BETTER HEALTH PARTNERSHIP
Better Health Partnership is a regional health care improvement collaborative committed to the triple aim of better care, better health and lower costs for Northeast Ohio residents with common chronic medical conditions.
- MetroHealth was a co-founder when the organization, formerly known as Better Health Greater Cleveland, was established in 2007.
- Better Health Partnership members include employers, insurers, community groups, agencies and nearly 900 health care providers from nine health care systems including MetroHealth.
- Better Health leverages region-wide partnerships among primary care providers in Northeast Ohio to establish common goals and uses evidence-based metrics and collaboration to improve care and outcomes of primary care patients with chronic diseases, including diabetes and high blood pressure, which are common, life-altering and costly.
- In 2015, Better Health launched a Children’s Health Initiative to focus on childhood asthma and obesity.
BUILD HEALTH GRANT
The BUILD Health Challenge, a national program, awarded The MetroHealth System along with Environmental Health Watch, the Cleveland Department of Public Health and other local organizations, a $250,000 grant to improve community health.
- This initiative targets deteriorating housing in the Stockyard, Clark-Fulton and Brooklyn Centre neighborhood, where residents can experience high levels of lead poisoning, asthma and COPD.
- These illnesses with long-term effects can be easily prevented when homes are improved.
- The BUILD Health Challenge grant has allowed Cleveland to create a Healthy Homes Zone. The healthy housing program, “Engaging the Community in New Approaches to Healthy Housing,” was one of 11 programs nationwide to receive funding.
- The grant is funded by the Advisory Board Company, Kresge Foundation, Colorado Health Foundation, de Beaumont Foundation and Robert Wood Johnson Foundation. MetroHealth is matching the $250,000 grant by providing in-kind services including tracking results.
CENTER FOR REDUCING HEALTH DISPARITIES
Since 2004, The MetroHealth System and Case Western Reserve University have collaborated on the mission to reduce health disparities through (a) research on root causes, mechanisms and interventions, (b) education of students, providers and policy makers and (c) partnership with community organizations and government agencies.
- The Center’s faculty and staff are involved in a number of research, education and community collaboration activities designed to address health disparities in Greater Cleveland and beyond.
- They have received more than $10 million from the National Institutes of Health (NIH), the Department of Health and Human Services and other agencies to understand and address health disparities related to hypertension, kidney disease and transplantation.
- Center faculty also play an active role in the Community Research Partnership Core of the NIH-funded Clinical and Translational Science Collaborative, a partnership involving Case Western Reserve University, University Hospitals, Cleveland Clinic and MetroHealth.
MetroHealth is a partner with the Cleveland Department of Public Health, Cleveland Metropolitan School District Safe Routes to School and other community partners for ciCLEvia, an initiative patterned after the international “Open Streets” movement made famous in Bogota, Columbia.
- The Cleveland version embraces the Clark-Fulton and Ohio City neighborhoods along West 25th Street, and is held monthly during the summer.
- Streets closed to vehicle traffic allow for walking, jogging, biking, dancing and many other activities in the streets. There is healthy food for purchase and an atmosphere of celebration during the vibrant city street experience.
CORRECTIONAL HEALTH PROGRAM
Established in 2013, this partnership teams leadership and resources from MetroHealth with Cuyahoga County Corrections Center health care providers to improve treatment for 2,200 inmates at the Cuyahoga County Corrections Center.
The current health care team is comprised of MetroHealth and county employees. MetroHealth provides the medical director, director of operations, nursing supervisor, and primary providers including physicians, nurse practitioners, physician assistants and paramedics. County staff includes the director of nursing, licensed practical nurses, registered nurses, an obstetrics/gynecology specialist, a pharmacist and medical team assistants. The main mission is the health and safety of all inmates.
- Two modern dental areas with state-of-the-art equipment and professional staffing provide preventive and comprehensive dental services.
- A family medicine chronic disease management program institutes on-site six-week diabetes self-management courses for inmates and also addresses chronic hypertension.
- MetroHealth’s real-time “virtual visit” telemedicine program enables consultation with specialty services such as cardiology, neurology, infectious disease, wound care and dermatology.
- On-site chronic disease management programs, digital in-house x-ray/ultrasound imaging and laboratory support and ongoing skills training (e.g., wound care, orthopaedics, suturing) improve the standard of care while reducing the need for inmate transports to MetroHealth Medical Center for services.
- The use of electronic health records provides a key link to MetroHealth specialists system-wide. Patient management is facilitated by this access, which includes lab and imaging data.
