Sharp Mesa Vista Hospital Community Health Needs Assessment Implementation Strategy Fiscal Years

Transcription

1 Needs Assessment Implementation Strategy Need: 1. Improve outcomes for seniors through culturally competent outreach services to high-risk seniors, including those in San Diego s disadvantaged communities, and through education targeting stigma reduction and healthy aging strategies. a. Continue to provide 16 hours each week to senior community centers (Gary and Mary West Center) as well as eight hours each week to Potiker Family Senior Residence, offering screening and referrals to lowincome, at-risk seniors. Chief Medical Officer, Sharp Manager, Sharp Mesa Vista Hospital Intake Alzheimer s Senior Collaboration Screening Throughout fiscal year (FY) 2017, Sharp Mesa Vista Hospital (SMV) clinicians collaborated with Serving Seniors to provide more than 1,000 hours of clinical services to senior clients at the Gary and Mary West Senior Wellness Center. Seniors received a variety of early intervention services, including examination by a nurse or psychiatrist; medication; referrals or counseling to reduce the risk of hospitalization and homelessness; and behavioral health screenings including Montreal Cognitive Assessments, which detect cognitive impairment. SMV also continued to collaborate with the Gary and Mary West Senior Wellness Center beyond the provision of clinical services. At this site, SMV provided free prevention and early intervention services designed to improve the utilization and effectiveness of behavioral health services for highrisk, culturally diverse seniors; and address barriers to accessing behavioral health care, including stigma, isolation and lack of available services. These services were further enhanced with free education as well as a weekly healthy aging support group led by an SMV clinician, which focused on Current as of: 9/24/2018 Page 1 of 27

2 Needs Assessment Implementation Strategy Need: aging and behavioral health issues, including depression, anxiety and coping with loss. Referrals are challenging to track through this effort and so currently evaluation methods are not in place. b. Continue community collaboration efforts to provide education and screenings to atrisk senior community members. SMV Business Development Specialist SMV Clinical Research Lead Alzheimer s Senior Collaboration Screening In FY 2017, SMV partnered with Alzheimer s San Diego to provide a variety of screenings, behavioral health education and resources to community members. At the Keeping Your Brain y Conference, approximately 120 community members learned about the latest research on reducing the risk of dementia. SMV educated 60 seniors about the latest in Alzheimer s disease research, including prevention and treatment. SMV also provided 400 community members with behavioral health resources and information about participation in clinical trials at Alzheimer s San Diego s Date with a Cure event. Throughout FY 2017, SMV and Alzheimer s San Diego offered free memory screenings a wellness tool that helps identify possible changes in memory and cognition to community members who were concerned about memory loss or interested in establishing a Current as of: 9/24/2018 Page 2 of 27

3 Needs Assessment Implementation Strategy Need: baseline to detect future changes. Further, SMV clinicians, including a psychiatrist, provided education and research on the early signs of Alzheimer s disease as part of Alzheimer s San Diego s Take Charge! Early Memory Loss Program, an educational support series for people living with early-stage memory loss and their care partners. c. Reduce stigma through education for community members and community providers on senior behavioral health issues. Lead Clinical Psychologist, SMV Senior Intensive Outpatient Program Alzheimer s Senior Collaboration Screening New in FY 2017: The SMV Senior Intensive Outpatient Program (SIOP) participates in Sharp Care s (Sharp s or SHC s) partnership with the City of San Diego to provide behavioral health education and resources to employees and residents in the City s nine districts. Topics include coping with caregiver stress, older adults and depression, and coping with life s transitions. For other details on this partnership see Action Item 5a below. Throughout FY 2017, the SMV SIOP provided seven community service initiatives, where staff members provided education and outreach to community members. The initiative focused on debunking the myths associated with older adulthood such as depression is a normal part of aging and growing Current as of: 9/24/2018 Page 3 of 27

