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The Critical Role of School Nurses in Today’s Changing Healthcare Environment
Maine School Nurse Summer Institute July 23, 2014Bates CollegeLewiston, Maine
Lois Skillings, RN, MSPresident and CEOMid Coast Health ServicesBrunswick, Maine
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Objectives:
• As national healthcare reform impacts the delivery and financing of healthcare, the role of school nurses is more important than ever. This presentation will highlight the goal of achieving the Triple Aim of improving healthcare, and the influence of school nurses in the transformation process.
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Fixing Healthcare:
An Economic and Social Imperative
• It is a whole new world out there. Aside from political views, the way we finance and deliver healthcare has to change.
• Our current healthcare system is not sustainable.
• This is the work of our generation of healthcare leaders.
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© Copyright Orlikoff & Associates, Inc. 2014
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© Copyright Orlikoff & Associates, Inc. 2014
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© Copyright Orlikoff & Associates, Inc. 2014
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The U.S. Healthcare Environment
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Trends: Demographics and Healthcare Costs
• 10,000 Baby Boomers turn 65 each day.
• Today, the elderly population utilizes hospital services five times as often as the non-elderly.
• Combine this with the fact that our healthcare system is already too expensive, and we are on a collision course for collapse.
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Trends: Maine Healthcare Scene
• Very high hospital quality outcomes and pretty good population health when compared nationally.
• Small and aging population, and poverty, makes cost shifting greater burden in Maine.
• All Maine hospitals are not-for-profit.
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Per Capita Healthcare Costs
United Kingdom
Germany
Japan
Canada
United States
Maine
$3,647
$4,683
$4,752
$5,741
$8,895
$10,647
Source: The World Bank: Health expenditure per capita (current US$) 2012; Maine data estimated
Maine needs to reduce costs by 20% just to achieve the
U.S. average, and we would still be double
other countries
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Free Care & Bad Debt – Mid Coast
$ 2.0Million
$ 4.4 Million
$ 2.8 Million
$3.3 Million
$ 3.8 Million
$ 5.4 Million
$ 4.9 Million
$ 5.1Million
$ 5.2 Million
$ 5.8 Million
2009 2010 2011 2012 2013
= Free Care
= Bad Debt
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Hope, Solutions and Strategies
• The “Triple Aim”• Partnership and Collaboration• Patient Centered Medical Home• Critical Role of School Nurses
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© Copyright Orlikoff & Associates, Inc. 2014
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Source: Institute for Healthcare Improvement, Cambridge, MA
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Solutions: The Triple Aim to
Accountable Care
Improve the Healthof the Population
Enhance thePatient
Experience of CareIncluding Quality, Access
and Reliability
Reduce, or Control,the Per Capita Cost of Care
Improve the Healthof the Population
Enhance thePatient
Experience of CareIncluding Quality, Access
and Reliability
Reduce, or Control,the Per Capita Cost of Care
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Prevention and Wellness
Our vision is to become an organization that
not only takes care of patients when they become sick, but also takes responsibility for the health and well-being of our community.
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Strategic Vision for Population Health
Primary Care / Patient-Centered
Medical HomeCommunity
Health
Employee Health / Worksite
Wellness
Accountable Care
Integrated, Coordinated, Accountable & Aligned toward a Culture of Health and Wellness
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© Steve Trockman 2012
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United Way of Mid Coast Maine Success By 6: Early Childhood
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Re-defining the “H”
Today
Future
HHOSPITAL
h ERor
If we are successful, the healthcare system in the future will necessarily need to look different. We can’t have it both ways (transformation and continue acute-care centric models.) Can we engage the community and employers to develop a culture of health and wellness? Can we integrate primary care, acute care, home care and elder care services to be more efficient and effective? Will all “hospitals” have inpatient beds? Can we afford as many hospitals? If we truly impact and improve the health of the population, will we need as many hospitals? We will need more community-based primary care and urgent care.
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Patient-Centered Medical Home
• Coordinated care focused on prevention through Primary Care.
• Relationship between patient and their physician and the care TEAM.
• Integrated care…physical, social, spiritual, emotional.
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Collaboration and Partnerships
• School Nurses are at the front line for the health of hundreds of thousands of children in our State. You have unique perspective and a critically important voice.
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Transformation
• Growing, learning, improving
• Revolution, evolution, change, makeover
• Change.
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References:
The Healing of America by T.R. Reid Copyright 2010
The American Health Care Paradox: Why Spending More Is Getting Us Less byElizabeth H. Bradley and Lauren A. Taylor Copyright 2013
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Thank you!
Questions?
Mid Coast Health
Our Community, Our HealthBrunswick, Maine