- More comprehensive, cost-effective care is provided for the 60-70 daily patients. The average length of stay in the jail is 45 days.
- New in 2016:
- Family Medicine Behavioral Health and Addiction Counseling: one-on-one counseling sessions and group therapy for addiction and behavioral health.
- Medication Assisted Treatment program: assisting inmates struggling with opioid addiction, including incarcerated pregnant women. This includes Vivitrol for inmates identified through drug courts and Subutex (Buprenorphine) for pregnant females with opioid use disorder.
- New in 2017:
- Comprehensive human immunodeficiency virus (HIV) and hepatitis C virus with referral for recovery support services
- MetroHealth Center for Biomedical Ethics providing consultation services for the Correctional Health Program
- Medical residents performing elective rotations at the corrections center
- Federal 340B Discount Drug Program, requiring drug manufacturers to provide outpatient drugs to eligible health care organizations or entities at significantly reduced prices, implemented for a great cost savings
CUYAHOGA COUNTY HEALTH CARE COUNCIL
Organized by the Cuyahoga County Department of Health & Human Services, this is a forum for health and social service providers to keep abreast of major developments affecting low-income individuals and families.
- The Council discusses and responds to changes involving Medicaid, behavioral health, senior services and prescription discount programs.
- MetroHealth participates in the quarterly meetings.
In 2016, MetroHealth opened a farm stand in partnership with The Healthy Living Kitchen, a local business operated by a certified whole foods chef and her business associate, a certified health coach.
- It offers locally-grown, seasonal produce for sale to patients, employees and the local community.
- The farm stand is located in the Outpatient Pavilion on MetroHealth’s main campus.
- Of the more than 1,500 transactions in the first three months, half were made by community members.
- This program received start-up funds from MetroHealth’s “Think Tank” competition (similar to TV’s “Shark Tank”), which encourages employees to pitch new program ideas that will improve health.
The Trust for Public Land has installed more than 68 Fitness Zones in communities across the country and has expanded to Ohio by launching a program in Cleveland’s Buckeye Neighborhood.
- MetroHealth and the St. Luke’s Foundation provided funding for the outdoor gyms designed to create a no-cost, supportive, accessible and social environment for getting fit.
- This project, in cooperation with Healthy Eating & Active Living, installed easy-to-use exercise equipment at three locations in the Buckeye neighborhood: East End Neighborhood House, Fairhill Center and the Woodhill Community Center.
HEALTHY CITIES CLEVELAND
In the summer of 2015, Morgan Stanley launched “Healthy Cities Cleveland,” part of a national program to encourage wellness, play and nutrition in underserved communities.
- MetroHealth’s School Health Program joined forces with the Greater Cleveland Food Bank and other community partners to support this initiative.
- Through the initiative, the Greater Cleveland Food Bank hosts a school-based pantry program at five Cleveland Metropolitan School District schools, one or two times a month.
- MetroHealth will provide multiple health screening events for students and community members at each of these school sites through May 2017. The schools are Adlai E. Stevenson, Case, Garrett Morgan High School, Marion-Sterling and Willson.
HEALTHY CLEVELAND INITIATIVE
This initiative, spearheaded by the Cleveland Department of Public Health, is a partnership of individuals, nonprofits and businesses with the common goal of a healthier Cleveland.
- Social determinants of health impacting Clevelanders where they live, work and play are addressed.
- By leveraging policies, partnerships and programs within the community, quality of life is enhanced and inequity is reduced.
- Areas of focus include: active living, behavioral health, clean air, violence prevention, behavioral health, healthy eating and health literacy.
- Employees of The MetroHealth System serve on a number of sub-committees, helping to move the work forward.
HEALTHY EATING AND ACTIVE LIVING (HEAL)
In 2010, the Center for Reducing Health Disparities at MetroHealth and the Saint Luke’s Foundation partnered to create the Healthy Eating & Active Living (HEAL) program to address chronic illnesses (e.g., hypertension, diabetes) in the Buckeye-Shaker, Larchmere and Woodland Hills communities.
- The HEAL initiative invited local residents to design healthy eating and active living opportunities.
- Together, families, friends, community groups, local organizations and businesses are working to transform their neighborhoods into places that support healthy living where options for healthy food and exercise are widely available, affordable, accessible and desirable.
- Guided by the leadership of the HEAL Coalition, made up of residents, local non-profits and other stakeholders, the initiative focuses on local voices to build strategies for making health and well-being a part of the everyday culture in the targeted communities.
- A Field Action Report on the HEAL Initiative was published in the June 2015 issue of the American Journal of Public Health.
