys and a community summit.

FARMINGTON — Every three years, officials at the San Juan Regional Medical Center take part in a months-long process designed to identify the community's greatest health needs before they develop an action plan to address them. Usually, that undertaking — known as the Community Health Needs Assessment, or CHNA — involves lots of face-to-face meetings and interviews, along with a final community summit where the findings are presented.

Because of the COVID-19 pandemic, hospital officials were forced to alter their approach this year, usually resorting to virtual sessions or telephone interactions to gather and share information. But hospital Chief Executive Officer Jeff Bourgeois said the pandemic made its presence felt in other ways, as well.

"I think it did in terms of the some of the results. By the time we had our summit meeting, it was May, and we were at the peak of COVID response," Bourgeois said, explaining that on May 15, the hospital's COVID-19 census reached its height of 54 patients.

"As a result, what we've learned since the summit is we really looked at the patient population we've had impacted by COVID-19, and it pointed out to us more starkly than anything else we've ever seen before the health disparities in our community."

FMN Jeff Bourgeois

The Native American community in San Juan County was disproportionately impacted by COVID-19, Bourgeois said, pointing to a higher hospitalization rate and a higher mortality rate. That was one of his leading takeaways from this year's CHNA, and it will strongly affect how the hospital proceeds with its effort to address the survey's findings.

Hospital officials used input from community members, physicians, community surveys and a community summit to compile the list, along with public health data, and demographic and psychographic materials. Stratasan, a health-case analytics and facilitation company based in Nashville, performed much of the work, but Bourgeois said approximately 20 hospital staff members were involved in the project. Nearly 140 people participated in the survey or summit.

The results of the CHNA were released on July 14, identifying diabetes, mental health, substance abuse, obesity and access to care as the most significant areas of need. Bourgeois pointed out there was a lot of overlap between this assessment and the last one that was done three years ago, most notably obesity, diabetes and access to care.

"That's not unlike many communities where the community health needs overlap over time," he said. "We really take this as a call to action to address these needs for improvement."

A steering committee now being compiled will be charged with developing an action plan and submitting it the hospital board for approval by the end of the year. Bourgeois said that committee likely will consist of a cross section of hospital employees, including physicians, clinicians, nurses, chronic disease managers and representatives of the human relations department.

Stroke coordinator Tina Biberdorf of the San Juan Regional Medical Center teaches children how to spot a stroke at the Sycamore Park Health Fair in Farmington in 2017.

The hospital has been developing the CHNA every three years since the early 2000s, and it has mounted a number of initiatives over that time designed to address those needs. Bourgeois said the hospital's diabetes education program is a direct result of that effort, while it also presents community health fairs, flu vaccine clinics, low-cost blood screenings and other public events.

Additionally, he said, the hospital is a sponsor of the nonprofit organization Capacity Builders Inc., the Don’t Meth With Us! program and the Race to Educate. It also is a partner with the city of Farmington and San Juan County in the Sobering Center, a voluntary shelter for intoxicated people.

"These are all examples of things that came out of prior community health assessments," he said.

Bourgeois said the hospital's role in the opening of the Sobering Center has yielded substantial benefits, resulting in reduced emergency department visits by some individuals and putting them on a path to sobriety. He also pointed to the success of the diabetes education program, where clients have seen their average time from referral to date of their first appointment with an educator reduced from 14 to 9.5 days.

"Helping people manage their diabetes can be a life changer," Bourgeois said. "Our diabetes education efforts are well worth it."

Care coordinator nurse Michelle Russo of San Juan Health Partners Internal Medicine visits with a patient as part of the San Juan Regional Medical Center's population health program.

He explained those are the kind of metrics the hospital uses to determine the success of its CHNA efforts. After an action plan is adopted before the end of the year, Bourgeois said the real work will begin, with new initiatives or changes to current ones underway by next summer.

The report itself states four broad themes emerged from this year's process, with the last one noting, "It will take a partnership with a wide range of organizations and citizens pooling resources to meaningfully impact the health of the community."

Bourgeois said this year's assessment may not have featured any surprises, but "it just calls out the persistent opportunity we have to make some potential impact on our community by addressing these issues."

The CHNA report can be found on the hospital's website at https://www.sanjuanregional.com/community-needs.

Mike Easterling can be reached at 505-564-4610 or measterling@daily-times.com. Support local journalism with a digital subscription.