4 Needs Assessment Implementation Strategy Need: old is characterized by loss and pain in order to benefit both the older adult patients providing the community service as well as members of the community. Lectures were delivered to more than 150 community members at various senior centers, a YMCA and a library. Throughout FY 2017, SMV s SIOP provided nearly 900 seniors and their family members with behavioral health resources, memory screenings, depression (Check Your Mood) screenings a brief questionnaire aimed at assessing risk for depression, and information about the hospital s senior services at numerous senior health fairs and community events in SDC. SMV s SIOP both provided behavioral health resources and presented at senior health-focused conferences throughout SDC, serving more than 1,500 community members in FY Lectures were held at a variety of community sites, including churches, community centers and other community based organizations. At these conferences, SIOP clinicians presented on a variety of topics, including attitudes and aging, reducing emotional suffering Current as of: 9/24/2018 Page 4 of 27

5 Needs Assessment Implementation Strategy Need: and brain health. 2. Improve housing options and living conditions for community members with mental health issues. a. Continue collaboration with community mental health providers and provide education to independent living facilities (ILF). SMV Business Development Specialist Housing Access to Care SMV continues its involvement in and in support of an initiative to improve housing conditions for community members living with serious, persistent mental illness. Within the past couple of years, member homes have increased and the model is being extended to other counties in California. Since 2012, SMV has actively participated in a community work team that secured a three-year contract with the County of San Diego and established an Independent Living Association (ILA) to help address challenges with safe and healthy ILFs for seniors. These efforts seek to both improve conditions for ILFs and the consumers housed there, and to help keep consumers linked with essential services and providers. The ILA is an initiative of CHIP s Work Team, in which SMV actively participates. b. Explore and expand collaborations with law SMV LD PET Housing SMV continued its collaboration with PERT through participation in PERT roundtables, monthly Current as of: 9/24/2018 Page 5 of 27

6 Needs Assessment Implementation Strategy Need: enforcement and housing planning committees to improve outcomes for community members living with mental health issues. Manager, SMV Intake Access to Care meetings and community-oriented trainings. SMV staff also supported approximately 600 SDC police officers at the quarterly PERT Academy Resource Fair. During these events, SMV team members provided officers with educational resources on understanding psychiatric emergencies and community psychiatric services. The police officers were subsequently paired with licensed mental health clinicians to help them evaluate and assess an individual s behavioral health condition and needs, and, if appropriate, transport the individual to a hospital or refer the individual to a community resource or treatment facility. 3. Increase access to mental health screenings and referral sources to members of the general community. a. Continue to provide free psychiatric evaluations and referrals for the general community. Manager, SMV Intake Screenings Access to Care SMV psychiatric evaluation and intake teams provided approximately 15,000 free psychiatric evaluations and referrals via phone calls and walkins for the general community in FY 2018 (includes ED, PERT, walk-ins). Sharp McDonald Center (SMC) also provided extensive community outreach and support through assessments and referrals to community organizations. During FY 2017, SMC spent more than 1,500 hours offering free chemical Current as of: 9/24/2018 Page 6 of 27

7 Needs Assessment Implementation Strategy Need: dependency assessments, educational materials and community referral resources to more than 700 community members. The free assessments were facilitated by a licensed mental health professional, who provided individuals with recommendations for appropriate programs and levels of care. Referrals are tracked; approximately 60% of the evaluated patients are referred to SMV, Sharp Grossmont Hospital or a psychiatric facility; the remaining evaluated patients receive referrals to community resources. 4. Reduce stigma and improve outcomes for individuals with mental health issues by community integration through community service activities. a. Continue participation in key mental health events alongside patients. SMV Business Development Specialist Stigma Access to Care SMV clinicians now also have increased presence at community events to further increase engagement and connect community members to helpful resources. SMV continues to maintain a Client Advisory Board, which obtains feedback from the hospital s outpatients on how to improve programs, empower patients, promote advocacy and better serve the community. During FY 2017, Client Advisory Board members and patients encouraged community members, staff, current and former patients, Current as of: 9/24/2018 Page 7 of 27

