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Leading the Way to the Future: The ‘why’ behind Legacy, housing and health
Key points:
 Legacy Health led a collaboration...
That’s when I decided that this was something we should pursue. I went to Ed Blackburn,
executive director of Central City...
Leading the Way is a regular series of email communication from Legacy leadership addressing major
initiatives across our ...
In addition, we know that there are health disparities in our community: inequalities in receiving
and accessing health ca...
Leading the Way to the Future is a regular series of email communication from Legacy leadership
addressing major initiativ...
 In interviews with patients, some said they chose Legacy–Go Health because of the
Legacy name and Legacy providers. “I h...
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Leading the Way to the Future

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Leading the Way to the Future

  1. 1. Leading the Way to the Future: The ‘why’ behind Legacy, housing and health Key points:  Legacy Health led a collaboration of health care organizations that will invest $21.5 million to address housing, homelessness and health care in our community.  One of the reasons we did so is because we have seen a direct connection between housing and health.  We feel that as part of our mission, we should help those most in need. My initial impression about the housing crisis in our community was that this was too big a problem for Legacy Health to do anything about. Then, one day, I was walking on Northwest 19th Avenue under the Fremont Bridge where all these people were living on the edge of society in cardboard boxes and tent-like structures, and it dawned on me: Legacy doesn’t have to do this alone. Why not reach out to other organizations to ask how can we come together to help? A unique collaboration for community health That was the beginning of the conversation that resulted in a collaboration between Legacy Health and five other health care organizations to invest $21.5 million in a unique partnership with Central City Concern to respond to Portland’s urgent challenges in affordable housing, homelessness and health care. The investment will support 382 new housing units across three locations. For more details about the initiative, go here. What I want to talk to you about today is why we are taking such an interest in housing. Housing and health First off, it has become clear that we have severe housing challenges in our community. We live in an area where the cost of housing continues to escalate. These rising costs put particular pressure on those who exist at lower incomes. Plus, decades of reduced investments in subsidized housing and mental health services nationwide have resulted in our cities becoming more and more challenged by homelessness. It has also become evident that housing is an important component to health. Studies have shown that individuals without safe, stable housing suffer from poorer health and cost society more in emergency department use and hospital readmissions. It’s just common sense: If you are worrying about basic survival, if you are making economic choices between food, shelter and medicine, how could you possibly maintain good health? Center on the mission Then consider Legacy’s mission –– good health for our community. How can we really achieve good health if there isn’t adequate housing for those most in need?
  2. 2. That’s when I decided that this was something we should pursue. I went to Ed Blackburn, executive director of Central City Concern, which has expertise in housing and health, and we invited the Portland-area health systems* to start a conversation. After about four or five meetings, everybody decided that we can do this together, and that it will have impact. This isn’t the complete answer to the housing problem, but it will be an important part of at least providing housing for those who are challenged with addiction, behavioral health issues or in severe economic distress. It also goes hand-in-hand with the Unity Center for Behavioral Health, which will provide immediate psychiatric care, as well as help in transitioning back to the community, for those facing mental health issues. No longer acceptable My hope is that by the example of the health care organizations, the business community will take a page from our playbook and find ways to help. It is in the best interest for all of us to address this housing issue. If you give people a hand to get them off the streets, they have a better chance of not only improving their lives but of becoming productive citizens, which also helps our community’s economy and quality of life. I think it is wonderful that the health care organizations have been able to come together on this project as we have for Unity. It is also significant because it shows that we are all realizing we live in a community with a mixture of people with different levels of challenge, and that we all have a responsibility to do what we can. It is no longer acceptable to look the other way. I’m glad my walk through the neighborhood helped me see that. *The other health care organizations making contributions to the initiative:AdventistHealth Portland,CareOregon, Kaiser Permanente Northwest, Oregon Health & Science University and Providence Health & Services–Oregon. . . . George __________________________________________________________________________________________________________________ George J. Brown, M.D. | President & CEO | Executive Office | Legacy Health 1919 N.W. Lovejoy Street | Portland, OR 97209 | (503) 415-5511 | (503) 415-5025 |*gjbrown@lhs.org
  3. 3. Leading the Way is a regular series of email communication from Legacy leadership addressing major initiatives across our organization. Leading the Way: Pride and progress inhealth literacy If you have ever wondered about the importance of successful communication with patients and families, what you know as “health literacy,” consider this true story: A patient was recently discharged with two prescriptions of blood thinner –– one medicine to be taken for 21 days; the other to be started after the initial 21 days. The patient, however, didn’t understand the directions and took both medicines at the same time. He ended up in the hospital with bleeding. His ability to read and write was strong; his understanding of medical directions was not. Fortunately, in the five years since Legacy began emphasizing health literacy, we have been able to prevent many of these cases by making progress in our communication with patients and their families. Now, as we look to the future with an eye toward our care, our mission and our strategies, how will health literacy evolve to help? Not “Health Literacy101” anymore Legacy has been on the forefront of health literacy nationwide for five years, making it a real source of pride at Legacy. Our annual health literacy conference is one of only a handful in the country and the largest. More than 2,300 professionals from Legacy and other organizations have attended since the first year, 2012, and it fills up quickly every year. In those five years, more than 4,300 of our doctors, nurses and others have undergone training