Harnessing individuals and the community to reconfigurecommunity to reconfigure

servicesMarianne Olsson

The story of Angereds närsjukhus…

Create a hospital in north-eastern Göteborg..

Th N th t t f G th bThe Northeastern part of Gothenburg

• Four city districts of G th bGothenburg

• 95 000 inhabitants

• 50 percent born outside Sweden

What we didWhat we did..

• Analyze needs-Analyze needs• Aggregating and disaggregating data

St di h d t l ki• Studies where data was lacking• Focus groups• Community dialogue

Mortality COPD, (Chronic Obstructive Pulmonary Disease)

District District District District All 4 Regio CountDistrictBergsjö

n

DistrictGunnar

ed

District Korteda

la

District Lärjedale

n

All 4District

s

Region

Country

Wome 81.6 71.5 51.1 39.6 61.0 30.8 26.6n

Men 63.5 57.7 59.2 41.4 55.5 30.7 30.1Men 63.5 57.7 59.2 41.4 55.5 30.7 30.1

Number of dead/100 000 (averag pop over 15 + yrs). Standardised numbers.Source: Socialstyrelsen. Dödsorsaksregistret.

A population in need of better care

• Mortality rate higher • Also highery gthan the country on a number of diseases

Also higher numbers on following

– Cardiovascular disease– COPD/Lung cancer

– Obesity– Daily smoking

– Alcoholrelated deaths – Physicial inactivity– Stress

What we didWhat we did..

• Stakeholder seminar involving cityStakeholder seminar, involving city districts, primary care, university hospital, union representatives commissioningunion representatives, commissioning board and hospital board

• Close cooperation with the commissioning• Close cooperation with the commissioning board who are responsible for the health of the populationof the population

VisionVisionWe will improve the health of the population in the northeastern part of Göteborg by:

- creating a innovative hospital that helps mobilize the local community

- act through partnership and participation in their health

MissionMission• We will take the lead in creating a well functioning

local healthcare-system

• We will create an ongoing process to asses the health-care needs of the population

• We will systematically involve patients and citizens in our work

• We will design processes to meet these needs

• We will provide an arena for testing• We will provide an arena for testing innovations in all areas of health-care

Wh t t t tWhat we want to create• A attractive and welcoming hospitalg p

• A health-care system that makes sense

• Coordinating care around the patient

• Accessibility and good outcome results

• A dynamic and joyful working environment

What we didWhat we did..• Involved community and

ti t i diff t• Social

b di / k tipatients in many different ways and levels

• Designed processes ith t d t

branding/marketing• Social media • Simulation

without regard to concepts like hospital, community care, primary care (integrated

• Integrated prevention into the care

• Involved academiacare (integrated prevention, individualised processes, one stop shops, trying so go from

Involved academia• Creative alliance with the

Opera house Ballet• Involving all staff inp , y g g

start to finish including diagnostics)

• Designed the premises to

Involving all staff in strategic planning

g psupport our vision

Harnessing the communityHarnessing the community• Open house mingling events• Participating in every local event, fairs, carnevals

etc• Inviting all religious congregations to dialogue• Inviting all religious congregations to dialogue

meetings• Inviting all organisations to dialogue meetingsInviting all organisations to dialogue meetings• Study circles on health• Social media• Used design as a way of showing respect• Did business locallyy

2011-01-30 marianneolsson5@gmail.com

2011-01-30 marianneolsson5@gmail.com

2011-01-30 marianneolsson5@gmail.com

2011-01-30 marianneolsson5@gmail.com

Mattias Olaisson (koreograf och d L i D d (d )dansare, Luisa Denward (dansare)

2011-01-30 marianneolsson5@gmail.com

Harnessing individualsHarnessing individuals

• Catch individuals at all eventsCatch individuals at all events• Create a dialogue process (see ehma.org)• Hired locallyHired locally• Art, film• Matron• Matron• Using social media• Methods for using patient stories• Methods for using patient stories• Empowerment methods in patient education

How did it reconfigure services?How did it reconfigure services?

• Self-referalSelf referal• Content

R ti• Reception• Clothing• Signs• Design (rooms processesDesign (rooms, processes• Examples…

Smoke cessationSmoke cessation

• 40% smokers (Sweden 15%)40% smokers (Sweden 15%)• Project: ”Rökfri zon Nordost”

A d i h it l Cit f G th b• Academic hospital, City of Gothenburg, City districts, ICA-owner, dentists, house

i i l l liowning companies, local police• Advertising company to do Pro Bono work• Result: numbers of smokers going down

COPDCOPD

• Early intervention: • New processEarly intervention:• Free, open house

type spirometri

New process including diagnostic procedure and mobile yp p

• Advertised in local radio station in

COPD unit

different languages• 50% diagnosed with

lung diseases

ResultsResults

• RecruitmentRecruitment• Medical results

P ti t ti f ti• Patient satisfaction• Financial results• Democratic results• Health outcomeHealth outcome

Lessons learned so far..Lessons learned so far..

• Start with needs• Start with needs• Alignment of epidemiology,

public health and care deliveryI l th l l it• Involve the local community

• Keep up a learning attitude• Be prepared to re-design processes • Use social marketing and branding• Understand the needs of co-workers• Create alliansesCreate allianses• Check out:• www.angeredsnarsjukhus.com

htt // d j kh bl t• http://angeredsnarsjukhus.blogspot.com• Angereds närsjukhus at Facebook