Taking Healthcare by Storm: Industry Insights with Kimberly Everett

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Kimberly Everett, BS, MA, Executive Director of the Bucks County Health Improvement Partnership. 

This episode highlights BCHIP's collaborative efforts with local hospitals and the county health department to address community health needs in Bucks County, Pennsylvania. Key topics include its COVID-19 response, chronic disease management, vaccine hesitancy, and programs like BCARES and Advanced Care Planning, emphasizing collaboration and social determinants of health. 

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website. 

Publication number QI-032825-GK

Transcript

Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

 Hello everyone and welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the Medical Director of Quality Insights, and today I'm excited to be joined by Kimberly Everett. She is the Executive Director of the Bucks County Health Improvement Partnership or B chip. I got very excited when I learned about this organization.

Since 1993, B chip has been dedicated to enhancing the health and well being of residents in Bucks County, Pennsylvania, by tackling a range of issues from chronic disease management to mental health, substance use and vaccine access, something that we are all Looking at all of those issues currently in this conversation, we'll dive into be chips impactful program programs.

The challenges faced during the covid pandemic, which we are still recovering from and how the organization continues to champion health. And well being for all stay tuned for a fascinating discussion on the power of a collaboration and community driven health care initiatives. Kim, thank you so very much for joining us today.

Well, good morning. I appreciate the opportunity to be here. Gene really looking forward to talking about some of our work to those that are listening and sharing having a good conversation today. 

Great. Me too. So tell us about the Bucks County Health Improvement Partnership. What makes it a unique organization to create positive transformations in public health?

Well, what I love about BCHIP is its history as you shared, it started 30 years ago and it came together because we had seven hospitals at the time and a county health department that said, what can we do collaboratively to address gaps in health care better than we could do these things individually.

And so even though they're competing hospitals, they came to the table for the betterment of the community, which I think is, it's truly a reflection of their commitment to the work. And what was fascinating is they did a community health needs assessment, which 30 years ago nobody was required to do and it was not needed to be done, but they did that.

And they identified the priorities in our community that they could all agree to to working on. Some of them have not changed in 30 years. Things like transportation, access to care health and wellness. So there were things that were identified at the time, and then each CEO led one of those committees.

So the fact that, again, we had those competing hospitals committed to working together was really a unique situation, and I think that is what has allowed BCHP to remain successful is because as each hospital system has changed significantly in the last 30 years, some of them significantly just in the last 30 days All of them have remained committed to this organization and true collaboration in our community.

And so there are other organizations that have, or other counties, other regions that have tried to do this and sadly haven't been able to do it successfully. And so I think it's a true testament to the work and the collaboration in Bucks County. 

I want to say as someone who has worked with different organizations, different facilities, bringing people together to work towards a common goal for competing health systems is remarkable.

So I don't know if everyone out there really realizes that, but it is. So BCHIP has been dedicated to improving the health and well being 1993, as you mentioned. Can you share how the organization's mission and priorities have evolved over the years? 

Absolutely. And like all organizations, they need to ebb and flow.

And I've always told anyone in health care, if you don't like change, then you shouldn't work in health care. Right? So, what I can tell you is when BCHIP started, as I shared, we did have seven hospitals at that time in the system. So we have six hospitals in our county, and we now have six, what has changed over the years is they've all become part of larger health systems.

So that's become challenging, right? Things that were easy to implement when you were had six local hospitals, compared to six health systems, some of them extending, far west into the Midwest. Best practices identified or sharing resources sometimes can be more challenging than it had been, but interestingly enough, in the 90s, access to care became a priority for BCHIP, and they did an incredible job of launching a clinic in the Ben Salem community, and it was a dental clinic and an adult health clinic, and they collaborated with one of our health systems around maternal child health.

And they did very good work. And I can share with Eugene that I've lived and worked in Bucks County for my entire career. And so as someone who's worked in public health in this community, BCHIP became known as the clinic in Ben Salem. And while they were doing really good work, The members of the board felt that BCHIP had lost its bigger vision, that vision of addressing larger health issues in the community, and really, if I'm the CEO of Grandview or St.

Luke's at the time, which are in Upper Bucks County, they were what is the value of me participating in this if BCHIP is simply a clinic in Benton Salem? And in my personal opinion, they weren't wrong. And so they did really good work. They secured a lot of funding. They provide services to folks that needed it.

