Download Northern Westchester Hospital Community Service Plan 2014

Northern Westchester Hospital
Community Service Plan
2014 UPDATE
1
Northern Westchester Hospital
Community Service Plan 2014 UPDATE
All voluntary hospitals in New York State submit a community service plan to the Department of Health annually. This
report is a summary of Northern Westchester Hospital’s community service initiatives, plans for program development
and collaboration with local healthcare providers and community partners to address New York State’s Prevention
Agenda priorities.
Table of Contents
Page
I.
3
3
3
3
3
II.
III.
IV.
V.
VI.
VII.
VIII.
Mission Statement
A.
Mission Statement for Northern Westchester Hospital
B.
Changes to Mission Statement
Service Area
A.
Hospital Service Area
B.
Service Area Used For Community/Local Health Planning
For the Purposes of the CSP
C.
Description of Service Area
D.
Description of Method(s) Used to Determine Service Area
Public Participation
Assessment of Public Health Priorities
A. Criteria of Public Health Priorities
B. Selected Prevention Agenda Priorities
C. Status of Priorities
D. Additional Prevention Priorities
Three-Year Plan of Action – Selected Prevention Agenda Priorities
Changes Impacting Community Health / Provision of Charity Care / Access to Services
Dissemination of the Report to the Public
About Northern Westchester Hospital
Appendix A:
Additional Prevention Agenda Priorities
Additional NWH Priorities
Appendix B:
Westchester County Health Planning Committee Process Summary
Appendix C:
Map of Community and Region
Attachment A: NWH Community & Region Census Data
3
3
3
3-4
4
4
4
5
5
5-23
23-24
24
25
26-31
32-36
37-38
39
2
I. MISSION STATEMENT
A. Mission Statement for Northern Westchester Hospital
We provide the highest quality diagnostic and treatment services for our community, while assuring access to a
coordinated continuum of healthcare services. We seek to improve and protect the health of individuals in the
community through programs that promote healing and wellness.
B. Changes to the Mission Statement
There have been no changes to Northern Westchester Hospital’s Mission Statement.
II. SERVICE AREA
A. Hospital Service Area
Founded in 1916, Northern Westchester Hospital (NWH) is a not-for-profit, 233-bed, all private room facility in Mount
Kisco, New York serving residents of Northern Westchester, Putnam and Southern Dutchess Counties in New York and
portions of Fairfield County, CT. The hospital offers state-of-the-art care in a warm and nurturing environment for all
area residents regardless of their health insurance status or ability to pay for medical care.
Northern Westchester Hospital’s ‘Community’ is defined as the ten towns/villages in the immediate radius surrounding
the hospital. The hospital’s broader ‘Region’ includes those additional towns/villages located to the north into Putnam
County and to the East towards the Hudson River border of Westchester County. The ‘Community’ and ‘Region’ are
defined by town lines.
(See Appendix C for Community/Region Map)
B. Area Used for Community/Local Health Planning (for purposes of CSP)
For purposes of the Community Service Plan, Northern Westchester Hospital focuses primarily on the Hospital’s defined
‘Community.’
C. Description of Service Area
Demographic and patient data are captured at the zip code level. The population within the Hospital’s service area has
increased 13% since the 2000 U.S. Census. Broken down by age, the most significant growth in population has occurred
in the 35-54 age group with a 55.2% increase followed by a 35.4% increase in the Senior population (age 55-64).
According to the 2010 U.S. Census, the Hospital’s service area is 74.7% White, 15.2% Hispanic/Latino, and 4.9% Black,
3.6% Asian. The Hispanic/Latino population experienced the greatest spike in growth rate at 96.5%.
(See Attachment A for NWH Community & Region Census Data)
D. Method Used to Determine Service Area
Northern Westchester Hospital’s service area is determined by zip codes and influenced by the Hospital’s previous
participation in the Stellaris Health Network.
III. PUBLIC PARTICIPATION
NWH serves the community alongside many dedicated community organizations. These organizations, groups and civic
leaders along with the NWH Board of Trustees, NWH Cancer Committee, employed staff, volunteers and affiliated
physicians are involved in assessing community health needs and contributing their ideas and input towards the
development of NWH’s community service priorities.
Among the many local organizations that collaborate with NWH are: Neighbor’s Link; Open Door Family Medical
Centers; Boys & Girls Club of Northern Westchester; local school districts; NWH President’s Council (which contains
representatives from many local businesses); NWH Junior President’s Council; local Chambers of Commerce, Rotaries
and civic organizations; local and county police departments; and elected officials.
3
Westchester County Health Planning Committee (WCHPC):
 Led by the Westchester County Department of Health, a collaborative group comprised of Westchester County
hospitals and healthcare providers formed the Westchester County Health Planning Committee in order to
advance New York State’s Prevention Agenda.
 This Committee met monthly and held a Health Planning Summit inviting appropriate agencies from throughout
the county.
(See Appendix B for Westchester County Health Planning Committee Process and Summary)
The Community At-Large:
Working with local media, Northern Westchester Hospital conducted a Community Health Survey of community
members within the Hospital’s service area. (Survey was conducted in 2013.)
The Strategic Planning Committee, Board of Trustees and Senior Management conduct an annual Strategic Planning
Retreat to evaluate the hospital’s Strategic Plan, Mission and program development based on the current healthcare
environment and needs of the communities served by the hospital.
IV. ASSESSMENT OF PUBLIC HEALTH PRIORITIES
A. Criteria of Public Health Priorities
County Hospitals and the County Department of Health were required to select two (2) Prevention Agenda Priorities to
address together. One of those items is required to address a healthcare disparity. The public health priorities were
evaluated using several criteria:
 Data – the health of Westchester County’s population was evaluated relative to New York State’s Prevention
Agenda indicators and goals to determine where improvement was needed.
 Impact – focusing on Obesity in the prevention of Chronic Disease will allow us to impact various health
problems: Cancer Prevention, Cardiovascular disease, stroke, and diabetes to name a few. Obesity, heart disease
and stroke were identified as top concerns for our community. Breastfeeding has been shown to reduce
childhood obesity and provide numerous health benefits for mother and child.
 Readiness – Northern Westchester Hospital has existing efforts and partnerships in place to support the chosen
priorities.
It’s important to note that the demographics of the Westchester County population served by each hospital vary
significantly, specifically in the ability to impact the chosen disparity.
B. Selected Prevention Agenda Priorities
The Committee met regularly throughout the year, and working together, selected:
Promoting Healthy, Women, Infants and Children
Focus Area 1: Maternal and Infant Health
Goal #2: Increase the proportion of NYS babies who are breastfed
Preventing Chronic Diseases
Focus Area 1: Reduce Obesity in Children and Adults
Disparity: decrease the percent of blacks and Hispanics dying prematurely from heart-related deaths
4
C. Status of Priorities
Both selected priorities will incorporate many of Northern Westchester Hospital’s existing public health initiatives. These
initiatives will be supported by existing, new and modified programs. All will be supplemented by input and support
from community partners to varying degrees.
As a hospital, we have always focused on 3 key constituencies:
1) Northern Westchester Hospital staff members: more than 1,500 employees.
2) The patients we serve: approximately 145,000 outpatient encounters and over 10,000 admissions in 2014.
3) The community at-large
D. Additional Prevention Priorities
Northern Westchester Hospital is committed to ensuring that all members of the community receive access to quality
healthcare and actively participate in programs focused on the prevention, diagnosis and treatment of diseases. In
addition to the initiatives that support the two selected Priorities, NWH has numerous efforts and ongoing programs
that support several priority areas of New York State’s Prevention Agenda.
NWH also offers programs that address the needs of the community that are not specifically included in New York
State’s Prevention Agenda.
(See Appendix A for NWH programs not included under the two Selected Priorities.)
V. THREE-YEAR PLAN OF ACTION – Selected Prevention Agenda Priorities
PRIORITY:
Promoting Healthy, Women, Infants and Children
Focus Area 1: Maternal and Infant Health
Goal #2: Increase the proportion of NYS babies who are breastfed
STRATEGIES:


Create an environment around women for initiation and sustaining breastfeeding for at least six months
Create a systematic approach looking at prenatal care providers, hospital policies, support groups to change
community environment
Program: Breastfeeding
Description & Purpose: Northern Westchester Hospital’s Lactation Department, in conjunction with the Maternal Child
Health Department, recognizes the importance of exclusive and sustained breastfeeding for the health and well-being of
the mother/baby dyad. Our mission is to break down barriers that prevent mothers from achieving their breastfeeding
goals and to effectively communicate best practices. Ensuring adequate prenatal education and support is essential to
successful breastfeeding. We follow the evidence-based “10 Steps to Successful Breastfeeding.”
Target Population: All women of child-bearing age in Mt. Kisco, NY and surrounding towns in Westchester County, NY.
Goals & Objectives:
Short-term:
 Exceed the Healthy People 20/20 goal of 81.9% breastfeeding upon discharge target.
o Achieved NWH measures in 2012 were 89.9%.
Long-term:
 Continued achievement of the evidenced-based gold standard of exclusivity of breastfeeding upon discharge,
encouraging rooming in per the CDC mPINC survey. (The Maternity Practices in Infant Nutrition and Care
5


(mPINC) Survey is a national survey of infant feeding practices in facilities that provide maternity care services.
The Battelle Centers for Public Health Research and Evaluation has conducted this survey for the Centers for
Disease Control and Prevention every other year since 2007.)
Increase number of mothers that exclusively breastfeed for 6 months
increase the attendance of the post-partum breast feeding support group
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
4th quarter 2012 through 2013
 Coalition building: Recruit a breastfeeding champion physician (an Obstetrician and/or Pediatrician) to co-host
Lactation Grand Rounds. This can be an effective tool to educate other physicians as well as increase visibility
and legitimacy of lactation services available
2013 through 2014
 Establishment of community wide Lactation advisory council to provide counseling, referrals and follow up
support. Involve lactation consultants, Doula’s, local WIC office. Post yearly calendar for community breast
feeding classes.
o Lactation Advisory Council:
The Lactation Advisory Council recognizes the importance of exclusive and sustained breastfeeding for the health and
well-being of the mother/baby dyad. The mission is to break down barriers that prevent mothers from achieving their
breastfeeding goal and to effectively communicate best practices not only to patients, but to other members of the
healthcare team. Ensuring the adequate education and support to both the inpatient and outpatient breastfeeding
woman is the responsibility of this council.
 Lactation Advisory Council Members:
Northern Westchester Hospital Maternal Child Health, Nursery/NICU, Maternity, Labor & Delivery, Pediatrics,
Lactation Consultants, Lactation Counselors, Prenatal Assistance Care Program; Mount Kisco Medical Group
(MKMG) Lactation Consultant, Clinical Coordinator
4th quarter 2013 through 2017
 Evaluate community outreach opportunities.
 Create content for distribution: blog posts, newsletter articles, public presentations, tips and information for
social media.