8 Needs Assessment Implementation Strategy Need: friends and family to join their walking team, the Mighty Mesa Vista Movers, in the annual San Diego County National Alliance on Mental Illness (NAMI) Walk to raise awareness and reduce stigma around behavioral health. 5. Raise awareness and reduce stigma through the provision of mental health education for patients, their loved ones, and the community. a. Participate in Sharp s partnership with the City of San Diego to provide behavioral health education and resources to employees and residents in the City s nine districts. SMV Business Development Specialist Content Expert, SMV Clinicians Stigma Access to Care New in FY 2017: SMV participates in Sharp s partnership with the City of San Diego to provide behavioral health education and resources to employees and residents in the City s nine districts. SMV provided education on a variety of behavioral health topics including mental health 101: signs and symptoms; culture, diversity and mental health; coping with caregiver stress; older adults and depression; dual recovery: addiction and substance abuse; and coping with life s transitions. b. Continue to host community speaking engagements and provide a variety of educational opportunities addressing various behavioral health topics. SMV Business Development Specialist Content Expert, SMV Clinicians Stigma Access to Care During FY 2017, SMV and SMC hosted numerous on-site community speaking engagements and workshops to increase awareness of behavioral health and substance use issues. addressed a variety of topics, including cognitive therapy, chemical dependency, suicide prevention, life transitions, domestic violence and child and geriatric psychiatry. SMV and SMC provided Current as of: 9/24/2018 Page 8 of 27

9 Needs Assessment Implementation Strategy Need: behavioral health education, resources and presentations to approximately 1,400 community members through participation in health and wellness fairs, conferences and events. Among many topics, this included SMV s monthly cognitive therapy lecture series designed to educate participants about cognitive behavioral therapy used to treat anxiety, anger, depression, panic disorder, bipolar disorder, phobias, relationship problems, grief and loss, and other challenges. In response to the need for information and support for caregivers of individuals with mental illness, SMV provided educational materials, local behavioral health resources and information on behavioral health support to family and friends in the hospital lobby through NAMI San Diego s Friends in the Lobby program. SMV provided an educational session on the connection between domestic violence and behavioral health to more than 100 community members at the Conviva y Aprenda (Share and Learn) educational series held at the San Diego Current as of: 9/24/2018 Page 9 of 27

10 Needs Assessment Implementation Strategy Need: Country Club in Chula Vista. SMV participated in the and Human Services Agency s (HHSA s) mental health forum discussion about the behavioral health challenges facing SDC and potential strategies to address community needs. Approximately 50 community members attended. Team members also provided education about opportunities for individuals with schizophrenia to enroll in clinical research trials. This included residents of Carroll s Care, an assisted living facility for mentally ill adults located in El Cajon, as well as health professionals at The Meeting Place, an organization that provides support to adults living with behavioral health disorders in SDC. c. Continue to host speaking engagements for community health professionals and students on various topics in behavioral health. SMV Business Development Specialist Manager, Outpatient SMV/East Chemical Dependency Stigma Access to Care SMV and SMC provided several educational offerings for behavioral health care professionals in FY 2017, including continuing education classes, conferences and trainings. SMV and SMC provided education to a variety of audiences, including psychologists, psychiatrists, community physicians, Current as of: 9/24/2018 Page 10 of 27

11 Needs Assessment Implementation Strategy Need: Manager, Specialty Outpatient Programs, SMV social workers, nurses and other health and human service providers, as well as the community at large. Topics included suicide prevention, integrating suicide risk assessment tools into treatment processes, current concerns in behavioral health care, dependency record-keeping and Insurance Portability and Accountability Act privacy laws. In FY 2018, SMV and SMC plan to host classes on mental health and substance use. During FY 2017, SMV hosted and participated in the Employee Assistance Professionals Association (EAPA) to increase knowledge and education in the behavioral health professional community. SMV and SMC also hosted educational events for the EAPA, where they provided resources and education regarding current concerns in behavioral health care, evidence-based therapies and emerging treatment models to approximately 50 community members throughout the year. and screening programs are evaluated by participants through survey. The goal is to educate and raise awareness for community members and Current as of: 9/24/2018 Page 11 of 27