But the utilization of the clinic was starting to decrease a bit as the health care again, environment change, the Affordable Care Act, things of that sort. And so, the board provided direction that they wanted to transition away from providing clinical care. So, that clinic, fortunately, became managed by one of our health systems.

So St. Mary Medical Center took that over. It is still there. They're still providing care to the community. Fortunately, we have another health clinic in Bucks County run, managed by Doylestown Hospital or the Ann Silverman Clinic. And so there were resources available and they felt that BHIP needed to get back to that bigger vision of addressing bigger concerns in healthcare.

So, You're pretty caught up because that was only five years ago, and they hired me to bring BCHIP back to addressing some of those larger goals, which I know we'll get into and talk to, talk about. But what was interesting is eight months into me being in this role, a pandemic broke out. And if anything secured the role of BCHIP in our community for the next hundred years, I can tell you that did.

And while COVID was a terrible thing, what was, Amazingly obvious is that the relationships that our CEOs and our health department had were critical to the success of managing that pandemic in our community. And so we convened meetings sometimes every other day, sometimes weekly. But for three years, we convened meetings for all of the leadership to address the challenges, share best practices, share resources, share purchasing things, share policy while they were all in the throes of dealing with a pandemic.

And so that really emphasized the value of this collaboration. 

Yeah, again, bringing people together, I think is just, it's profound. It's very powerful. So one of the key areas Beachhip focuses on is chronic disease management. probably the biggest health issue in the country. So what are some of the most pressing chronic health conditions affecting residents in Bucks County?

And how is B chip working to address these issues? 

So, the largest chronic health condition right now that is identified as concern for Bucks County is cardiovascular health and then also mental health. And so cardiovascular health there are lots of opportunities available through the health system.

So, BHPS goal is really not to duplicate efforts. So, the one program that is very specific in addressing cardiovascular health.

That's a grant that we've had for about 28 years now. It's the tobacco settlement funds. And so if BCHP does its job well, what happens, Jane, is I secure grants that can support the health systems or our community partners, like the health department and others, so that they don't have to write, you One grant each, and they don't have to do these programs on their own.

And so the smoking cessation program is a good example of that. So we get the funds for the county. We do smoking cessation classes at all six hospitals in the county. We also do them virtually post COVID. And then that's a complement to some of the work that the hospitals may be doing. If they're doing the low density CTs or they're doing other programs, we then refer into their health systems for the other programs that they're doing to support cardiovascular health.

Most of the hospitals are all doing blood pressure screenings in the community, cholesterol screenings, those kind of things as well. But from a public health perspective, we know that truly, long term change isn't something that happens at just a screening, right? So we really try to connect folks with their primary care providers to manage that.

I love the smoking cessation classes. I think a lot of people don't think about smoking cessation. initiatives anymore. So I think that's fantastic. So you talked about the COVID pandemic. It had obviously a profound impact on healthcare systems nationwide. So you talked a little bit about how the pandemic influenced BCHP's goals and programs, but what about in terms of increasing access to vaccines and other healthcare resources?

I'm sure it was a challenge during that time and probably impacted it, has impacted it since. 

100%. So it's fascinating to me that again, being someone who has worked in public health, my entire career I found it fascinating that during the pandemic, that there was such a heavy lean on our health systems.

I feel that while they were managing very sick patients and really spinning their wheels themselves to manage crisis and staffing and taking care of the patients they were seeing on top of it. Our. Our communities decided or our public health system decided that they were going to be a majority of the solution to the problem.

And to be honest, I think that was a disservice to our health systems. That being said I can tell you that across the country, our health systems rallied and they rose to the cause and they did what they needed to do to support their community. So. In Bucks County, our county health department was offering vaccines where they could and when they could get supply and our health systems were responding.

When the directive came out that the hospitals had to do community health care workers there was just no preparation for that. They didn't have a system in place to do that. And the system that we put in at the time was just really antiquated and really challenging, particularly for some of our most vulnerable communities.

So one of my favorite examples of how to talk about how we improved access to vaccines is I called Dr. Damsker, who is our medical director of our board and the medical director of our county health department. And I said, we need to eliminate these barriers. The system we're using is just not working.