4th quarter 2012 through 2017
 Collaborate with Prenatal Care Providers to create systematic approach on standard of care expectations
sharing professional organizations Policy Statements.
 Community outreach to educate on benefits of breastfeeding, norms of breast feeding in public, trying to create
an environment around women.
2015
 Maternal/Child Health department is collaborating with Patient Care Research staff to develop a tool to capture
breastfeeding information post hospital discharge through 6 months. Anticipated launch is 2015.
Outcome Measures:
At this time, we are able to report 2013 Breastfeeding statistics:
Breast feeding upon leaving NWH – 87.8%
Exclusive Breast feeding upon leaving NWH – 65.59%
Community Partners: Community businesses, Obstetricians, Pediatricians, WIC, La Leche League,
building coalitions and normalizing breastfeeding within the community.
Partner
Role
Prenatal Clinic
Reaching underserved population
Neighbors Link
Reaching underserved population
WIC
Reaching underserved population
6
Mount Kisco Medical Group
Westchester Health OB
PEDI Nurse Managers
Chambers of Commerce
Prenatal educational opportunity
Prenatal educational opportunity
Post-partum educational opportunity
Reaching business community
Program: Accommodation of Breastfeeding Staff
Description & Purpose: Recognizing that breastfeeding is an essential aspect of life for mothers and allows for the
optimum growth and development of infants, NWH makes available an environment that supports breastfeeding staff.
 NWH encourages all staff to have a positive, accepting attitude toward breastfeeding staff. NWH will not
tolerate any discrimination and/or harassment of breastfeeding staff. Any incidents of harassment of a
breastfeeding staff member will be addressed in accordance with NWH policy of “Discrimination and
Harassment.”
 NWH policy allows for reasonable break time for staff to express milk at work.
 NWH provides a functional, private space with comfortable seating to express breast milk. The location is
protected from view, and absent of intrusion from co-workers or the public. The location has access to an
electrical outlet for the sole use of an electronic breast pump as well as a sink with hot water and soap for hand
washing and cleaning of breastfeeding equipment.
 Additionally, expressed breast milk must be labeled with the staff member’s name, date and time and can be
stored in the assigned refrigerator.
Target Population: NWH Staff who are breastfeeding
Goals & Objectives: Provide an environment which supports and encourages staff who are breastfeeding when they
return to work.
PRIORITY:
Preventing Chronic Diseases

Focus Area 1: Reduce Obesity in Children and Adults
o Disparity: decrease the percent of blacks and Hispanics dying prematurely from heart-related deaths
STRATEGIES:


Engage both youth and adults in the community to create awareness, educational opportunities, screening
occasions, and clinical programs that address the obesity epidemic from both a prevention and management
standpoint for both chronic disease and cancer.
Create a systematic approach looking at providers, hospital policies, and support groups to change community
environment.
Program: Food is Care
Description & Purpose: The NWH Kitchen was redesigned to enhance the delivery of patient food services and Cafeteria
offerings and to support implementation of a full room service menu for inpatients. Nutritional programs have been
instituted to reach NWH staff and visitors as well as patients. The following initiatives have been implemented as part of
the NWH Food is Care program.
Target Population: NWH Patients, Staff and Visitors
Goals & Objectives: Create an environment that promotes and supports healthy food and beverage choices.
7
Strategies/Interventions used to Achieve Objectives:
Healthy Dining
Grab ‘n Go
The NWH Healthy Grab n’ Go Station in the NWH Café is a refrigerated unit featuring healthy choices that are easy for
employees and visitors to “grab n’ go.”
Nutrition Education
Starting November 1, 2013, nutritional labels have been placed on items made in our kitchens. Nutritional information
labels have been made to provide the following information to customers: Name of product, calories, carbohydrates,
sugar, fiber, fat, cholesterol, protein, and sodium. These labels also feature Point-of-Purchase symbols designed to alert
customers with special nutritional needs whether or not it is an item that is appropriate for their diet. These symbols
include: Gluten-free, vegetarian, vegan, spicy and lactose free. 75% of our offerings in the cafeteria are labeled with
nutritional content.
Healthy Plate Program
The Wellness Committee and the Nutrition Department launched the Healthy Plate Club in the Cafeteria modeled after
U.S. government’s ‘MyPlate.’ NWH Registered Dietitians designated a healthy, hot meal selection each week that meets
portion control recommendations and provides a healthy meal option. After a staff member purchases 9 Healthy Plates,
the 10th Healthy Plate is complimentary. The purpose of this program is to increase staff awareness of healthy choices
in our cafeteria; motivate staff to choose healthy selections for meals; and lastly increase servings of fruits and
vegetables that staff consumes.
Re-Think Your Drink Poster Campaign
In conjunction with our new Healthy Grab n’ Go Station, NWH has launched a new campaign for better drink choices in
the NWH Café.’ This campaign provides information about the benefits of choosing healthier drinks with less sugar as
well as information about how to choose a healthier drink. The information is displayed on posters in the cafeteria and
also directly outside the main entrance to the cafeteria. We also have streamlined our drink selection to discontinue use
of sugar sweetened beverages and now only offer water, diet and unsweetened products.
Healthier Vending Machines
Unhealthy choices have been replaced with substitutes that are both tasty and healthy. Customers can even purchase
fresh fruit if they choose to. It is the hope that by providing healthier choices in the vending machines, both employees
and visitors will have an easier, more convenient way to make smart food decisions, regardless of the time of day.
Coffee Bar (located in Front Lobby)
Healthier options are provided, as well as several Gluten-Free Items from Local Gluten-Free Bakery “Three Dogs.” In
addition, a healthy grab n’ go was placed at the coffee bar.
Staff Education
Smoothie Cart
The smoothie cart was launched in August, 2013. NWH CEO, Joel Seligman and Registered Dietitians provide nutritious
smoothies and recipes to hospital staff each month. The goal of this unique smoothie cart is to provide nutritious snacks,
an opportunity for education and staff appreciation.
National Nutrition Month 2013
Weekly during the month of March, Registered Dietitians provided complementary smoothies and recipes along with a
variety of nutrition information to staff and the public. Topics included: How to enjoy more fruits and vegetables, How
8
to read a food label, The importance of breakfast, and Everyday healthy eating. RDs also brought healthy snacks around
to staff in various departments and patient care areas.
Monthly Lunch and Learns
All staff are invited to gather monthly to hear a wellness lecture while eating a complimentary healthy meal. A Q & A
session follows each lecture. Topics are determined based on aggregated screening and HRA data provided by
HealthFitness. 2014 topics included: Deconstructing Popular Diets, Combatting High Cholesterol, Fat Loss: The Healthy
Way, The Very Versatile Vegetable, Nutrition and Fitness Applications, Stress and Inflammation, Sun Protection and
Melanoma Prevention, Beverages: The Healthy Choice, How to Get a Good Night Sleep, Diabetes and Pre-Diabetes: The
Good, the Bad, and the Ugly and Swapportunities.
Nutrition Tip of the Month
Registered Dietitians have developed a ‘Nutrition Tip of the Month’ to be displayed on NWH’s internal TV screens to
staff and visitors. Tips are also posted twice a month on local online media outlets to reach the larger community.
Nutrition Corner
Launched in first quarter 2014, Registered Dietitians are available once per month in the cafeteria for staff and visitors
to stop by to obtain education materials, recipes and answer any nutritional questions.
Nutrition Education Videos
Projected to launch first quarter 2015: Registered Dietitians will develop a library of Nutrition Education Videos to be
offered to patients and their families over the hospital’s health information channel in patient rooms. Future videos may
also include food demonstrations and may be available to the public via the hospital’s website.
Wellness Corner in the Cancer & Wellness Center
Launched in second quarter 2014, a reserved space for outpatients to relax, exercise, research, and learn about healthy
cooking. The space is set up with a library, internet access, light exercise equipment and yoga mats, and a healthy food
cupboard and cooking cart. A registered dietitian has nutrition and cooking classes weekly. In this same space, if the
patient prefers, they can have a one-on-one nutrition consult with the registered dietitian.
Community & Staff Outreach
Content Creation
NWH Registered Dietitians are contributing to NWH Experts’ blog, electronic newsletter (35,000 subscribers), and print
newsletter (200,000 distributed). These articles are focused on various nutritional and wellness topics to educate staff
and the community on healthy eating practices with corresponding recipes. This content is also shared with our media
partners for distribution online and in print.
Meatless Monday & Fiber Friday Campaign
NWH Registered dietitians have developed a ‘Meatless Monday’ and ‘Fiber Friday’ tip that will be promoted on NWH’s
Facebook and Twitter accounts. These tips were published the first Monday and Friday of each month throughout 2014.
This campaign is available to all of our constituent groups.
Twitter Campaign
First quarter 2014: A one-time 30 minute virtual event on Twitter, inviting followers to Ask the Registered Dietitian
nutrition related questions. This campaign is available to any individual who follows
Chappaqua-Mt. Kisco Patch Blog
9
Beginning fourth quarter 2013 - NWH Registered Dietitians created and contributed quarterly nutritional pieces to the
Patch (local online media outlet). This blog is available to staff as well as the community.
Healthy Recipes
Compilation of healthy nutritional recipes for various meals and occasions, available on the Hospital website.
NWH Restaurant Partnership
The goal is to create a sustainable partnership to allow NWH Registered Dietitians and local restaurants to demonstrate
their shared concern and support for community health. The restaurants will offer a minimum of two exclusive healthy
dishes incorporating nutritional guidelines that meet the criteria of NWH’s Healthy Plate Program. The partnership
would also encourage a more widespread outreach communications program to target individuals, groups, etc. to
benefit from and/or contribute to the overall objective. This programs projected launch date is fourth quarter of
2013/first quarter of 2014.
PCAP (Prenatal Care Assistance Program)
Assess and educate patients through the prenatal care assistance program (PCAP) who are screened and found to be at
high nutrition risk.
The Diabetes Center @ NWH
Our Registered Dietitian Diabetic Educator works in conjunction with Registered Nurse Diabetic Educator to educate
patients in different scenarios – Diabetes Self-Management Education classes (DSME), One-on-One Nutrition education
as well as support group (RD runs 1-2 support group/year).
Pulmonary/Rehab Luncheon
Initially ran as a cardiac lunch 1x/month. This luncheon will begin to be offered to all patients who are involved in either
cardiac or pulmonary rehab. The goal of this luncheon is to help to encourage an open dialog between the patients and
RD to reinforce healthy eating. (Each of the patients as part of their rehab receives 1 (one-on-one) nutrition visit).
Bariatric Support Group
A nutrition themed monthly group to provided support and ongoing nutrition education to help encourage patients
preparing or who have had bariatric surgery make the healthy lifestyle changes necessary for weight loss.
Cancer & Wellness Support Group
Projected launch date first/second quarter of 2015.