The Health Improvement Partnership (HIP)-Cuyahoga is a collaborative, county-wide health improvement effort with a mission to inspire, influence and advance policy, environmental and lifestyle changes that foster health and wellness for everyone who lives, works, learns and plays in Cuyahoga County.
- More than 100 community partners have come together in the HIP-Cuyahoga Consortium to build opportunities for everyone in Cuyahoga County to be healthy.
- Priority issues are: Eliminating Structural Racism, Healthy Eating and Active Living, Linking Clinical and Public Health, and Chronic Disease Management.
- The Cuyahoga County Board of Health provides strategic and operational support. The MetroHealth System has a representative on the HIP-Cuyahoga Steering Committee, as well as a number of employees serving on various subcommittees.
Homeowner classes are an effort to help individuals invest in Cuyahoga County neighborhoods.
- It uses the format of Third Federal’s HomeToday™ with the tagline “strengthens communities one owner at a time.”
- It is a comprehensive program, which combines group educational sessions and personal counseling to teach the fundamental skills of good financial management and successful homeownership.
- The homeowners program is co-sponsored by MetroHealth, Metro West Community Development Organization (formerly Stockyard, Clark-Fulton & Brooklyn Centre Community Development Office) and Third Federal.
- Those who complete the seminar may be eligible for a $2,000 down payment from Third Federal.
Infant mortality, defined as when a baby is born alive but dies within the first year, is devastating to families and our community, and is a critical concern across the country.
- In 2015, the national infant mortality rate was 6.0 for every 1,000 live births.
- With an infant mortality rate of 7.2, Ohio ranks 44th in the country. That is 1,005 infants dying before their first birthday.
- Prematurity, sleep-related deaths and birth defects are the leading causes of infant death in Ohio.
- In Cuyahoga County, the infant mortality rate is even higher, with one in 95 babies dying in the first year, an infant mortality rate of 10.5.
- In an attempt to reverse the trend, MetroHealth has several programs aimed at educating pregnant women, new moms, their partners and families. In 2016, MetroHealth continued to offer programs such as Boot Camp for New Dads, Childbirth Preparation Classes, Sibling Classes, Teen Pregnancy Clinic and High-risk Pregnancy Management Services.
- Cribs and clothing were provided to families that needed assistance. Cuyahoga County Women, Infants, and Children (WIC) services and home visits by nurses were also offered — all promoting awareness, parent education and better outcomes for babies.
- In 2015, MetroHealth partnered with the city of Cleveland, Cuyahoga County and other stakeholders to launch the First Year Cleveland initiative to advance a community response to infant mortality. In 2016, the commitment to this program continued to improve infant mortality rates across our community.
- Programs introduced in 2016, with the goal of improving pregnancy and infant outcomes, included:
- Centering Pregnancy: group prenatal care to enhance participation in prenatal care and improve pregnancy outcomes
- The Nurse-Family Partnership: home visits by nurses during and after pregnancy to identify specific family needs and provide education and counseling
- Long-Acting Reversible Contraception program: providing women with the most effective long-acting contraception, on the day they request it at any MetroHealth site or with immediate postpartum IUD insertion — both enabling women to plan for and space pregnancy as they choose.
- MetroHealth’s High-Risk Pregnancy Service has been a leader in pregnancy care in the region for decades, improving pregnancy outcomes and preventing preterm births.
- In addition to providing complex pregnancy care, clinicians are teaching the next generation of doctors and conducting research studies that change pregnancy care locally and nationally.
- MetroHealth neonatologists provide the highest quality care for high-risk pregnancies, and premature babies and babies with complex medical needs get the expert care they need in the Level III Neonatal Intensive Care Unit.
LA VILLA HISPANA
As the cultural and economic hub of the Hispanic/Latino community in Northeast Ohio, it is geographically centered on the intersection of West 25th Street and Clark Avenue and extends about a quarter mile in all directions.
- La Villa Hispana is a cultural placemaking* initiative with a concentration in two areas: 1) La Plaza Central/Central Plaza, which hosts public gatherings that include music, arts and culture and food, and is also the home of La Placita, a Latino-themed festival and market. 2) The MarketPlace@ La Villa, which serves as a small business incubator, offering unique opportunities for local entrepreneurs to create and grow local businesses.
- The entire effort is led by a steering committee of community stakeholders including the local councilperson and community development corporation (CDC), Hispanic Business Center, Hispanic Alliance, Julia de Burgos Cultural Arts Center, MetroHealth, residents and the faith-based community.