And we were hearing from our communities of color and some other folks that they just could not access vaccines. So I said to them, well, what will work? And they said that they trusted their church leaders. And so we stood up a system during the pandemic that the church leaders would take names and phone numbers.

Dr. Damsker agreed to give us access to the Medical Reserve Corps and gave us I guess I want to say about 20 volunteers. Fortunately, the office space we were using at the time was donated by one of the health systems and they had sent everybody home. So we just had an empty office space. So we brought in the Medical Reserve Corps and every day we would hear from the hospitals what vaccine supply they had and what appointment times they had.

They would try to give it to us hopefully a week in advance. And at times though we knew we couldn't do that based on restrictions with supply, but we did the best we could. And we actually just did it the most old fashioned way ever, where the church leaders would send us an email with names and phone numbers, and then the Medical Reserve Corps would call them, and using a shared Google Drive, we would schedule everybody for appointments to wherever vaccine was available that week.

So, we were able to get thousands of folks vaccinated doing that, and then when resources became available we made sure we, following the directive of the federal government, we made sure that we were including our community outreach folks, people that were taking care of, our most, again, most vulnerable, whether it was people with severe mental illness, people with disabilities, folks that had health care providers coming into their home.

We prioritized them in getting them vaccinated. We worked really closely with our police and fire and EMS. And then we also made sure we were getting into all of this. Not all. We have a few shelters here in the county. We have a women's shelter from domestic violence. We have a human trafficking shelter.

We have a general emergency shelter. So we were taking vaccines on site and we were able to do that because of the collaboration and having those resources. 

Those are just And we continue 

to do that. We continue to do that now. 

Fantastic examples. I'm sorry to interrupt. I was just very excited hearing about, the community coming together like that.

So, talking about vaccines now, we're dealing with challenges around vaccine hesitancy and misinformation. How has BHIP worked to combat misinformation and what strategies have you found to be most effective in educating the public about vaccines? 

Well, I think the most important strategy is honesty, right?

And I believe that nobody through this pandemic lied. That is my belief but I do believe that what we thought to be true at one point ended up not being true, right? The things we thought the COVID vaccine would help us with it certainly helped, but it didn't do what we had thought it would do originally.

And I think we need to own that. Because if we don't, then how is anybody going to believe anything we say again? Right? And I think we need to teach people the difference between a COVID and a flu vaccine and a polio and measles vaccine, right? We know that vaccines can eradicate disease. We know that they prevent disease.

We also know that vaccines like flu and COVID Tend to minimize the severity of a disease, which is a different approach to vaccination or immunization, right? And those words aren't necessarily the same, but so I think. Really owning the fact that throughout cobit, the information we gave the community was what we believe to be true at the time we, but they were new vaccines, like measles.

Right. And even some of the other vaccines, chicken pox, they've been around for a very long time. And we do know how they work. And we do know the efficacy of them and really trying to gain folks confidence in those vaccines, because seeing those diseases coming back to our community that are so preventable, ending life when they don't need to is really key.

gut wrenching. We know that we have the science and the tools to eradicate some of that disease or minimize that disease, and so we really need to gain the trust of the community back, I think, by being honest. 

Yeah, I agree. Honesty is so very important. So last question about immunization. You oversee the Bucks County Immunization Coalition plays a key role in vaccine distribution.

So can you just tell us about some of the initiatives that were implemented to ensure access to vaccine like in vulnerable populations like the homebound seniors, childcare centers. 

Yeah, I'm so excited about a program that we have, though I will tell you it is, based on the most recent federal directive, we are concerned that we may not have this program in the future, but for right now, what we were, what we learned through the pandemic was that there are folks who are homebound that needed access to vaccines, and I was under the assumption that if they had a home visiting nurse from some sort of agency, that they would be able to provide that vaccine, and we've learned that was not the case.

And so it was certainly a gap that was identified, which if we're true to our mission, that's what BCHIP does as we identify gaps and it's BCHIP's job to try to find a resource to fill them. And so we've been able to secure some funding from U. S. A. G. And they help us fund our homebound vaccine program.