This support group will meet weekly to focus on cooking demonstrations and nutritional topics of concern for outpatient
cancer and wellness patients.
Youth Program Highlights/Nutrition
At NWH, we have made it our mission to improve and protect the health of individuals in our community through
programs that promote healing and wellness. To that end, we continue to develop “hands-on” programs, including
classroom workshops and interactive display programs designed to reach a wider audience. We have also strengthened
and broadened our relationships with community partners.
New and Up-dated Nutrition Workshops
#BetterinBalance Campaign – NWHC’s youth council developed a campaign designed to promote better health choices
among children and teens. Programs for elementary to high school students teach practical skills, such as cooking, and
include interactive workshops on basic nutrition, food labels, healthy snacking and beverage choices, eating the rainbow
(foods from all color groups), and body image.
10
•
•
•
•
•
Nutrition 101 and Portion Control
Reasons to Love Labels
Smart Snacking
Eat the Rainbow
Getting Active
Fox Lane Middle School - After School Cooking Club
Over the course of the 7 week program students learned to view “snacks” as a nutritional opportunity, and gained
practical experience in preparing healthy snacks from scratch.
Workshops included:
 We Need Plants to Live - Plant Parts Dip and Veggies
 Think About Your Drink - Almost Sodas
 What’s in that Snack? - Fire Roasted Salsa
 Make ½ Your Grains Whole - Chicken Fried Rice
 Break Out with Breakfast - Apple Filled Crepes
 Exercise – Just Do It! - Fruit Smoothies
 Diet & Sports Nutrition - A Better Ade, Fruit with Dips
Program: Community Health Outreach Program (CHOP)
Description & Purpose:
CHOP’s initiatives and objectives are aligned with the goals of NYS DOH’s Health Improvement Plan: The Prevention
Agenda 2013-2017. Phase I includes preventing chronic and vaccine preventable diseases; promoting initiatives that
focus on primary and secondary prevention; healthy women, children and infants; and, mental health. Phase II includes
promoting access to quality health care and reducing health disparities. Prevent chronic and preventable diseases.
CHOP’s programs improve healthcare access and delivery to the growing underserved population in our region through
targeted and effective community outreach and education initiatives, and to reduce healthcare disparities between the
underserved, and the general public. Prevent chronic and preventable diseases & reduce healthcare disparities.
Each year through CHOP, Northern Westchester Hospital provides essential health education and outreach through free
health fairs, lectures, screenings, and flu vaccines to individuals in the region.
Registered nurses, dieticians and other clinicians (some of whom are bilingual) conduct health screenings and distribute
culturally sensitive, bilingual health education materials to community members to reinforce healthcare messages.
These programs increase access to high-quality healthcare and minimize healthcare disparities in our underserved,
particularly the immigrant Latino population, and the general public.
Health screenings include blood pressure, diabetes (glucose), osteoporosis, cholesterol, stroke, and vascular. Medical
equipment includes stethoscopes, two types of blood pressure cuffs, six cholesterol machines, one bone ultrasonometer
(a portable device to detect osteoporosis) ,and all necessary medical supplies.
Bilingual educational brochures that are culturally sensitive are distributed to promote effective follow-up with a
primary physician. Bilingual health screening forms contain information about a particular health screening, where NWH
staff record the participant’s results and provide recommendations and resources available to help reduce their risks.
Target Population: Underserved or economically disadvantaged.
11
Goals & Objectives:
 Prevent chronic and preventable diseases; promote initiatives that focus on primary and secondary prevention;
promote access to quality healthcare and reduce health disparities.
 Increase screening rates for blood pressure, diabetes (glucose), cholesterol, stroke, and vascular especially
among disparate populations.
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
 Screenings, bilingual educational materials.
 As part of CHOP, a licensed dietician now works with a nurse at cholesterol or glucose screenings to educate
how dietary changes can foster better health.
Outcome Measures / Frequency:
Program success is determined using qualitative and quantitative measures. We measure program effectiveness through
a database that tracks the number of: events; partner sites; individuals provided education and screening, and education
materials distributed. We will obtain anecdotal information from clients, staff and partners on participant demographics,
overall program satisfaction and growing demand for education services and screenings.
The overall success of CHOP continues! The following highlights accomplishments achieved from September 2013 –
September 2014: Prevent chronic and preventable diseases & reduce healthcare disparities.
• Participated in 69 health screening events, health fairs, education & outreach programs, and flu clinics reaching
3000 community members.
• Strengthened partnerships with area community organizations and faith-based organizations. Held 10 health
screenings/flu clinics at Neighbor’s Link and 8 at The Community Center of Northern Westchester, reaching a
total of 897 individuals (underserved, immigrant Latino population)
• Increased outreach to seniors through health education programs at Heritage Hills, Yorktown Senior Center,
New Castle Seniors, Bedford Seniors, Pound Ridge Senior Fair, and Pinecrest Manor. New Castle Seniors, Bedford
Seniors and Yorktown Seniors were new partnerships in 2014.
• Continued our active membership in the Latino Providers Network of Northern Westchester.
• Continued to provide nutritional counseling by registered dieticians at all community events/screenings to raise
awareness of the link between weight, exercise and diet and a reduction in the risk of developing chronic
diseases. In addition, to enhance our nutrition education materials, NWH provides bilingual information on
nutrition and food labels and an accompanying food label chart display.
• Developed new bilingual screening forms for blood pressure, cholesterol, osteoporosis, and diabetes/glucose.
The forms contain information about a particular health screening, the participant’s results and
recommendations and resources to help reduce risk, if appropriate.
Community Partners: NWH registered nurses, dieticians, a bilingual patient navigator, physicians, technologists, and
radiologists (some of whom are bilingual) work in collaboration with our Director of Community Health Outreach and
over 20 community organizations to conduct flu vaccine clinics and develop and implement health screenings and fairs.
Program: Youth Health Education
Description & Purpose: Each year, Northern Westchester Hospital partners with school districts and community based
organizations in our service area to conduct health education programs on a variety of topics for all students, from grade
school through high school. All of the programs are designed to help children improve their overall health by:
(1) introducing facts, principles and techniques in given subject areas,
(2) providing strong encouragement for positive behavioral change, and
(3) increasing student awareness, interest and confidence about these subjects to encourage maintenance of good
health.
12
Educational topics include: first aid and safety, healthy snacks/cooking, nutrition and fitness, hand hygiene, tobacco
and alcohol awareness, medical careers, healthy relationships, and healthy ways to handle stress.
Target Population: Children/Adolescents/Teens - K-12
Goals & Objectives:
 A great deal can be achieved in supporting and advancing healthy behavior such as:
o Introduce specific important items of knowledge in subject areas: facts, principles and techniques.
o Provide strong encouragement to arouse intent for positive behavioral change.
o Increase awareness, interest, confidence, and a sense of importance of the subject area for maintaining
good health.
 Create community environments that promote and support healthy food and beverage choices and physical
activity.
 Prevent childhood obesity through early child care and schools.
Outcome Measures / Frequency:
We use Process Evaluation (monitoring) to determine how many people are served by our programs.
We use Outcome Evaluation to determine whether a program has the effect we expect it to have.
 To assess the quality and effectiveness of our instruction, a survey, that includes two free response questions, is
completed by school faculty or CBO observers at each session. Observer-teachers return the survey at the end of each
session. They are asked to evaluate our instructional approach, student reactions, engagement, and motivation.
 Periodically, we assess changes in student understanding/appreciation of the subject area, and administer a before
and after survey.
 We also receive anecdotal feedback from teachers, staff and students, which we use to improve and grow our
programs.
September 2013 to September 2014, NWH Health Educators achieved the following: Provided a total of 193 health
education programs to 8,224 children in Northern Westchester’s elementary, middle and high schools by way of over
190 interactive programs and/or workshops. Support and advance healthy behavior.
 Reached over 1,700 parents and students through panel presentations, with topics ranging from alcohol awareness to
stress and nutrition. Increase awareness & support community.
 Engaged 2,425 children through tabling events in school cafeterias, farmer’s markets and the hospital’s own annual
Teddy Bear Clinic. Support Healthy food and beverage choices & prevent childhood obesity.
 Summer 2014, our Registered Dietitian promoted wellness with nutrition workshops at five local camp locations,
reaching over 1,000 children. Support Healthy food and beverage choices & prevent childhood obesity.
 Expanded on our relationship with Chappaqua , Katonah - Lewisboro and Pleasantville schools to include more
programs K- 12, with a focus on nutrition. Support Healthy food and beverage choices & prevent childhood obesity.
 Using interactive displays we engaged the public at local events, including races, community fairs and programs run by
local organizations – The Wheel of Nutrition, Exercise Dice, Germ Busting, First Aid, and food demos. Support and
advance healthy behavior and increase awareness & support community.
Evaluation and Notable Survey Responses
 “The nurse that came into my classroom was so kind to the students and answered all of the questions they had. It
was a very informative and enjoyable experience.”
 “Good reinforcement of WHEN to wash hands and WHY.”
 “Blue light/germ activity was very effective and really had an impact on the students.”
 “The presenter was extremely informative and encouraging.”
 “Students were amazed that even though food labels say ‘healthy,’ you MUST read nutrition labels.”
13
 “Students were eager to participate and learned from the nutrition BINGO activity.”
 “It was great that the students got to practice making 911 calls.”
Community Partners:
Partner
Role
Northern Westchester Public School Districts:
Receive education / Advise on development
Bedford Central, Byram Hills Central, Chappaqua
Central, Katonah-Lewisboro, Lakeland Central,
North Salem Central, Pleasantville Union Free,
Somers Central, Yorktown
Neighbors Link
Receive education / Advise on development
Boys & Girls Club
Receive education
Girl Scouts
Receive education
Community Libraries
Provide use of facility for events
Program: Northern Westchester Local Food System Project
Description & Purpose: The Northern Westchester Local Food System Project is an outgrowth of the Bedford 2020
Coalition – a local grassroots organization formed to implement Bedford, New York’s Climate Action Plan through
activities such as local food procurement. The Coalition’s food and agriculture task force was assembled to promote
local foods and local farms.
Mission: “Build an economically viable, high-quality locally-sourced food system for institutional buyers. This system
must be reliable, resilient, responsive and replicable.”
To date, the hospital has begun the process of ordering through the aggregator, Red Barn Produce. The Executive Chef is
pleased with the very seasonal product, the resulting menu, and the service. The hospital is now taking the steps
necessary to continue ordering. However, until other institutions agree to participate in this new local food system,
Institutions may only willing to invest in this project if the local product costs are competitive with existing vendor
pricing
Hyper-Local Farms
Five hyper-local farms are interested in participating in the project, and Red Barn Produce is disposed to source from
them. None are currently GAP certified, so they may only be able to supply produce to be cooked:
Amba Farms, Bedford Hills – organic practices
Ryder Farm, Brewster – certified organic
JD Farm, Brewster – conventional
Meadows Farm, Yorktown – conventional
Stuart’s Farm, Somers – conventional
There are grants administered by NYS for the USDA, to reimburse costs associated with getting GAP certification, which
is helpful to small farms. Sustainable Food Systems will reach out to the 5 hyper local farms with information about this
“NYS Good Agricultural Practices/Good Handling Practices Certification Assistance Program.”