12 Needs Assessment Implementation Strategy Need: physicians. d. Continue to provide clinical programs and education focused on drug/alcohol addiction of teens and Transitional Age Youth (TAY). SMV Sustainable Early Episode Clinic (SEEC) Clinical Research Team Chemical Dependency Stigma Access to Care Clinical Programs: As of year to date FY 2018, the SEEC clinic has provided 1,035 contact hours providing psychoeducation for young adults with schizophrenia and schizoaffective disorder and over 300 contact hours providing psychoeducation for families on how to support their young adult children. The impact of the SEEC program on participants symptoms and quality of life are evaluated using standardized measures. The SEEC clinic is also measuring participants rates of involvement in community activities/work/school and improvements in caregiver burden. Background: SMV opened the SEEC Clinic in January 2017 and began providing services for young adults newly diagnosed with schizophrenia and schizoaffective disorder and their caregivers. All services are provided free of cost and include education Current as of: 9/24/2018 Page 12 of 27

13 Needs Assessment Implementation Strategy Need: sessions about illness and recovery, support groups, community integration, employment and educational support, psychotherapy, peer support services, and medication management. In FY 2016: SMV completed the design of an early episode clinic model (known as SEEC) created to provide services for young adults with schizophrenia or schizoaffective disorder. The SMV Clinical Research Team wrote a grant proposal to fund this project through Janssen research and Development, LLC. Funding was secured and strategic planning for program implementation began with a target date of January e. Provide education (general health, workforce development, etc.) and resources to TAY with behavioral health issues to empower and support their continued health and well-being. SMV Business Development Specialist Workforce Development Stigma Reintegration Care Management educational sessions: In FY 2017, SMV provided a specialized TAY Program for young adults, ages 18 to 26, with behavioral health issues. Through the TAY Program, SMV offered education and resources to empower and support the continued health and well-being of these young adults. In April, the SMV TAY Program supported a croquet tournament at Balboa Park benefitting Impact Young Adults, an organization Current as of: 9/24/2018 Page 13 of 27

14 Needs Assessment Implementation Strategy Need: that empowers young adults with behavioral health challenges through social activities, mentorship, and leadership opportunities. SMV provided behavioral health resources to approximately 40 community members at the event. SMV also provided TAY with education and resources at a festival titled From the Ground Up benefiting Urban Beats, a creative arts program for TAY experiencing behavioral health issues, as well as at the Oasis Clubhouse youth center s Ducky Award Resource Fair. In addition, SMV collaborated with Planned Parenthood to provide three classes on safe sex practices to more than 60 attendees. Further, the SMV TAY Program partnered with the Consumer Center for and Advocacy to assist more than 30 TAY with insurance and legal forms and help them understand their rights. Collaborations continue to be explored to address a repetitive theme SMV patients need better community reintegration assistance as they exit SMV programs. New in FY 2018: The TAY program at SMV participated in St. Mark s Episcopal Church Fair, Oasis Clubhouse Resource Fair, San Diego Current as of: 9/24/2018 Page 14 of 27

15 Needs Assessment Implementation Strategy Need: State University (SDSU) Expo, City College Expo, and the Changing Minds Minds Matter South County Resource Fair. Through Sharp s partnership with the City of San Diego, the TAY program also educated community members on the signs and symptoms of mental health. In addition, SMV plans to participate in the SDSU Expo and the City College Expo in FY f. Continue to provide mental health education, support and resources for San Diego veterans and their families through the VA Choice (formerly Veterans Engaged in Supportive Treatment) program. Manager, Specialty Outpatient Programs, SMV Screenings Support Access to Care In FY 2017, SMV provided specialized services to active duty servicemembers, veterans and their families. These programs provide a safe environment for veterans to learn effective methods for managing symptoms of post-traumatic stress disorder (PTSD), acute stress disorder and mood-related disruptions. SMV s military-specific programs also decrease the use of maladaptive coping skills through evidence-based practices and include services for spouses and family members who experience distress when a loved one returns with symptoms related to the trauma of war. Team members provide education and resources to Current as of: 9/24/2018 Page 15 of 27