in “teach back,” a method in which providers confirm whether a patient understands what is being explained to them. We have also offered dozens of classes to teach staff to write in “plain language.” Legacy policy now states that patient education material be written at a sixth-grade reading level. (Go here for more on health literacy at Legacy.) While we have a long way to go in health literacy, the practices have taken hold. Health literacy is integrated into the discussion at Legacy more naturally than it was five years ago. And not just at the administrative level, but on the front line. Legacy is not a “Health Literacy 101” place anymore. A valuable tool Health literacy has emerged as a valuable tool across many fronts: to help improve the experience of our patients; to help reach our mission of improving the health of the community; and to help advance our strategy of transforming care by managing the health of populations. To keep evolving in health literacy, we have made the initiative part of our Patient Experience Program, under the direction of Sara Sluder, program director of Patient Experience and Health Literacy. “We have found that health literacy is a way to open dialogue so we can create more authentic partnerships with our patients,” Sara says. “We are having discussions with our patients, not just around them or about them.”
  4. 4. In addition, we know that there are health disparities in our community: inequalities in receiving and accessing health care across racial, ethnic and socioeconomic groups. One of the best ways to bridge these gaps is to improve our culture competency and our communication with these groups. Good tools for those goals can be found in the health literacy toolbox. Same thing for population health. Because populations consist of all kinds of diverse people of different backgrounds and languages, if we really want to make sure we improve health status, we have to make sure we break down the health care jargon and communicate in a way that promotes better health. What’s next? On a broader level, we have opportunities to use health literacy in a range of communication: Every place where patients and families have to make a decision, we should make sure we are communicating in a way that they understand us –– think billing, insurance, directions. We also could improve our communication to each other for patient safety and for our own job satisfaction. And, again, health literacy gives us the tools. I know that is a big undertaking –– there are 11,000 of us. But, hey, we have come a long way in five years, and I am excited to see where we can go in the future. Thank you for all you do for our patients, Sonja Steves Senior Vice President Human Resources
  5. 5. Leading the Way to the Future is a regular series of email communication from Legacy leadership addressing major initiatives across our organization. Leading the Way to the Future: Legacy–GoHealthexceeds expectations Key points  Legacy–GoHealth Urgent Care has so far met or exceeded our expectations in growth, volumes and patient satisfaction, as well as electronic connection and referrals to the rest of the system.  The centers offer more options for care to the community and give our employees a new place for urgent care.  The centers also fit into our strategy of being in touch with patients outside of the hospital. We’ve been pleased with the progress of Legacy–GoHealth Urgent Care. We launched the new line of urgent care centers with our partner GoHealth in 2015 as a way to give people more options and meet the needs of those seeking convenient care. In less than two years, we are hitting or exceeding our targets. First, we are growing faster than we had initially planned. Our original goal was to have 20 locations by the end of 2017. By early 2017, we expect to have about 20 clinics in place, putting us almost a year ahead of schedule. In addition, we are very happy with the locations. Legacy–GoHealth has helped us extend into parts of the metro area where we haven’t had many services. A good example is Legacy–Go Health Johnson Creek, which takes us into Southeast Portland. Satisfaction, connection, efficiency and referrals We have several other measures of success:  Referrals from Legacy–Go Health to our other services have been strong, especially as we open more locations. In April and May, Legacy–GoHealth Urgent Care locations sent 1,390 referrals to Legacy providers; in June alone, more than 1,350 referrals were made to Legacy providers.  Adopting a measure of consumer satisfaction used mostly in the retail industry, our satisfaction score is 84 out of 100, exceeding such companies as Costco (79), Southwest Airlines (62), Apple (47) and Amazon (38).  We are happy with the ability to integrate GoHealth with Legacy’s Epic electronic health record. Our electronic connection to our providers has been a differentiator between Legacy–Go Health and other urgent care clinics.  The centers are running efficiently. Our goal is to have “door-to-door” time –– from when a patient enters the center to when they leave –– average 45 minutes. We are currently averaging between 47 and 48 minutes, very close to meeting our goal. Plus, online scheduling is a hit with patients. Other interesting developments We have found other benefits of this network of urgent care centers:
  6. 6.  In interviews with patients, some said they chose Legacy–Go Health because of the Legacy name and Legacy providers. “I had a good experience with Legacy while in the hospital, so I decided to trust Legacy–GoHealth,” one patient told us.  Of the Legacy employees and dependents who use urgent care, some 70 to 80 percent now choose Legacy–Go Health.  We did a comparison and found that a large majority of our employees live within a five- to 10-minute drive of a Legacy–Go Health location, meaning our employees and their dependents have easy access to Legacy–Go Health centers. Connected to our strategies As for the future, once we hit our goal of 20 sites, we will likely take a pause from opening new centers. In the big picture, we feel as if Legacy–GoHealth fits nicely into a vision of Legacy being less reliant on “episodic” trips to the hospital, and more toward being in touch with patients all along the continuum of their health care. Our urgent care centers are in line with this vision because they allow us to connect with many patients before they need hospital care. It allows us to keep in touch with patients, perhaps even helping them manage chronic conditions. Our centers also are in line with our mission of good health for the entire community in that they accept patients on Medicare or Medicaid; some other urgent care clinics do not. We realize that launching and expanding a new line of services has taken dedication and focus by a number of people. We appreciate your commitment and applaud the success of Legacy– GoHealth, now and in the future. Trent S. Green Senior Vice President & Chief Strategy Officer President, Legacy Medical Group 1919 N.W. Lovejoy Street | Portland,OR 97209 503.415.5121 Office| 503.415.5025 Fax | tsgreen@lhs.org Assistant:Sheryl Miller | Phone: 503.415.5373 | shemiller@lhs.org www.legacyhealth.org

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