Target Population: Institutions and local farms in Northern Westchester
This is a program that began as a pilot in 2011
Goals & Objectives: Create community environments that promote and support healthy food and beverage choices.
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
14
A recently released American Farmland Trust report confirms the Northern Westchester Local Food Project is cuttingedge, and has been focusing on the right issues to ensure the project becomes an early success story. The report is
called Scaling Up. Strategies for Expanding Sales of Local Food to Public and Private Institutions in New York.
Outcome Measures / Frequency :
Aligning more institutions with the program
Adding more hyper-local farms to the stable of suppliers
Community Partners:
Partner
Role
Red Barn Produce of New Paltz, NY
GHP certified aggregator/distributor for regional
produce to start, and later in the project for hyperlocal produce
Flik Independent School Dining (Rippowam Cisqua Institution
School and other schools they manage).
Sustainable Food Systems
Northern Westchester Hospital
Institution & Steering Committee.
Bedford 20/20
Steering Committee
Green Schools Coalition of Westchester
Steering Committee
Bedford 2020 Coalition
Steering Committee
Program: Pediatric Medically Supervised Exercise/Wellness Program
Description & Purpose: A Pediatric Medically-Supervised Exercise Program for children and adolescents with lung and
breathing disorders. The pediatric program will be a comprehensive program for both patients and their families. This
age/developmental individualized program, seeks to enhance physical and social performance, and improve healthrelated quality of life. The rehabilitation staff will examine, diagnose, treat, and teach participants to prevent, correct
and limit physical disability, and illness or disease. To provide a safe and effective exercise program, the availability of
nutrition counseling and stress management training and education, and training and education on pulmonary disease.
Target Population: Children and adolescents seven years of age and older with a pulmonary disease.
Existing program
Goals & Objectives: Our goal is to enable any child or adolescent to lead a full and satisfying life within his/her family,
school and community. This goal is achieved through the recognition, assessment, treatment and management of
symptoms and limitations arising from chronic illness. These goals will be achieved by meeting the following objectives:
•
To promote and maintain improvement in physical capabilities
•
To improve body composition
•
To improve ability to participate in daily activities in home, school, and community
•
To increase and encourage continued participation in physical education, leisure, and fitness activities at home
and with family and friends
•
To develop in the individual a perception of well-being
•
To assist the individual in developing methods to cope with his/her disease
•
To provide the individual with a better understanding of his/her disease process
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
The program will include Education and Training, Cardiopulmonary and Resistance training, proper Nutrition,
Psychosocial support, and Recreational Therapy to focus on a return to previous activity level. An Exercise Prescription
specific for children and adolescents with pulmonary disease (frequency, intensity, time, duration, resistance and
flexibility); Nutrition Consultation; Education and Training; and Stress Management Classes.
15
Outcome Measures / Frequency:
Outcome Measures are tested prior to starting the program and after 32 sessions.
1. Functional Status/Exercise capacity – 6 Minute Walk Test;
2. Cardiopulmonary Exercise test (selected patients)
3. Exercise Challenge Test (selected patients)
4. Dyspnea Measure During 6 Minute Walk Test – Modified Borg Dyspnea Scale;
5. METS (Metabolic Equivalent) – Unit of Energy Expenditure;
6. Strength Test/Fitness Tests – Fitness Gram;
7. Quality of Life Questionnaire;
8. Disease Knowledge Test;
9. BMI Determination.
2014- The program did not develop as we anticipated (very small enrollment) – Unable to capture outcomes
(participants failed to report for post outcome measurements).
2015- We will continue to reach out to parents and physicians to increase patient volume. We will stress need for pre
and post outcome determinations.
Program: Medically Supervised Exercise/Wellness Program for Adults
Description & Purpose: A Medically-Supervised Exercise Program for individuals with a pulmonary disease. To provide a
safe and effective exercise program; the availability of nutrition counseling and stress management training and
education; and training and education on pulmonary disease.
Target Population: Adults with a Pulmonary Disease
Goals & Objectives: Improve patients’ ability to carry out activities of daily living, improve functional level and quality of
life. Help patients become less fearful of physical activities and become more active. Alleviate anxiety and depression.
Improve mood and self-esteem. Improve body composition and weight. Provide a better understanding of his/her
pulmonary disease.
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
An Exercise Prescription specific for individuals with pulmonary disease (frequency, intensity, time, duration, resistance
and flexibility); Nutrition Consultation; Education and Training; and Stress Management Classes. References: American
Thoracic Society, American College of Chest Physicians, American College of Sports Medicine, American Association of
Cardiovascular and Pulmonary Rehabilitation.
Outcome Measures / Frequency:
Outcome Measures are tested prior to starting the program and after 36 sessions.
2014 Outcomes - First Quarter (January-March) & Second Quarter (April-June)
Outcome Measures / Frequency:
1. Functional Status/Exercise
capacity – 6 Minute Walk Test;
2. Dyspnea Measurement –
Modified Borg Dyspnea Scale
The “Rating of Perceived Exertion”
(patient symptoms) during the 6
2014 Outcomes - First Quarter
(January-March)
An average score improvement of
34% on the post program 6 Minute
Walk Test (Goal - 40%).
An average score improvement of
20% on the post program 6 Minute
Walk Test (Goal – 20%).
2014 Outcomes - Second Quarter
(April-June)
An average score improvement of
25% on the post program 6 Minute
Walk Test (Goal - 40%).
An average score improvement of 22
% on the post program 6 Minute
Walk Test (Goal – 20%).
16
Minute Walk Test.
3. Quality of Life – St. George’s
Respiratory Questionnaire SGRQ)
4. Patient Retention
5. Change in Upper Body Strength
6. Change in Lower Body Strength
7. METS (Metabolic equivalent) - A
unit of energy expenditure during
the 6 Minute Walk Test
8. COPD Assessment Test (CAT) –
The CAT is a tool to measure COPD
health status and to quantify the
impact of COPD on one’s life and
the changes over time. It identifies
where COPD affects the patient’s
health and daily life the most.
9. Psychosocial (Depression
Module): Patient Health
Questionnaire (PHQ-9)
An average score improvement of
18% on the post program
questionnaire versus pre-program
questionnaire (Goal – 20%).
80% (Goal – 50%)
improvement of 51% (Goal - 40%)
improvement of 37% (Goal - 40%)
improvement of 25% (Goal – 20%)
An average score improvement of
10% on the post program
questionnaire versus pre- program
questionnaire (Goal – 20%).
86% (Goal – 50%)
41% (Goal - 40%)
45% (Goal - 40%)
31%
Outcome not started this quarter.
(Goal – 20%)
10%
improvement of 50% (Goal – 20%)
52%
Program: NWH Center for Diabetes
Description & Purpose: The Center for Diabetes seeks to educate patients and their families about Diabetes and the
skills necessary for effective self-management and health promotion.
Through an interdisciplinary team approach, the Hospital staff serves both inpatients and outpatients, focusing on the
individual teaching needs of each patient and coordinating with the patient, the family, the physician/LIP, and other
resources as necessary.
Target Population: Patients with a diagnosis of diabetes ( type 1, type 2, or gestational diabetes) or at risk of developing
diabetes.
Goals & Objectives:
To understand the basics of the diabetes disease process and understand acute and long term complications of diabetes.
Understand the basics of a balanced diet, including the components of a healthy meal and portion control.
Understand the basics of diabetes dietary management including:
What foods affect blood sugar;
Portion sizes of carbohydrates;
Healthiest types of carbohydrates and foods to limit;
Pairing of carbohydrates with protein sources;
Understand the importance of physical activity and exercise in diabetes management, as well as recommended exercise
levels.
Understand the importance of staying healthy, including checking blood sugar levels, cholesterol and
blood pressure regularly, and doing regular self-exams.
Understand the importance of maintaining a healthy weight in diabetes management.
Gestational diabetes: Understand risk for development of type 2 diabetes in the future.
Understand lifestyle interventions postpartum can prevent onset of type 2 diabetes.
Understand benefits of breastfeeding on glycemic control and weight management.
17
PCC Gestational diabetes program: Added postpartum OGTT prior to insurance cessation to identify women who are
either prediabetic or diabetic and counsel/refer accordingly.
 It is the standard to have a postpartum OGTT to identify women who continue to have diabetes after pregnancy.
The program had referred women back to their Primary care provider for testing but it was felt women did not
follow up with this testing. It was also a revised goal/objective to have another educational opportunity for
diabetes prevention with sustained lifestyle interventions postpartum.
2015 PLANS
Tentative: New Audience: Work with Breast institute to establish an algorithm or treatment plan for people with
diabetes and breast cancer. Reinforce importance of good glycemic control to decrease recurrence and promote selfmanagement skills.
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
 American Diabetes Association Recognized DSMT Site.
 American diabetes Association: Clinical Practice Recommendations 2013.
 AADE 7 self-care behaviors
Outcome Measures / Frequency:
ADA requires annual status report and recertification 4 years
o NWH Center for Diabetes received ADA re-recognition status from 4/2014-4/2018. The ADA certificate
recognizes the center for diabetes as meeting the national standards for diabetes self- management education.
o Report to NWH quality department quarterly.
Community Partners
Partner:
NWH Diabetes advisory committee:
endocrinologists from MKMG and Westchester
health, podiatrists, inpatient hospitalists, inpatient
& outpatient nutritionist, Diabetes educator from
Open Door Family Medical Center, one person
with diabetes (from the support group), 2 NWH
staff nurses, wound care program representative.
Role:
Reviews data from the NWH Diabetes Center and
advises on proposed changes, provides
recommendations for future changes.
Program: Prescription to Wellness ™
Description & Purpose: This program was developed in conjunction with area physicians. For patients who are at risk of
becoming obese, developing diabetes, and/ or facing cardiovascular problems, physicians can refer them into this
program designed to provide participants practical education and coaching in nutrition and fitness activities. The goal is
to help these participants learn healthy behaviors with a goal of preventing the onset of more serious illnesses.
Target Population: Patients at risk of becoming obese, developing diabetes, and /or facing cardiovascular problems.
o Offered to NWH staff in 2014
Goals & Objectives: Complete two sessions in 2014
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
Baseline respiratory and cardio testing. The tests will be completed at the end of the program for comparative
purposes.
18
Outcome Measures / Frequency:
Outcomes will vary based upon the condition of patients and will be collected at the inception and conclusion of the
program.
Community Partners:
Partner
Westchester Health Associates
WeeZee World
Role
Physicians identifying and referring patients
Interactive sensory activity facility
Program: Surgical Weight Loss Support Group
Description & Purpose: Support Group for patients who are preoperative or postoperative bariatric surgery.