16 Needs Assessment Implementation Strategy Need: reduce the stigma surrounding behavioral health issues in the military community. During FY 2017, SMV s military-specific programs supported approximately 300 veterans and community members. In addition, SMV and SMC collaborated with partners in the military community to provide behavioral health education and resources to more than 500 community members at events throughout SDC. Events included the United States of America Veterans Affairs (VA) San Diego care System 2017 Mental Summit, Sharp HospiceCare s We Honor Veterans Recognition, and Resource Expo, the Live Well San Diego (LWSD) 2016 Veterans Forum: Fostering Collaboration to Connect San Diego County Veterans, and the Veterans Resource Fair at Silverado Memory Care in Encinitas, which was sponsored by San Diego County Hospice- Veteran Partnership and the Caregiver Coalition of San Diego. Further, in FY 2017 SMV provided education and resources about opportunities for participation in PTSD and depression research to physicians in the VA Trauma Program. SMV also Current as of: 9/24/2018 Page 16 of 27

17 Needs Assessment Implementation Strategy Need: continued to participate in the San Diego Military Family Collaborative (SDMFC), which meets monthly to discuss community-based services for military servicemembers and their families, as well as the Hidden Heroes campaign, which raises awareness and support for caregivers of veterans and active duty servicemembers. In October 2016 and August 2017, SMV sponsored the SDMFC s Annual Conferences, and provided PTSD resources and information about SMV s behavioral health services to more than 600 community members. SMV s VA Choice Program (formerly Veterans Engaged in Supportive Treatment - VEST) began in FY Evidence-based practices are used to provide comprehensive treatment for posttraumatic stress and substance abuse. The VA Choice Program utilizes the PCL ( ments/ptsd-checklist.asp) to measure PTSD symptoms. The tool is utilized at the beginning, middle and end of treatment, and provides an indication of how the patient is doing in treatment Current as of: 9/24/2018 Page 17 of 27

18 Needs Assessment Implementation Strategy Need: and whether they are ready to discharge. The tool is normed for many populations, including general trauma (military, males, females, and children). Screening results and follow-up data continue to show positive changes in the PTSD symptoms of the Veterans seen in the VA Choice program. SMV/SMC now also have a specific offering that assists veterans in learning effective ways to manage symptoms of PTSD, manage mood related disruptions to their lives, and decrease use of destructive coping skills. In FY 2018, the VA applied changes to the contract with SMV and SMV will not be seeing as many patients as in previous years. g. Participate in outreach activities across different Sharp entities to increase community awareness of mental health services. SMV Business Development Specialist Stigma Staff Development Access to Care SMV and SMC assisted in planning Sharp Chula Vista Medical Center s Changing Minds Minds Matter South County Resource Fair, a free during which more than 40 community partners gathered to educate South Bay community members about behavioral health challenges and raise awareness of available community services and resources. During the event, SMV and SMC Current as of: 9/24/2018 Page 18 of 27

19 Needs Assessment Implementation Strategy Need: provided workshops on substance use and behavioral health, as well as Check Your Mood screenings and behavioral health resources to approximately 120 community members. In FY 2017, SMV and SMC provided substance abuse education, nearly 30 Check Your Mood screenings, and led a group-based mindfulness experience as well as offered behavioral health resources to approximately 1,000 attendees at the Sharp Women s Conference in April. programs are evaluated by participants through survey. The goal is to educate and raise awareness for community members and physicians. 6. Provide support and resources to community members impacted by mental health and chemical dependency issues. a. Collaborate with community behavioral health organizations and provide space for support groups to serve members of the community impacted by mental health issues. SMV Business Development Specialist Support Collaboration Access to Care Throughout FY 2017, SMV provided more than 1,800 hours of free meeting space for a variety of self-help groups on a weekly basis, including Narcotics Anonymous; the Narcotics Anonymous Family group; Alcoholics Anonymous; Al-Anon; Cocaine Anonymous; Pills Anonymous; Project SMILE 12 Step Recovery Workshop; SMART Recovery San Diego; Co-Dependents Anonymous; Obsessive Compulsive Disorder support group; Current as of: 9/24/2018 Page 19 of 27

