Allied Services Integrated Health System
Rehabilitation Hospitals
Community Health Needs Assessment 2013
As a founding member of the Healthy Northeast Pennsylvania Initiative (HNPI), Allied Services
Integrated Health System (“Allied”) collaborates with hospitals, insurers and public health
organizations to improve regional health. HNPI’s work is based, in part, on periodic Community
Health Needs Assessment (CHNA) studies of Lackawanna and Luzerne counties. Released in
December, 2012, the latest CHNA study features population health statistics, provider and
consumer feedback, and recommendations on a wide range of health topics.
Allied Services Integrated Health System is a nonprofit, post-acute health care provider, serving
persons who have disabilities, serious injuries, chronic or age-related illnesses. At the core of
the system are Heinz Rehab (Wilkes-Barre) and Allied Rehab (Scranton) hospitals. The hospitals
offer medical rehabilitation and related care for stroke, brain injury, spinal cord injury,
amputation and pediatric disabilities.
Allied has reviewed the CHNA from its unique perspective as a post-acute care organization,
keeping in mind its core competencies and charitable mission. Allied has adopted the following
CHNA implementation strategies for the period July, 2013 through June, 2016, pursuant to the
requirements of the Patient Protection & Affordable Care Act. Several of these strategies
continue or build upon existing programs and practices.
Area 1: Mental Health
2012 CHNA Findings:
 Mental Health issues are increasing [sic], but the stigma of treatment still exists.
 There is a strong correlation between substance abuse and mental health issues.
 Medical personnel must be trained to spot mental health issues.
Background:
Locally and nationally, mental illness is the leading cause of disability. As part of Allied
Services Integrated Health System, a variety of residential and community-based
Behavioral Health programs promote the recovery of people who have experienced
mental illness-----severe depression, schizophrenia, bipolar disorder, etc. Psychiatric
rehabilitation counselors, behavioral health specialists and support staff work closely
with consumers, helping them to secure appropriate treatment and counseling; to
identify employment or job training, housing, and other supports; and to reconnect with
family and community.
Within the Allied Rehab and Heinz Rehab hospitals, representatives of the Psychology,
Rehab Counseling and Social Work departments a integral members of any treatment
team. We rely upon their expertise in clinical psychology, behavioral health, personal
and rehab counseling, etc., to identify and correctly address behavioral and mental
health concerns. Their extensive familiarity with community mental health systems,
psychiatric inpatient programs and outpatient clinics, substance abuse treatment
programs, etc., is essential in guiding patients to appropriate resources. These
professionals also play a lead role in training clinicians, caregivers and support staff, and
in shaping our patient care policies and practices.
Mental Health implementation strategies:
1. Improve mental health awareness/sensitivity among direct care and support staff
through training programs, in-service opportunities and periodic updates on
community mental health resources
Outcome: Completion of training by direct-care, clinical and customer-contact staff.
2. Provide charitable and in-kind support to community mental health initiatives
including crisis intervention training for first responders, National Alliance for Mental
Illness, suicide prevention, crisis intervention organizations and peer support
organizations.
Outcome: Continued voluntary contributions to these organizations in our
community. (Details enumerated in Schedule H.)
Area 2: Community Health Education & Health Resource Information
2012 CHNA Findings:
 Lack of health resource awareness by patients, residents [of Luzerne and
Lackawanna counties]
 Lack of understanding of key health issues and preventive care
 Information on health programs is scattered and can be difficult to piece together.
 High blood pressure and high cholesterol is high [sic] among the sample.
Background:
In an effort to reduce the regional burden of preventable illnesses, injuries and
disabilities, Allied Rehab and Heinz Rehab hospitals operate a variety of health
education programs Throughout the year, hospital staff conduct and/or host free
health education workshops, physician and clinician lectures; free consumer health
screenings; and on-site support groups for persons affected by stroke, brain injury,
Parkinson’s disease, Myasthenia Gravis, autism spectrum disorders, pulmonary disease,
obesity, head and neck cancers, Amyotrophic Lateral Sclerosis, and osteoporosis. We
also host annual information fairs for persons living with spinal cord injury, amputation,
mobility limitations and chronic illnesses.
Allied Services Integrated Health System provides financial and in-kind contributions to
the local affiliates of the American Heart Association, Multiple Sclerosis Society,
National Stroke Association, American Cancer Society, Muscular Dystrophy Association,
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Susan G. Komen for the Cure (Breast Cancer), and other established providers of health
education and support services. (These contributions are recapped in Schedule H.)
Health Education/Information implementation strategies:
1. Continue free health education lectures, screenings, support groups and other
community/patient education opportunities.
Outcome: Provision of these services to residents of Luzerne & Lackawanna counties.
2. Continue financial and in-kind contributions (guest speakers, facility use,
refreshments, supplies, patient education materials) to recognized providers of
health education and supportive services.
Outcome: Provision of these services to residents of Luzerne & Lackawanna counties.
(These contributions are recapped in Schedule H.)
Area 3: Population Diversity
2012 CHNA Finding:
 [The region’s] increasing racial and ethnic diversity requires cultural training and
[health] professionals with multiple language proficiencies.
Background:
Allied’s Human Resources policies and practices incorporate best practices that foster
diversity and inclusion in recruitment, hiring and staff development and advancement.
Such practices ensure that our employee population mirrors the growing racial, ethnic
and cultural diversity of the community we serve. To facilitate quality care for an
increasingly diverse patient population, we maintain a language interpretation service
(Interpre-Talk), which is contracted for 24/7 assistance for patients who are not fluent in
English.
In November, 2012, Allied’s clinical leadership conducted a systematic assessment of
communication and cultural competence as related to care-delivery. The review
resulted in the adoption of Allied Services Integrated Health System’s 2013 Cultural
Competency & Diversity Plan. The following strategies are taken from the plan.