Target Population: Patients who are planning to have or have had bariatric surgery.
Goals & Objectives: Provide community and support to the bariatric surgery patient population.
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
Monthly Support Group - MaryPat Hughes, RD (facilitator):
The Importance of Journaling - research shows people who keep a food and exercise journal are more successful with
their weight loss attempts and so I encourage my patients to keep a journal.
Bariatric Tool Box - together with the participants a list of important tools for success was developed, ie. water bottle,
small utensils and plates, clock, vitamins, sneakers. This tool box discussion helps to reinforce the idea that the surgery
is also a tool and not a cure for obesity. The success is dependent on the patients making lifestyle changes and the
tools talked about help to make this change possible.
Mindful Eating - This topic helps the participants to start to make the transition from an impulsive eater to an intuitive
eater. The participants are educated to start to think about eating as a biological necessity as opposed to an emotional
response or a physical activity.
Common Nutrition Mistakes After WLS - During this session the diet modifications following WLS are discussed to
reinforce some of the principles. For example, portion size control; "rule of 30" which refers to avoiding fluid for 30
min before and after meals; eating adequate protein and eating pro 1st, veg 2nd and cho last; encouraging the
avoidance of sweets and carbonation.
Outcome Measures / Frequency:
Attendance; collected monthly
Jan – Aug 2014: 145 attendees
Program: Workplace Wellness
Description & Purpose: Our goal at Northern Westchester Hospital is the improvement of our patients’ lives through
process-oriented patient-centered care. The outstanding quality care we bring to the community is only possible
because of our outstanding staff. We recognize the individuality of our staff and celebrate the diversity of your many
interests and experiences that you bring to NWH.
When trying to balance the demands of work, home and family, it’s all too often that wellness becomes a lower priority.
NWH’s Wellness Committee is an active group who knows the importance of wellness in your work and your life!
Wellness is more than just not being sick, it’s fitness of mind, body and spirit. Everyone takes different steps to enhance
their health and well-being.
Target Population: NWH Staff
19
Goals & Objectives: Create community environments that promote and support healthy food and beverage choices and
physical activity. To offer a comprehensive worksite wellness program to employees that promotes an environment of
organizational and individual responsibility for health, and well-being.
Planned Activity:
Nutritional Consultations: Staff enrolled in the NWH group health insurance are eligible for up to 12 visits per year. A
diagnosis is not required. Onsite consultations are available with a NWH Registered Dietician. The co-payment for onsite
consultations is waived.
Fitness Reimbursement Program: NWH pays a $100 reimbursement to eligible staff who complete a confidential annual
Health Risk Assessment and log their physical activities such as walking, running, or working out at a gym, for at least
two times per week for six consecutive months.
Wellness Discounts, Promotions, and Events: In an effort to enhance the overall health and well-being of our staff, NWH
communicates with local business as well as businesses in the communities in which staff live, to offer discounts and
promotions to our staff. These discounts include; Fitness Center discounts, restaurant discounts, and family
entertainment discounts. NWH also makes it a point to inform staff of local farmer’s market locations, athletic events
such as marathons and walks, and charity based events in the local community. Discount and promotion offerings as
well as community events are communicated to staff via electronic newsletter, the Staff Website, Employee Congress
meetings, and onsite vendor events.
Work/Life Program: available to staff and their immediate family members includes: Confidential Counseling, legal
consultations, financial resources, telephonic health and Wellness Coaching, Work/Life Resources
E4 Healthcare/Lifescope Tobacco Cessation: Online or with a Tobacco Cessation Coach, Individual Telephone Coaching:
Up to one year working with an American Lung Association certified Freedom from Smoking Coach by telephone, InPerson Counseling: Up to 3 sessions of Face to Face counseling with an Addiction Counselor, Virtual Group Sessions: BiMonthly by telephone, NRT Therapy: First 4 weeks of Nicotine Replacement Therapy patches will be provided, Materials
and Resource Library: Materials sent by email with additional articles, videos, and assessments on the
wellnessworklife.com website, Additional Coaching: Unlimited access to Stress Management, Fitness, or Weight Control
coaching as needed.
Northern Westchester Hospital Tobacco Cessation: FREE Smoking Cessation classes offered to community with free NRT
and unlimited counseling
• $25 surcharge per pay period deducted from smoking staff member and smoking spouses (only applies if staff member
and/or the spouse participate in the NWH medical plan)
• Quit Smoking Cold Turkey – offered during the holidays. Staff (and their spouses) can receive a gift card toward the
purchase of a holiday turkey for committing to smoking cessation classes.
LIVING WELL PROGRAM: $500 Wellness Credit
3 Easy Steps: STEP 1) Onsite Biometric Screening or Alternative Means Screening form completed by physician and
faxed to Health Fitness (third party vendor), STEP 2) online Health Risk Assessment and STEP 3) set and meet a Wellness
Goal. This can be accomplished by using the HealthFitness Empowered Coaching program or through current NWH
Wellness Programs including: Move It to Lose It, Fitness Reimbursement, Weight Watchers at Work, Monthly Lunch and
Learns, Registered Dietician counseling, Tobacco Cessation and through a pre-approved “set your own goal” process.
Aggregate data reported by HealthFitness is essential to the development of future NWH Wellness Programs to assist
our staff to improve their health and enhance their wellness journey.
20
Move It to Lose It: Program to encourage staff to be more active and encourage healthy weight loss where appropriate pedometer based fitness competition. Various prizes from area fitness vendors. RESULTS - 168 staff members competed
in 2014 in this 9 week pedometer/percentage of weight loss program. A total of 651.1 lbs. lost and 119,205,248 steps
taken.
Maintain Don’t Gain: New in Fall of 2013. Weight maintenance program for staff members over the holidays. Available
for all staff.
Weight Watchers at Work: Hospital discounts offered to staff and their spouses, may attend weekly onsite meeting, may
also use the discount toward community Weight Watcher Meetings. Part time and Full time staff who attend 10 out of
12 meetings are eligible for 50% reimbursement from NWH.
Monthly Lunch and Learns: Topics are determined based on aggregated screening and HRA data provided by
HealthFitness. All staff are invited to gather monthly to hear a wellness lecture while eating a complimentary healthy
meal. A Q & A session follows each lecture. Topics covered this year included: Deconstructing Popular Diets, Combatting
High Cholesterol, Fat Loss: The Healthy Way, The Very Versatile Vegetable, Nutrition and Fitness Applications, Stress
and Inflammation, Sun Protection and Melanoma Prevention, Beverages: The Healthy Choice, How to Get a Good Night
Sleep, Diabetes and Pre-Diabetes: The Good, the Bad, and the Ugly and Swapportunities.
Healthy Plate: 1) increase staff awareness of healthy choices in our onsite Cafeteria, 2) motivate staff to choose healthy
selections for meals and 3) increase consumption of fruits and vegetables. NWH Registered Dieticians designate Healthy
Options which may be selected as part of the NWH Healthy Plate Meal. For every nine, $5 Healthy Meal purchased, the
tenth meal is FREE.
Staff Yoga: 2013 program. Weekly staff yoga classes offered to staff and spouses.
Cancer Gold Standard: NWH received re-accreditation in 2014. To earn Cancer Gold Standard accreditation, a facility
must establish programs to reduce cancer risk by discouraging tobacco use; encouraging physical activity; promoting
healthy nutrition; detecting cancer at its earliest stages when outcomes may be more favorable; and providing access to
quality care, including participation in cancer clinical trials.
Prescription to Wellness: Offered to NWH staff free-of-charge. For those who are at risk of becoming obese, developing
diabetes, and/ or facing cardiovascular problems. This program designed to provide participants practical education and
coaching in nutrition and fitness activities. The goal is to help these participants learn healthy behaviors with a goal of
preventing the onset of more serious illnesses.
American Heart Association Platinum-Level Fit-Friendly Worksite: NWH was recognized in 2014 for taking steps to
decrease employee healthcare expenses and increase productivity. Employees are physical activity options in the
workplace; Increase healthy eating options at the worksite; Promote a wellness culture in the workplace; Implement at
least nine criteria outlined by the American Heart Association in the areas of physical activity, nutrition and culture;
Demonstrate measurable outcomes related to workplace wellness.
Outcome Measures / Frequency:
Biometric screening data collected bi-annually. Objectives are evaluated and modified on an ongoing basis based on
aggregate screening results as well as other data.
• Program participation
o 219 fitness reimbursement submissions
21
o
168 staff members competed in 2014 Move It To Lose It program. A total of 651.1 lbs. lost and 119,205,248
steps taken.
• Successful management of rising healthcare costs demonstrated through reduction in healthcare claims and
quantifiable improvement in employee awareness and well-being. Nationally, healthcare costs have risen by 11%-12%.
The NWH healthcare plan has increased 5.7%
Community Partners:
Partner
Health Fitness
Wellness committee (comprised of NWH staff)
Community gyms and fitness centers
E4 healthcare/Lifescope
NWH Registered Dieticians
Weight Watchers
Role
To provide confidential screening and coaching
services.
Represent staff interests when developing
wellness programs. Assist in implementation and
evaluation/modification.
Membership discounts
Work/Life Program; Smoking Cessation Program
Instructors
Program Partner
PRIORITY:
Preventing Chronic Diseases

Focus Area 2: Reduce Illness, disability and Death Related to Tobacco Use and Secondhand Smoke Exposure.
o Disparity: decrease the percent of blacks and Hispanics dying prematurely from heart-related deaths
STRATEGIES:


Engage adults: staff and community members to create awareness, educational opportunities, and clinical
programs that address smoking cessation.
Create a systematic approach through hospital policies, education and support groups to change community
environment.
Program: Live To Be Tobacco Free Smoking Cessation Program
Description & Purpose: Program offered to all staff and community members, free of charge, to educate and assist in
the process of stopping tobacco use.
 Classes are promoted via Hospital website, social media and various community outreach material
 Flyers are distributed to the doctors at Mt. Kisco Medical Group and Westchester Health and hospital facilities.
 Patients who have indicated they are tobacco users are identified. The cessation program is discussed with them
and literature is provided.
Evidenced-Based Strategies/Interventions used to Achieve Objectives :
 Monthy, 4-week program
o 45-minute Session: Quitting without weight gain. Facilitator: Jennifer Lucas, RRT, NWH
o 30-minute Session: Recognizing triggers. Facilitator: Jennifer Lucas, RRT, NWH
o 30-minute Session: Hidden dangers of tobacco use. Facilitator: Jennifer Lucas, RRT, NWH
 New York State Quitline materials
o 20-minute Session: Statistics associated with tobacco use. Facilitator: Jennifer Lucas, RRT, NWH
 American Lung Association handout
22
Outcome Measures / Frequency:
Data is collected monthly by Smoking Cessation Program Coordinator. Follow up letters and phone calls are made to all
participants after one month, three months, six months and one year of their participation in the program.