20 Needs Assessment Implementation Strategy Need: Hoarders Working support group; Shyness and Social Anxiety group; San Diego Phobia Foundation; Concerned United Birthparents; the California Board of Registered Nursing s Nursing support group; A New PATH; and the SMV and SMC Aftercare and Lifetime Support meetings. b. Facilitate various support group meetings (monthly, weekly, etc.). SMV Business Development Specialist Support Access to Care Current SMV-facilitated support groups include: A weekly Mood Disorders support group was available for individuals, family and friends impacted by depression, bipolar disorder, PTSD or anxiety. A National Association of Anorexia Nervosa and Associated Disorders support group was also offered weekly for individuals and families affected by an eating disorder. Further, a biweekly Dialectical Therapy (DBT) support group utilized DBT ideas and skills to help attendees manage severe emotional reactions, intense anxiety, impulsivity, self-harm, suicidal thoughts and high-conflict relationships. SMV also offered a free support group to provide psychoeducation and support for veterans and their families. More than 1,800 community members attended these support groups in FY Current as of: 9/24/2018 Page 20 of 27

21 Needs Assessment Implementation Strategy Need: 7. Strengthen partnerships with community organizations to foster future collaborations and fundraise for behavioral health services. a. Continue participation in key mental health events and fundraising activities. CEO, SMV SMV Business Development Specialist SMV Philanthropy Council Collaboration Access to Care Throughout the year, SMV and SMC sponsored and participated in 10 walks to increase awareness and raise funds for behavioral health services, including the San Diego County NAMI Walk, San Diego NEDA (National Eating Disorders Association) Walk, American Foundation for Suicide Prevention s Out of the Darkness Walk, Survivors of Suicide Loss Save a Life San Diego/San Diego Chapter of Yellow Ribbon Suicide Prevention Program Walk, Alzheimer s San Diego s annual Walk4ALZ, McAlister Institute s Walk for Sobriety, the Heroes in Recovery 6K Run/Walk, the MCCS Camp Pendleton Suicide Prevention Walk, the Travis Manion Foundation s 9/11 Heroes Run/Walk and the American Heart Association s (AHA) 2017 San Diego Heart & Stroke Walk. With the exception of the AHA 2017 San Diego Heart & Stroke Walk, SMV and SMC provided a booth with behavioral health resources during these events. At the Walk to End Alzheimer s, SMV offered education on Alzheimer s disease, clinical trials and community resources to more than 500 attendees. Throughout 2017, SMV sponsored and participated in community several events, benefitting Current as of: 9/24/2018 Page 21 of 27

22 Needs Assessment Implementation Strategy Need: organizations such as Mental Systems, NAMI, Jewish Family Service of San Diego (JFS), MHA Meeting of the Minds, International Bipolar Foundation, San Diego Psychological Association, y Lives Safe Communities, Justice Connected, A New PATH, and the Recognition Dinner, which recognizes individuals who work to support community members achieve recovery without stigma. Check Your Mood Day is an annual event held in conjunction with National Depression Screening Day in October to raise behavioral health awareness, fight stigma, and encourage community members to assess their emotional well-being. During Check Your Mood Day, SMV partnered with CHIP and LWSD to provide Check Your Mood screenings a brief questionnaire aimed at assessing risk for depression and resources at events across SDC. SMV offered Check Your Mood screenings, education and behavioral health resources to nearly 450 community members. Further, in recognition of National Recovery Month, SMV provided behavioral health and substance use Current as of: 9/24/2018 Page 22 of 27

23 Needs Assessment Implementation Strategy Need: resources and screenings to approximately 200 community members at HHSA s annual Recovery Happens: Celebration in the Park event to support those on the journey to recovery. Throughout FY 2017, staff at SMV and SMC regularly led or attended various community and professional health boards, committees, and advisory and work groups, including but not limited to A New PATH, Alzheimer's San Diego Client Advisory Board, Alzheimer s Project Safety Workgroup, LWSD Check Your Mood Committee, CHIP Work Team, CHIP ILA Advisory Board and Peer Review Advisory Team, CHIP Suicide Prevention Council, Inner City Action Network, JFS Committee, JFS Public Affairs Committee, MHA Board, NAMI, PERT, Residential Care Committee, San Diego College District, San Diego County Older Adult Council, San Diego County Falls Prevention Task Force, San Diego Mental Coalition, San Diego Mental History Planning Team, and VA San Diego Mental Council. Current as of: 9/24/2018 Page 23 of 27