Population Diversity implementation strategies:
1. Ensure that pre-admission assessment, nursing assessment and communication
sheet reflect cultural/language communication information and updates.
This is an ongoing activity.
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2. Ensure that continuing education of staff, orientation of new staff, and clinical
materials address cultural competence and diversity issues.
This is an ongoing activity.
3. Make key patient information, compliance, patient and caregiver education
documents available in Spanish.
Documents will be translated and incorporated into hospitals’ processes for
registration, admissions, discharge, etc.
Area 4: Provider Communication & Collaboration
2012 CHNA Findings:
 Lack of collaboration among organizations, resources, providers
 Area hospitals have opportunities to work together in several specialty areas
 There is a perception of unavailability of health care providers within the region
 There is no collaboration between primary care physicians and specialists.
Background:
Medical rehabilitation is a multi-disciplinary endeavor that demands high levels of
coordination between/among therapists, physicians, nurses, pharmacists and many
other hospital employees. Close coordination with outside physicians, hospitals, labs,
pharmacies, home health and family caregivers is also required.
The “team approach” is fundamental to our systems or care. Allied Rehab and Heinz
Rehab have adopted clinical protocols and technologies that hard-wire coordination in
ways that improve efficiency, safety and care quality. The latest such innovation is the
Allied ASpire! electronic health record system, which will expedite real-time information
and improve decision-making.
Finally, Allied’s physician relations and marketing personnel are continually engaged in
outreach to acute care hospitals, physicians and specialists, health and human service
organizations, long-term care providers. They share the latest information about the
hospitals’ programs, clinical specialties, rehab technology. They also help to expedite inbound and out-bound patient referrals, discharge planning, coordination of home care,
etc.
Communication & Collaboration implementation strategies:
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1. Complete the implementation of ASpire! EHR system-wide to improve the accuracy,
timeliness, and effective use of clinical information; and to enable integrated, multidisciplinary decision making, for safer and more effective care.
Outcomes include more effective, efficient care.
2. Institute real time patient tracking/reporting to referring physicians, hospitals, etc.
Outcomes include better coordination of care—e.g., reduced lag-time in
obtaining/expediting physician orders; improved safety and efficiency of transitions
between care settings and discharges to other facilities or to home.
3. Continue outreach to physicians, specialists, care coordinators, community health
and home health organizations regarding Allied Rehab and Heinz Rehab programs
Outcomes include written and in-person communications with physicians/specialists,
care providers, hospitals, home health organizations, long term care organizations
The following CHNA-identified needs will not be addressed:
1. The perception of [poor] quality must be addressed with medical professionals and
residents/patients.
2. Physician skills, such as time management and customer service, are needed.
3. Physician shortage must be addressed.
4. Lackawanna and Luzerne Counties fall behind the Commonwealth in several areas
with regard to health status and physicians per capita.
5. There is a perception of poor quality of care within the region.
6. Respondents are disappointed by the lack of respect and lack of cooperation within
the health care system.
7. Research and innovation improve perceptions of quality.
8. Primary care physicians see that the quality of specialists is an issue.
9. Primary care physicians see the wait time to see specialists, coupled with testing,
prognosis and treatment plan, as a problem.
Response:
Founded in 2009, The Commonwealth Medical College (TCMC) has served as a convener
and catalyst for community efforts to improve the health of northeastern and central
Pennsylvanians. TCMC was founded for the express purpose of increasing the region’s
supply of physicians and specialists; and has received widespread public support.
Moreover, the College has taken a leadership role in regional population health research
and needs assessments (including the 2012 CHNA).
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Our support of TCMC includes offering extended internship and “shadowing”
opportunities for medical students; presentations, lectures, mentoring of medical
students by Allied clinicians and administrators.
With regard to the findings listed above (items 1 through 9), Allied prefers to
complement and indirectly support, rather than duplicate, TCMC’s work and continuing
efforts to educate highly-qualified physicians that will serve our region. Further, some
of these findings (e.g., physician communication/attitudes, physician-patient
communications, out-migration of patients) --- may be targeted for collaborative action
by the Healthy Northeast Pennsylvania Initiative, the Institute for Public Policy &
Economic Development. Allied is a member of both of these organizations.
10.
11.
12.
13.
14.
15.
16.
Respondents are in overall good health.
Based on research results, income and mental health status are related.
There are a high number of overweight and obese residents.
There are many low income residents.
Substance abuse is a problem in the region.
There is a strong correlation between substance abuse and poverty.
Social service resources are disjointed and stressed.
Response:
As northeastern Pennsylvania’s leading provider of care to persons with disabilities and
chronic illness, Allied Services Integrated Health System is serving a population that is
disproportionately affected by poor physical health, obesity, poverty, unemployment,
and poor mental health. As mentioned above, a variety of departments and professions
play a part in helping our patients/consumers to secure appropriate services from other
health, human service, social service, and health insurance programs.
Allied supports (and avoids duplicating) the efforts of nonprofits that provide social
services, job training, sobriety/substance abuse counseling to individuals, and of
agencies that promote regional economic development. Our support takes the form of
voluntary contributions, free meeting space or other in-kind assistance, and “release
time” for staff who wish to take part as volunteers.
17. Each insurer is using a different methodology to reach plan participants about
wellness programs.
18. Names of renowned facilities improve perceptions of quality.
19. Facility design and décor impact quality perception.
Response:
Several of the conclusions listed in the CHNA (items 17 – 19, above) are based on the
opinions of CHNA survey respondents. These statements are not indicative of
specific community needs or public health problems. We propose no strategies to
address these comments.
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