Program: Smoke-free Campus
Description & Purpose: It is the policy of Northern Westchester Hospital to maintain a Tobacco-free campus by
prohibiting all use of tobacco products in any form throughout the hospital campus at all times.
Target Population: All Hospital Visitors, Staff, Patients, Physicians, and Vendors
Goals & Objectives: Improve and enhance the level of health of our patients and community
VI. Changes Impacting Community Health / Provision of Charity Care / Access to Services
As a not-for-profit hospital, Northern Westchester Hospital provides many community benefits including charity care
and outreach to the community’s most at-risk patients. Programs include:





Care coordination through the NWH Patient Navigator helps facilitate access to healthcare and resources
primarily for patients who are uninsured or underinsured. The Patient Navigator also assists non-English
speaking or limited English speaking patients with language translation services to ensure their understanding of
complex healthcare issues. The Patient Navigator is a specially trained, culturally sensitive, bilingual healthcare
worker who provides support and guidance to patients and their family members. The Patient Navigator helps
facilitate access to a variety of healthcare professionals and services at NWH and within the community,
including our two (2) medical group partners: Mount Kisco Medical Group and Westchester Health Associates.
The Breast Health Initiative which provides a continuum of free breast health services (including mammography
and breast screenings) to uninsured and underinsured women.
The prenatal care assistance program (PCAP) which provides comprehensive care to under-insured and
uninsured pregnant women in Westchester and Putnam Counties.
The GI Clinic- which provides access to board certified gastroenterologists for low-income uninsured patients.
The Inpatient Behavioral Health unit continues to be offered as one of our acute care services in order to satisfy
unmet needs within our community.
While facing the same financial and resource constraints most hospitals face, Northern Westchester Hospital did not
plan or budget reductions to the services it provides or reductions in the amount of financial assistance provided.
Positives changes:
Inpatient redesign including Plan of Care to enhance clinical care and patient-centered experiences.
95%+ utilization of electronic order entry
Electronic Medical Record
Specific recruitment of physicians in needed specialty
Continued efforts to be a cost efficient provider
Concerns:
Lack of clarity of long-term impact of national healthcare reform
Reliance (sustainability) on (of) cost shifting to managed care payers to subsidize governmental reimbursement
Continued difficulty in securing access to specialty care for uninsured patients
23
Financial Assistance
Northern Westchester Hospital believes that a critical component to providing access to all segments of its community is
a robust financial assistance program. Adopted by the Board of Trustees, this program includes an active communication
plan, guidelines that exceed mandates, and readily available multilingual Financial Counselors. To complement this
program, NWH provides a multilingual patient navigator program that assists patients receiving financial assistance at
NWH, as well as helping these same patients in securing services provided outside the Hospital. Enhancements to this
program focused on educating our front-line registration staff on the importance of informing uninsured patients about
this program. In addition, the Hospital’s self-pay billing process includes discussions with patients on the availability of
financial assistance.
Corporate Structure
Northern Westchester Hospital’s corporate structure changed in 2014, in that Stellaris Health Network was no longer
NWH’s corporate parent. This change did not affect the Hospital’s ability or commitment to meet community health
needs, charity care and access. In the wake of this change, NWH evaluated new strategic partners – those that shared
our mission of providing high-quality diagnostic and treatment services to our community, assuring access to a
coordinated continuum of healthcare services and improving and protecting the health of community members through
programs that promote health and wellness.
In 2014, NWH completed its evaluation of strategic partners. North Shore – LIJ emerged as the preferred partner and the
due diligence process was conducted. The NWH and the NS-LIJ Boards approved NWH joining the NS-LIJ Health System
as of January 1, 2015.
VII. DISSEMINATION OF THE REPORT TO THE PUBLIC
NWH’s annual Community Service Plan will be posted in the ‘About Us’ section of the hospital’s website
(www.nwhc.net). In addition, a link to the CSP will be included in upcoming issues of NWHealth electronic newsletters.
For more information about NWH, visit www.nwhc.net. For referral to a member of the medical staff, call
1.800.4NWH.DOC.
24
VII. ABOUT NORTHERN WESTCHESTER HOSPITAL
Designated Planetree Patient-Centered Care Hospital
Northern Westchester Hospital is extremely proud to be one of the first five hospitals in the country to
receive the prestigious recognition of Designated Planetree Patient-Centered Care Hospital with
Distinction. NWH is also the first hospital in New York State to receive this designation, which is a strong
endorsement of the expertise and humanity of the entire staff. Planetree is a non-profit organization that
provides education and information in a collaborative community of healthcare organizations, facilitating
efforts to create patient-centered care in healing environments.
Magnet® Recognition
Northern Westchester Hospital has received Magnet® Recognition for excellence in nursing service and the
overall quality of care provided to patients and the community.
We are proud to be the only Designated Planetree Hospital with Distinction that has achieved Magnet
Recognition in the nation! The Magnet Program is recognized as the gold standard of nursing excellence. Currently, less
than 400 of the more than 6,000 U.S. healthcare organizations have received this credential. Magnet Recognition
signifies that an organization provides high-quality patient care, promotes nursing excellence and is one of the country’s
finest healthcare organizations.
Joint Commission on Accreditation of Healthcare Organizations
Northern Westchester Hospital has received accreditation from the Joint Commission, an independent, notfor-profit organization that evaluates and accredits nearly 18,000 healthcare organizations and programs in
the United States. Joint Commission Accreditation is recognized as a symbol of quality that reflects an
organization's commitment to meeting stringent performance standards.
and among
Quality
Additionally, NWH was recognized as one of the Highest Quality Hospitals in the United States,
the Top Performers on Key Quality Measures™ in the Joint Commission’s 2011 annual
report. NWH is the only hospital in Westchester County to be recognized as one of the "Highest
Hospitals in the US" and was among only 16 hospitals in NY State to receive this prestigious
recognition.
Best Hospitals 2013-2014 U.S. News & World Report
U.S. News & World Report once again lists Northern Westchester Hospital among the "Best Hospitals
2013-14," indicating that NWH is highly proficient in serving the needs of our patients. NWH has been
recognized by US News & World Report "Best Regional Hospitals" in five specialties: Urology,
Gynecology, Geriatrics, Orthopedics, and Neurology.
25
Appendix A
Additional Prevention Agenda Priorities
PRIORITY:
Preventing Chronic Diseases

Focus Area 3: Increase Access to High-Quality Chronic Disease Preventive Care and Management in Clinical and
Community Settings
o Disparity: decrease the percent of blacks and Hispanics dying prematurely from heart-related deaths
Program: NY State Designated Stroke Center / Get With the Guidelines Stroke Gold
Performance Achievement Award – The American Stroke Association
Description & Purpose: NWH is designated as a Stroke Center by the New York State Health Department, and has
received the Get With The Guidelines® Stroke Gold Performance Achievement Award* (GWTG–Stroke) by the American
Stroke Association. NWH is also recognized as a recipient of the Target: Stroke Honor Roll by the American Heart
Association for improving stroke care.
With a stroke, time lost is brain lost, and the Get With The Guidelines–Stroke Gold Plus Quality Achievement Award
demonstrates Northern Westchester Hospital's commitment to being one of the top hospitals in the country for
providing aggressive, proven stroke care.
The award recognizes NWH’s commitment and success in implementing a higher standard of stroke care by ensuring
that stroke patients receive treatment according to nationally accepted standards and recommendations.
Target Population: General Population
Goals & Objectives: Consistently comply with the requirements in the Get With The Guidelines–Stroke program. These
include aggressive use of medications like tPA, antithrombotics, anticoagulation therapy, DVT prophylaxis, cholesterol
reducing drugs, and smoking cessation.
Evidenced-Based Strategies/Interventions used to Achieve Objectives :
In order to achieve this prestigious designation, NWH is required to meet stringent guidelines and maintain clinical
standards which are reviewed annually by the DOH including:
 Following specific protocols designed from evidence-based guidelines established by the American Heart
Association and the American Stroke Association
 Ensuring the availability of a dedicated Stroke Team including all of the staff in the Emergency Department
Caring for You After You Leave NWH:
Customized patient education materials, based on patients’ individual risk profiles, are made available just before
discharge. The take-away materials are written in an easy-to-understand format and are available in English and Spanish.
In addition, the American Stroke Association’s Patient Management Tool provides access to up-to-date cardiovascular
and stroke science at the point of care.
Planned Activity:
 Conduct ongoing staff education specifically focused on stroke care
 Monitoring continuous quality improvement efforts
 Annual training with the local ambulance departments
26
Outcome Measures / Frequency:
Percent of Northern Westchester Hospital patients who were eligible ischemic stroke patients have received tissue
plasminogen activator, or tPA, within 60 minutes of arriving at NWH (known as ‘door-to-needle’ time). A thrombolytic,
or clot-busting agent, tPA is the only drug approved by the U.S. Food and Drug Administration for the urgent treatment
of ischemic stroke. If given intravenously in the first three hours after the start of stroke symptoms, tPA has been shown
to significantly reverse the effects of stroke and reduce permanent disability.
Community Partners:
Partner
NWH
Community EMS / VAC
Role
Stroke team. Educators. Presenters.
Program: Acute Stroke Assessment: Time is Brain
Description & Purpose: Annual Stroke symposium.
Program Leader: Dr. Akira Todo, Director Stroke Program, NWH
Target Population: EMS, VACs, ER Clinical Staff (RNs & MDs)
Goals & Objectives:
 Educate first responders to recognize patient with potential acute stroke.
 Convey importance of rapid stroke assessment.
 Present patient care options.
Evidenced-Based Strategies/Interventions used to Achieve Objectives :
Data, guidelines, recommendations, survivorship stories
Outcome Measures / Frequency: Attendance. Satisfaction survey results.
 120 attendees in 2014 (slight increase over 2013 attendance)
Community Partners:
Partner
Role
Various town/village EMS & VAC
Attendees
Northern Westchester Hospital
Staff attendees. Presenters.
PRIORITY:
Preventing Chronic Diseases

Focus Area 3: Increase Access to High-Quality Chronic Disease Preventive Care and Management in Clinical and
Community Settings
Program: GI Clinic AND Community Access Program (CMAP)
Description & Purpose: The GI Clinic provides GI consults, endoscopies and colonoscopies to uninsured/underserved
patients in our community catchment area. The GI clinic consists of 3 GI doctors and occurs 3 times a month. CMAP
provides both surgical and orthopedic consults and surgeries at NWH for patients in our community catchment area.
CMAP consists of a general surgeon and an orthopedic surgeon. CMAP occurs twice a month.
Target Population: Patients who are uninsured/underserved who live in our catchment area.
27
Goals & Objectives: The goal of the clinics is to provide medical access to patients that are uninsured/underserved in
our community catchment area.