*placemaking: a people-centered approach to the use of public spaces to bring together and benefit a community
LINCOLN-WEST SCHOOL OF SCIENCE AND HEALTH
This year-round high school meets on the MetroHealth campus three days a week for classroom academics, presentations by MetroHealth staff and others, and hands-on job shadowing. The idea for the school evolved from a recent mentoring program with MetroHealth and the Cleveland Metropolitan School District.
- The school opened in September 2016 with 45 students and already grew to 58.
- The mission of the school is to prepare students for post-secondary and career opportunities.
- Every student has a mentor and benefits from a robust curriculum complemented by experiential learning.
- The vision is that graduates will be universally recognized for their sense of self and purpose, their strong preparation for post-secondary education and careers, and their commitment to improving the health and vitality of their community.
MI METROHEALTH AT LA PLACITA
MetroHealth’s Mi MetroHealth family festival, formerly an annual summer event with activities for all ages, health screenings and food, has become part of the La Placita monthly summer series.
- La Placita is a pop-up open-air market near the intersection of Clark Avenue and West 25th Street.
- It celebrates the neighborhood’s Hispanic/ Latino culture and identity, with music and other arts, food, artisan vendors and community partner organizations.
- MetroHealth, a community partner, is integrating aspects of the Mi MetroHealth campus festival into each of the La Placita events.
NORTHERN OHIO TRAUMA SYSTEM (NOTS)
MetroHealth and Cleveland Clinic founded NOTS in 2010 as a collaboration to provide the best trauma care for people in our community by transporting them to the right place for the right care at the right time.
- Other community partners are Southwest General, Cuyahoga County Board of Health, Cuyahoga County Public Safety and Justice Services, the City of Cleveland Department of Public Safety.
- Research has proven that collaboration among hospitals that provide different levels of trauma care saves lives.
- MetroHealth is a verified Level I Adult Trauma Center and Level II Pediatric Trauma Center. Cleveland Clinic Fairview Hospital and Hillcrest Hospital are Level II Trauma Centers and Southwest General is a Level III Trauma Center.
- New in 2017: University Hospitals joining NOTS.
Violence and injury prevention is an integral part of an outstanding trauma system. In 2016, a specially trained individual, the violence interrupter, began working in the MetroHealth Emergency Department with patients who are victims of violence and their friends and families.
- MetroHealth is the pilot site for this hospital-based violence prevention program.
- On-site social workers make the initial contact with victims and then make referrals to the violence interrupter who is a member of the Cleveland Peacemakers Alliance, an anti-crime agency.
- The violence interrupter works at MetroHealth through the night, when most violence occurs.
- The initial goal is to defuse emotional reactions to conflicts and prevent retaliation. Victims and their friends and families are then linked to community resources providing alternatives to a continued path of violence.
- A grant from United Way is supporting the position, with other costs covered by NOTS.
PARTNERSHIP FOR A HEALTHY NORTH ROYALTON (PHNR)
The mission of the PHNR is to promote a healthy, drug-free community by empowering youth and adults to make responsible decisions.
- With representation from 12 community sectors and a federal grant from the Drug-Free Communities Support Program, the Partnership serves as the community catalyst for:
- youth developmental asset building (skills, experiences, relationships and behaviors for youth to become successful and contributing adults)
- youth leadership development
- community substance abuse prevention
- The MetroHealth System has a representative on the PHNR Advisory Board.
Project DAWN (Deaths Avoided with Naloxone) is an opioid overdose education and naloxone distribution program.
Participants are individuals who are at risk of opioid overdose — those in recovery and those actively using opioids — and individuals who know someone who is at risk for opioid overdose.
Program participants are educated on the risk factors of opioid overdose, how to recognize an opioid overdose and how to respond to an opioid overdose by calling 911, giving rescue breaths and administering nasal naloxone.
Eligible participants are given FREE naloxone kits containing naloxone and other educational materials.
Since the program was established in 2013, more than 5,000 kits have been distributed by Cuyahoga County Project DAWN, resulting in 799 known opioid overdose reversals.
Community Partners include Ohio Department of Health, ADAMHS Board of Cuyahoga County, Cuyahoga County Board of Health, Circle Health Services (formerly known as The Free Medical Clinic of Greater Cleveland), Cleveland Department of Public Health’s Thomas F. McCafferty Health Center, Hispanic UMADAOP, Cuyahoga County Corrections Center and Cleveland Emergency Medical Services.