24 Needs Assessment Implementation Strategy Need: Further, partnership with Research Foundation ( to improve collaboration with patients in the community continues. 8. Collaborate with local schools to promote interest in health care careers and provide opportunities for students and interns to explore behavioral health care professions. Longer-term impact of improving behavioral health workforce shortages in San Diego. a. Continue to support workforce development and provide student mentorship in various health care disciplines. Supervisor, Psychology Lead Clinical Psychologist Manager, Professional Development/Patie nt Safety/MAGNET Throughout FY 2018, SMV participated in internship and clinical training programs for trainees and students in various health care disciplines, including clinical dietary/nutrition, psychology, clinical social work, social work administration, marriage and family therapy (MFT), pharmacy, health information technology, clinical chaplains, medicine and nursing. SMV provided clinical supervision and training for 26 psychology trainees, including 16 graduate students, 7 doctoral interns, and 3 postdoctoral fellows, as well as 8 MFT and 8 Master of Social Work (MSW) student interns. In total, all ancillary (non-nursing) students served 33,020 hours on the SMV campus. In addition, more than 520 nursing students worked clinical rotations of 6 to 12 hour shifts and spent approximately 33,280 hours at SMV. Nursing students were placed in all inpatient units and several of the outpatient programs at SMV. SMV offers two clinical rotations Current as of: 9/24/2018 Page 24 of 27

25 Needs Assessment Implementation Strategy Need: in one day, including morning and evening shifts, and nursing students are on campus seven days a week. Approximately 13 students received clinical preceptorship time (one student paired with one nurse for a semester), accounting for nearly 1,800 hours. At SMV and SMC, psychologists, licensed marriage and family therapists and licensed clinical social workers provided more than 20,000 hours of direct clinical supervision to trainees. SMV provided two hours of lectures every week for psychology doctoral interns. Several lectures were provided on various subjects and also open to trainees throughout the hospital. Current as of: 9/24/2018 Page 25 of 27

26 Needs Assessment Implementation Strategy Needs: Cardiovascular Disease, Diabetes, Obesity Anticipated Impact Themes in 2016 CHNA Findings 1. Address the integration of physical and behavioral health by exploring programs that address social determinants of health and common co-occurring chronic health conditions (e.g., diabetes, cardiovascular disease, etc.). NA SMV Business Development Specialist Manager, Benefit and Improvement SHC Continuing Medical Various SMV Departments/ Teams Cardiovascular Disease Diabetes Obesity Stress Nutrition Co-morbidity with physical health conditions (Diabetes, etc.) In general, as a specialty hospital providing treatment and services for behavioral health, these additional identified community health needs do not fall within the scope of SMV's services and resources. However, In light of findings from the 2016 CHNA, SMV is exploring options to educate and address the issue of mind-body integration and effects of physical health on behavioral health and vice versa. Current efforts focus around internal Sharp team member education on the intersection of food insecurity/lack of access to healthy food on health outcomes (focusing on behavioral health). The effort is a collaboration with Sharp s Continuing Medical Department and Sharp Benefit. A CME-accredited educational session was provided to nutritionists at sharp Mesa Vista Hospital in FY 18. Further, SMV is exploring connections with San Diego to address access to healthy food. In addition, SMV continued to support the San Diego Rescue Mission by donating food three times Current as of: 9/24/2018 Page 26 of 27

27 Needs Assessment Implementation Strategy Needs: Cardiovascular Disease, Diabetes, Obesity Anticipated Impact Themes in 2016 CHNA Findings weekly to help support approximately 400 men, women and children living in the shelter. Each week during FY 2017, SMV collected and donated more than 300 pounds of food for the San Diego Rescue Mission an organization that helps San Diego s homeless and poor population create better lives for themselves through comprehensive programs, including services that address housing, hunger, behavioral health and other education and awareness programs. Current as of: 9/24/2018 Page 27 of 27