Outcome Measures / Frequency: We Plan to collect numbers of initial patients and procedures done though the clinics
on a quarterly basis.
GI CLINIC
Initial Consults
1st
Quarter
2014
13
2nd
Quarter
2014
17
3rd
Quarter
2014
8
16
30
6
Total Minor Surgery
C-MAP -SURGERY
1st
Quarter
2014
Initial Consults
Total Surgery
2nd
Quarter
2014
3rd
Quarter
2014
13
19
9
6
8
5
Community Partners: All of the clinics require the patient to have a primary care physician; we work
closely with Mount Kisco Open Door for patient’s referrals.
Partner
Role
Mount Kisco Open Door
Primary Care providers and referral source
Program: Breast Health Initiative for Underserved Women
Description & Purpose: NWH’s Breast Health Initiative for Underserved Women successfully provides a holistic
continuum of free, accessible, comprehensive, and timely breast health services, from education and screening to
diagnosis, state-of-the-art treatment, and follow-up to underserved (Latina) women in Northern Westchester.
Target Population: BHI targets women age 40+ or those at high risk. 90% of our patients live at or below the poverty
level and 85% have no health insurance.
Goals & Objectives:
1) Increase patient encounters 10% over 2013 – to an estimated 984 in 2014 and 1,082 in 2015;
2) Maintain high-quality patient navigation and retention rate of 85%+; and
3) Rollout of the successful Risk Assessment Pilot Program to all BHI clinic patients and women who attend the BHI
educational seminars and assess 100% of all women in these two groups.
Evidenced-Based Strategies/Interventions used to Achieve Objectives: Breast cancer is the leading cause of cancer
death among Hispanic women in the United States and they are more likely to be diagnosed at a later stage than non –
Hispanic women. A lower rate of mammography utilization and delayed follow-up of abnormal screening results likely
contributes to this difference. Breast cancer screening (clinical breast exams and screening mammography) promotes
early detection and improves outcomes in this population of women.
Planned Activity
On-site breast clinic
Timeline
monthly
Diagnostics, Surgery &
Appointments as needed
Lead Person/Organization
BHI Nurse Practitioner & Patient
Navigator - NWH
Patient Navigator & BHI Nurse
28
Treatment
Cancer Prevention & Education
Outreach Seminars
Breast Cancer Risk Assessment
& Reduction
Patient Navigation
Nutrition Program
Twice a year
Monthly at breast clinic and
education seminars
Daily
TBD
Practitioner - NWH
BHI Nurse Practitioner & Patient
Navigator - NWH
BHI Nurse Practitioner & Patient
Navigator – NWH
Patient Navigator
Dietitian & Patient Navigator NWH
Outcome Measures / Frequency:
Yearly measures:
Patient Satisfaction Surveys
100% satisfaction rate for courtesy, addressing patient concerns and recommend program to others;
99% satisfaction rate for translation services and
96% satisfaction rate for appointment location ease.
Yearly retention rate goal is 85%
Yearly encounters goal is 10% more than the previous year.
Risk Assessment Program:
Our goal is to assess 100% of the women who come to the monthly BHI Clinic at NWH and those we educate at our two
community seminars each year.
In addition, we track a variety of patient statistics such as number of: screening and diagnostic mammograms;
ultrasounds; breast MRI; biopsies; breast surgeon consults; cancer diagnosis; total patient encounters; and total
education/outreach encounters.
Community Partners:
Partner
Open Door Family Medical Centers
Hudson Health Plan
Planned Parenthood
NYS DOH CSP
Avon Foundation
Role
Patient Referrals
Patient Referrals
Patient Referrals
Patient Referrals
Grant Provider
Program: Cancer Health and Wellness Program
Description & Purpose: Our Cancer Treatment and Wellness Center provides a patient-centered healing environment
for individuals receiving cancer treatment (radiation, chemotherapy, infusion services, and Gamma Knife) at NWH.
Among the Center’s offerings, the Health and Wellness Program helps high risk individuals, cancer patients and/or
cancer survivors access and develop the necessary tools to cope with stressors that occur as a result of a cancer
diagnosis and treatment. In addition, the H&W Program provides therapies that have been shown to reduce the risk of
cancer recurrence. The Program supports patients by giving them free access to a wide-range of health and wellness
modalities.
Target Population: Individuals at high-risk of cancer; those diagnosed with cancer and/or those who are finished with
active treatment (survivors) who live in Northern Westchester, Putnam and Southern Dutchess Counties in New York
AND have a physician who is credentialed at Northern Westchester Hospital.
Goals & Objectives:
1) Increase the number of total wellness visits over the prior year;
29
2) Help patients manage the stress associated with a cancer diagnosis and treatment;
3) Decrease distress testing scores for patients after they have completed the program;
4) Maintain high patient satisfaction scores.
Evidenced-Based Strategies/Interventions used to Achieve Objectives: American Cancer Society, Cancer Facts and
Figures, 2012: There is strong scientific evidence that healthy patterns in combination with regular physical activity are
needed to maintain a healthy body weight and reduce cancer risk. The Society of Integrative Oncology: Evidence shows
the benefit of support groups, supportive/expressive therapy, cognitive-behavioral therapy, and cognitive-behavioral
stress management for cancer patients.
Planned Activity
Health Coach
Nutrition counseling
Physical activity
Acupuncture and Reiki
Mindful wellness/Counseling
Timeline
Appointments as needed
Appointments as needed
Appointments as needed
Appointments as needed
Appointments as needed
Support Groups
Monthly
Lead Person/Organization
Nurse Practitioner
Registered Dietician
Exercise Physiologist
Holistic Registered Nurse
Psychiatrist, Psychologist or
Social Worker
Trained Facilitators
Outcome Measures / Frequency:
1) 1596 Wellness visits through August 2014. A 10% increase over total 2013 visits.
2) Distress Management Screening Tool (Quality of Life Assessment): This is administered when a patient enters the
Program and when they complete the Program. In 2014, patients’ stress scores dropped an average of 35% after
completing the Program.
3) Patient satisfaction surveys are sent out to every patient who has recently completed the program. The surveys are
sent out four times a year. In 2014, 100% of the patients responded that the H&W Program helped them manage their
stress. In addition, 100% of patients found working with the Health Coach was helpful.
Community Partners:
Partner
Physicians
Cancer Survivors
Volunteers
American Cancer Society
Support Connection, Gilda’s Club
Cancer Coalition of Westchester
Role
Patient Referrals
Patient Advisory Council
Social worker, Pilates, Yoga, Expressive Writing
Support Groups
Support Groups
Networking, Support Groups, Programs and
Services
American Cancer Society
Look good, Feel Better: co-sponsored with the ACS – monthly meetings held at NWH; NWH
provides the cosmetic bags via the ACS and provide wigs for patients undergoing chemo.
Prostate Health: we had a successful lecture series co-sponsored with ACS in 2012-2013.
Patient Navigators at the Cancer Center: Women who are cancer survivors visit patients, give
support and help connect patients and their families with resources – i.e. rides for chemo etc.
ACS “Strides Walk” supported by NWH staff.
NWH Cancer Committee meeting attended by ACS representative.
Support Connection
Breast Cancer Support Group – facilitated by Support Connection; hosted by NWH at Chappaqua
30
Crossing location.
Support Connection Support-A-Walk – supported by NWH staff.
Bi-annual public education forums – NWH provides speakers for this group. NWH works with
representatives from Support Connection in developing each program.
May 2013 : Dr. Karen Arthur, Breast Surgeon, Mary Greco, NP for the Breast Institute, and
Nancy Cohen, MS, CGC , Genetic Counselor spoke at our 15th Educational Forum "Breast Health &
Cancer Risk: What Can You Do? 30 in attendance.
Gilda’s Club
Support Services – offered free to patients with cancer and their families
NWH Cancer Committee meeting attended by Gilda’s Club representative.
NWH staff participates in Gilda’s Club fundraising events
Hosts monthly Cancer Coalition of Westchester meetings
Cancer Coalition of Westchester
This is a network of many cancer services programs throughout Westchester County: Leukemia and
Lymphoma Society, Gilda's Club, American Cancer Society, Support Connection, Westchester
Jewish Services, Sole Ryders, NWH, Lawrence Hospital Survivorship NP, Cancer Support Team, St.
John's Riverside, MSKCC. The group collaborates on lectures and presentations and shares
information regarding programs and services each group provides to the Westchester County
community.
PRIORITY:
Promote a Healthy and Safe Environment

Focus Area 4: Injuries, Violence and Occupational Health
o Goal #1: Reduce fall risks among the most vulnerable populations.
Program: NWH Post-Rehab/Wellness Program
Description & Purpose: This program provides an opportunity for individuals who have completed a formal course of PT
or OT the opportunity to continue their exercise in a nurturing and supportive environment. Program members are
permitted to exercise under our direction/supervision 3X/week. Balance and fall prevention are emphasized.
Target Population: Senior citizens who are not comfortable exercising independently in the home or health club setting.
Goals & Objectives:
 Improve the functional status of our community dwellers
 Improve members’ balance
 Decrease members’ risks of falling
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
The Lancet, Volume 366, Issue 9500, Pages 1885 - 1893, 26 November 2005; Prevention of falls and consequent injuries
in elderly people.
Outcome Measures / Frequency:
We track the number of program members on a monthly basis.
 30 Members
 Implement a satisfaction survey program in 2015.
31
Additional NWH Priorities
PRIORITY:
Community Education & Support
Program: Presidents Junior Leadership Council
Description & Purpose: The PJLC is a youth leadership organization that builds young people’s connections to their
community and engages them on issues that matter to them. Council members are liaisons between the hospital and
their schools and serve as ambassadors to the community conducting outreach, prevention and wellness programs.
Students are empowered to develop projects that are meaningful to them. These projects allow them to work
collaboratively to design and produce original programs and materials.
This select group of teens also has the opportunity to meet and interact with hospital personnel, explore career
opportunities in health and medicine, and gain skills to help prepare them for the challenges and responsibilities they
will face as college students and beyond.
Mission: The President’s Junior Leadership Council is committed to improving the health, safety, and well-being of
adolescents and young adults in northern Westchester County.
To accomplish this mission the President’s Junior Leadership Council will:
 Act as a liaison and serve as a “voice” between community youth and NWH administration and staff.
 Support, advise, and assist NWH administration and staff in their efforts to promote health and wellness.
Help identify and prioritize key health issues affecting young people, and develop and implement programs to address
these issues.
Target Population: Teens
The NWH PJLC developed an exciting wellness program, the #BetterinBalance Campaign.
The goals of the #BetterinBalance Campaign are to get people talking about food, fitness, and body image. We hope to
inspire people to make healthy food choices and feel confident in their own skin.
This initiative includes a student designed poster, social media feeds through Twitter and Instagram (@JuniorCouncil,
#betterinbalance), and an interactive lesson plan that includes discussions about the basics of healthy nutrition, the
connection between a balanced diet and achieving goals, and extreme nature of dieting and its effect on our bodies.