Project DAWN was launched in Cuyahoga County by MetroHealth’s Dr. Joan Papp who later educated lawmakers about the life-saving aspects of HB 170, which passed and allows for naloxone to be prescribed to individuals who may be in a position to assist someone experiencing an overdose and allows law enforcement to carry and administer naloxone to victims of suspected opioid overdose.
ST. MARTIN DE PORRES PROGRAM
In a work/study program, students from St. Martin de Porres High School gain experience in a hospital setting.
- They work in several areas including logistics, medical records, nursing and human resources.
- In 2016, 24 students participated in the program.
Since 2006, the Partnership for a Safer Cleveland has managed Standing Together Against Neighborhood Crime Everyday (STANCE), which has helped to reduce violence in three of Cleveland’s highest crime neighborhoods.
- The program has three basic elements: comprehensive prevention, strategic enforcement and targeted re-entry.
- STANCE’s success in sustaining reductions in violent crime and reducing calls for police services reinforces an evidence-based approach of linking enforcement, outreach workers, prevention services, and re-entry policies and programs.
- STANCE was initially funded by the Department of Justice.
THE CENTER FOR HEALTH AFFAIRS, COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ROUNDTABLE
In 2015, The Center for Health Affairs created the CHNA Roundtable to initiate community health assessment and planning strategies.
- Meeting quarterly, the Roundtable brings together individuals from the hospital community and other essential stakeholders to share best practices, provide support to one another and discuss opportunities for collaboration.
- The MetroHealth System has a representative serving on the CHNA Roundtable.
TRANSGENDER JOB FAIR
The job fair offers an opportunity for transgender and gender non-conforming individuals to attend workshops and one-on-one sessions for career development, and to meet potential employers.
- The second annual event, hosted by MetroHealth in 2016, attracted more than 70 participants, 20+ community partners and 18 employers.
- Attendees heard inspirational speakers, worked on interview skills, and built resumes and LinkedIn profiles.
- A resource guide with information about LGBT-friendly organizations and the MetroHealth Pride Clinic also was distributed.
- The transgender community has a national unemployment rate twice the overall rate, according to the National Transgender Discrimination Survey by the National Center for Transgender Equality and the National Gay and Lesbian Task Force. The unemployment rate for transgender people of color is four times the national rate, the survey found.
- MetroHealth was recognized as a 2015-2016 Leader in LGBT Healthcare Equality by The Human Rights Campaign Foundation, the educational arm of the country’s largest lesbian, gay, bisexual and transgender (LGBT) civil rights organization.
MetroHealth staff regularly provide voter registration forms to patients who express an interest in registering to vote.
- They also provide mail ballot applications to patients who expect to be in the hospital or long-term care during an election.
- When patients are unexpectedly hospitalized and need a ballot for an election, MetroHealth government relations staff work directly with the local Board of Elections to facilitate so patients can participate in the election.
WEST 25TH STREET REVITALIZATION
The MetroHealth campus transformation continues to catalyze the revitalization of the West 25th Street Corridor. As a major anchor institution and the largest employer on Cleveland’s West Side, MetroHealth is a partner in the West 25th Street Corridor Initiative — a collaborative effort with the goal of building on the area’s existing assets and bringing economic revitalization to the corridor and its adjacent neighborhoods.
- MetroHealth renovation and construction, current and future real estate projects, public transportation and infrastructure improvements, and placemaking* enhancements will contribute to the growth of residential, commercial and retail development along the corridor.
- Some examples of the investments being made include: Fresenius Dialysis Center — a $4 million partnership with Metrohealth and Cleveland Clinic that broke ground with a planned opening in 2017, Horizon Education Centers: Market Square — a $4 million facility providing quality early childhood education, The Lofts at Lion Mills — a $9 million renovation producing 36 units of affordable housing in summer 2017, La Villa Hispana — a plan to create the cultural and economic hub of the Hispanic/Latino community in Northeast Ohio, which received approval for its five-year action plan from the Cleveland City Planning Commission, and The Dream Neighborhood — an initiative to welcome refugees to Cleveland and help them thrive by providing access to safe and affordable housing, education, workforce opportunities and other assets that support their transition into the community.
*placemaking: a people-centered approach to the use of public spaces to bring together and benefit a community.
WINDOW OF HEALTH
In a partnership with the Government of Mexico, through its consulate in Detroit, MetroHealth began the Ventanilla de Salud (Window of Health) Program in 2015.
- The program includes bilingual, bicultural health education, enrollment in insurance programs and referrals.
- Though it is aimed at Mexican nationals and their families, the program assists other Spanish-speaking patients as well