Support and advance healthy behavior & food and beverage choices & prevent childhood obesity.
Program: Speaker Series
Description & Purpose: The community is offered opportunities to get to know Northern Westchester Hospital’s expert
medical staff as its healthcare experts speak on topics that they know best. Attendees learn what the Hospital can do to
serve their needs, and how to take control of their family's health and wellness. Attendees enjoy a relaxed atmosphere
and can educate themselves on topics that interest them and directly relate to their life.
 Health and Wellness Lectures 4 times a year.
Target Population: Community members with children in elementary and middle school.
Goals & Objectives: To provide the general public with health and wellness information from a respected and trusted
source on a variety of topics that are of interest to families with children.
32
Outcome Measures / Frequency: Participant surveys are conducted after each lecture to assess satisfaction with the
topic and speaker and to determine the level of interest for future lectures. Attendance is also tracked.
 In 2014, an average of 42 community members attend each lecture.
Community Partners:
Partner
Physicians or healthcare professional
Foundation Board Member
Essentialmom.com (community blog)
Volunteers
Role
Lecturer
Volunteer organizer
Social media and PR / contribution of topic ideas
Promotion to garner attendees / serve as hosts
Program: 55+ Community Connection Lecture Series
Description & Purpose: The purpose is to keep community members involved with the Hospital.
Target Population: 55+ age group
Goals & Objectives: Keep older adults active in their community.
Planned Activity
Medicare Lecture
Financial Savings Lecture
Safe Senior Living
Caregiver Choices
Timeline
Lead Person/Organization
Doreen/Empire Blue Cross
Su/Morgan Stanley
Brenda/The Kensington
Anthon/Comforcare
Outcome Measures / Frequency:
Attendance is tracked.
Program: Building Cultural Competency: A Community-Wide Initiative
Description & Purpose: Northern Westchester Hospital, in cooperation with Neighbors Link and the Mount Kisco Police
Department, developed a cultural sensitivity training program designed to help achieve the complementary mission of
each group and to increase cultural awareness in order to build positive relations with immigrant communities.
Target Population: Law enforcement officers
Goals & Objectives:
 Increase cultural awareness in order to build positive relations with immigrant communities.
 Encourage communication and trust between local law enforcement and the immigrant community.
 Actively enhance the healthy integration of immigrants in the community.
Planned Activity
Work with Stamford, CT
Neighbors Link to roll out
program
Initial conversations regarding
training with additional towns:
Bedford
New Initiative
Timeline
4th quarter 2013 – 1st quarter
2014
Lead Person/Organization
Neighbors Link & NWH
4th quarter 2013
NWH, Neighbors Link, Town of
Bedford Police Department
2015
NWH & Neighbors Link
33
Submitted grant proposal in
partnership with Neighbors
Link in response to RFP to train
Westchester County employees
Outcome Measures:
Since the program’s inception:
50 Mt. Kisco police officers have participated in the training (2012)
450 Westchester County police officers (2013)
50 Bedford police officer (2014)
Partner
Neighbors Link (Mt. Kisco, NY & Stamford, CT)
Mt. Kisco Police Department
NWH Human Resources and Training staff
Westchester County Police Department
Role
Liaise with, and represent the immigrant
community. Collaboration on program
development, implementation and evaluation.
Collaboration on program development,
implementation and evaluation.
Provide trainers and original curriculum.
Collaboration on program development,
implementation and evaluation.
Program participant
Program: Internship and Shadowing Opportunities for the Community
Description and purpose: Northern Westchester Hospital supports internship opportunities for engaged students in our
community to support and grow health care careers as their primary choice.
Internships give students great learning experiences while gaining knowledge of a particular clinical area, insight into the
day-to-day responsibilities of support areas and afford the students access to professionals within a hospital setting.
Learning objectives for the individual internship are coordinated by referring schools/districts and matched through
placement of interns with a corresponding department that can address the stated objectives and goals.
Targeted audience:
Anyone with a strong desire to be in healthcare!
 Local High School Students
 Technical School Students
 College Students
 Post-Graduate Students
 Individuals pursuing a career change
Results:
Number of Internships Completed at NWH
 2011 – 40 interns (11 New Visions)
 2012 – 58 interns (12 New Visions)
 2013 – 54 interns (12 New Visions)
 2014- 52 Interns (13 New Visions Students)
34
Interns that became NWH Staff
 20 Interns have become staff members
 RN’s Laboratory, Human Resources, Support Services
Community Partners
Bedford, Chappaqua, Armonk, North Salem School Districts, Putnam/ Northern Westchester BOCES, local colleges and
universities
Program: The Ken Hamilton Caregivers Center
Description & Purpose: KHCC is dedicated to the support and well-being of the family caregiver, as well as the
professional caregiver. Services include counseling by social worker, referrals to community resources, trained caregiver
coach volunteers providing support and encouragement to family caregivers. TKHCC provides a place of respite within
the hospital for family caregivers to recharge. Provide monthly caregiver support group, as well as bi-monthly perinatal
bereavement group open to members of the community free of charge.
Target Population: family caregivers of inpatients, out-patients, as well as community members who are caring for a
loved one, professional caregivers.
Goals & Objectives: To help family caregivers effectively manage the stress associated with caring for a critically ill loved
one through supportive counseling, assist with navigating the health care system, provide community resources to
family caregivers, provide a place of respite and relaxation to caregivers, regardless of whether they have a loved one
hospitalized at NWH. Services are offered free of charge.
Evidenced-Based Strategies/Interventions used to Achieve Objectives:
Existing Program:
Daily Rounding on floors 2 – 3 times, on all inpatient units to provide support and encouragement to family and
professional caregivers. Support and respite provided to family caregivers of patients and family caregivers in the
community who visit the center. Support groups for caregivers, perinatal bereavement and general bereavement.
Results:
 Family interactions through September 2014 total 6312, projected to be 8400 through year end 2014.
 Recruited and trained 6 new caregiver coaches, bringing total of trained and committed coaches to 30.
Replication Program:
Materials and guidance for institutions interested in creating and developing a Caregivers Center, dedicated to the
needs of the family caregiver. Since its inception, the administration of The Ken Hamilton Caregivers Center has assisted
numerous healthcare institutions in replicating the successful model.
Results:
 Added three new hospitals to our growing list of replicated partners. New hospitals include: Englewood Hospital (NJ),
Hospital of the University of Pennsylvania (PA) and Mercy Medical Center (IA).
 We now have a total of 10 replicated centers
 Held two symposiums for Consortium of Caregivers Centers focused on sharing of best practices and techniques for
supporting volunteers
 Presented the KHCC replication program at the 2014 Planetree International Conference
Community Involvement:
Jerri Rosenfeld, Social Worker, presented Advanced Directives to Support Connection group.
2014 Awards:
 Marian Hamilton received “Quality of Life” award by Volunteer – NY, a division of United Way
35
 Marian Hamilton selected by Caregiver Action Network for “Advancing Excellence: Best Practices in Patient and Family
Engagement”
Resource Materials:
Completed comprehensive handouts for Advanced Directives and Home Health Aides
2015 PLANS:
Replication Program:
 Continue to pursue new hospitals via Planetree network, Caregiver Action Network and PR efforts
 Continue to plan Caregivers Center symposiums focused on identified needs
 Continue to recruit and train new volunteer coaches
Ongoing Program:
 Develop a resource tool detailing recommended online caregiver resources
 Maintain ongoing relationships with community resources – WJCS, Cancer Coalition, Support Connection
Outcome Measures / Frequency:
1) Family interactions through September 2014 total 6312, projected to be 8400 through year end 2014.
2) Recruited and trained 6 new caregiver coaches, bringing total of trained and committed coaches to 30.
3) Added three new hospitals to our growing list of KHCC replication program partners
36
Appendix B: Westchester County Health Planning Team
(January – October 2013)
On December 10, 2012 the New York State Health Commissioner Dr. Nirav Shah sent letters to all county health
departments and local hospitals requesting within each County the joint collaboration with the development of the
community health assessment and health improvement plans required for submission by November 15, 2013.
Specifically, Commissioner Shah asked hospitals and local health departments to work together with local
community partners on assessing community needs, identifying at least two local priorities, one of which should
address a health disparity, and developing a plan to address the identified priorities.
To help support and coordinate this collaboration, the Westchester County Department of Health (WCDH) invited all
sixteen Westchester County hospitals to attend a kick-off meeting on January 31, 2013. In addition, the three
Federally Qualified Health Centers were also invited to attend. The meeting was held at the Westchester County
Department of Health (10 County Center Road in White Plains).
At the first meeting Sherlita Amler, MD, Westchester County Commissioner of Health, welcomed all participants to
the meeting. WCDH provided a brief overview of the prior planning process and the new requirements for both the
health department and the hospitals specific to the development of community health assessments and community
health improvement plans. The Planning Team supported working collaboratively on this project and during the past
ten months has demonstrated its commitment by attendance at monthly meetings, participation in two conference
calls and hosting a Health Summit entitled “Working Together Toward a Healthier Westchester.” In addition, the
team has shared information, resources and updates through email and phone calls.
The team conducted an extensive review of all the health indicators contained in the Prevention Agenda. For each
indicator, the team reviewed whether the County was below, meeting or exceeding the state established
targets/goals, the estimated number of people affected by each indicator (when available), the County’s overall
ranking for the indicator compared to other New York Counties, and the performance range within the State. The
team often requested the Westchester County Department of Health to provide additional reports/analysis,
including data at a sub-County level to allow a more complete understanding of the problem.
In addition to a thorough review of the data, the priorities selected included consideration of priorities that were
attainable and that aligned with each agency’s mission and service area. With the diversity and the number of
hospitals in the County, it was quite challenging for the team to select its priorities especially when for a number of
indicators the data revealed only certain parts of the County being impacted. After careful deliberation and
discussions, the following two priorities were selected:
1. Increasing breastfeeding (Focus Area: Promote Healthy Women, Infants and Children) and
2. Decrease the Percentage of Blacks and Hispanics Dying Prematurely from heart related deaths (Focus Area:
Prevent Chronic Disease)
The team developed an agency profile that was distributed to community partners. The profile requested each
agency to provide general agency information, such as hours of operations, office locations and service areas, as well
as to include current activities, training and policies in place to support the selected priorities and any new activities
planned. The team also invited community partners to a half-day summit that was devoted to sharing current
activities/programs and to discuss what could be done to address the selected health priorities.
37
As part of its ongoing commitment to addressing the identified health priorities, the team is planning to continue
meeting to review progress in implementing the improvement plans developed by each agency, to work together,
when applicable, on planned activities, to discuss barriers to implementation and consider new strategies that could
be adopted. The Team is also planning to regularly convene the attendees from the health summit to provide input
and support on project implementation.
38
Appendix C: MAP OF COMMUNITY AND REGION
39