So we partner with a vaccine provider. And we go, we serve the needs of anyone who's homebound with vaccine and they can now access any of the recommended vaccines in their home. Some folks would say, why does someone who's homebound need vaccines? But I can tell you that they need them because they typically aren't in that home by themselves.

And so as long as they have a family member or a community member, like a caregiver that is in the community and bringing services to them, then they are at risk for any of those diseases. So, this is why we want them to have their vaccine, vaccines. So, and of course, typically they're vulnerable to begin with.

So, we. Provide the homebound program. We really believe that is one of the most valuable programs we have related to vaccine. We also work with our senior centers and our senior living facilities here in Bucks County and any of them who don't have a vaccine partner already. We bring vaccines on site for them.

And we do, I know I'm advertising by talking about it on here. We don't advertise that we will cover the cost of uninsured because we have very little funding for that. In fact, right now, we don't have any, but we are trying to use some general funds for it. But if someone shows up at any of these vaccine clinics that we manage, and they are not insured, we do provide them vaccinations and we cover the cost with that by securing some small grants and things of that sort to do that.

So we try to eliminate all those boundaries, right? Or all those barriers, I mean, so we eliminate the access by trying to go to them and where they are. We're trying to eliminate any barriers as far as cost as far as children's vaccines the vaccines for children program is a federal program. And we do have that in our county and the county health department does a great job with that.

The challenge with that program is it's only available during the day on weekdays. Yeah. And so that I believe provides some barriers for families who are trying to get their Children vaccinated. So, most recently, what we did is we evaluated the data from our school districts and we're partnering with those that had the highest rates of Children who were not vaccinated and we're bringing vaccines to the school districts.

A few times a year to address the needs of the students that need to be vaccinated on site. So, again, it's all about just trying to eliminate those barriers and making it as easy as possible to reach the most vulnerable folks. 

Yeah, meeting people where they are. Exactly. Exactly. Yes. So, okay. Shifting away to vaccination.

BCHIP has a variety of health and wellness initiatives. Could you provide an overview of the BCARES program and how it helps individuals struggling with substance use disorders in Bucks 

County? Yeah, BCARES is just a great program. And full disclosure, Jean, it's not truly a BCHIP program, although BCHIP supports it.

Absolutely. So it's just a great example of how BCHIP works. Many years ago, our county was able to secure some funding to have a warm handoff program in the emergency departments with certified recovery specialists. So this is someone with lived experience with substance use disorder that is trained to help people when they come to the hospital and try to encourage them to seek treatment.

And we know that when someone has a warm handoff, In a vulnerable moment of when they've been ill enough or had an overdose that landed them in a hospital, that it is a time when they are really Willing to consider treatment options, and that a certified recovery specialist, someone that can have this lived experience is a great resource for them to help guide them in that way.

And so the county wanted to launch this program in our hospital systems in Bucks County, and so they came to a BCHIP board of directors meeting. And I always like to tease my CEOs, but sometimes peer pressure is a wonderful thing. And so at the Beachhip board of directors meeting, all six hospitals agreed in that one moment.

And this was prior to me being part of the team, but all agreed to launch the be cares program. And so they have there are different providers at different hospitals. The program is managed a little differently at every site, which we would anticipate, but all 6 hospitals in Bucks County now have a warm handoff program and It has expanded.

They used to respond only if someone had an overdose. Now they are referred to if anyone is identified with substance use disorder in the emergency department. Some of the health systems have expanded it to their inpatients as well. So if anybody is identified with substance use disorder, they're referred to the BCARES team and that person goes in and meets with them and talks to them about treatment options whether that's inpatient, outpatient or what they can how they can support them in their treatment.

Managing that illness as well. 

So very important, especially now. So shifting to something that I am a huge fan of as a, I consider myself a nursing home physician. So can you tell us a little bit about the advanced care planning consultation program? How is this program helping individuals have important conversations around their healthcare wishes?

Well, this is again, such a neat program in that first of all, again, it predates me and we had this lovely volunteer in the community whose husband was a physician and she saw him struggle as families were aging and not having plans in place about how hard it was to coach those families through those challenging times.

So the advanced care planning program to me is so valuable because we call it a gift for your family. And everyone thinks you either have to have an illness already or be very old before you should consider these things. And truly, we have a student that started with us a couple weeks ago, and we're encouraging her to do this with her family.

Anybody over the age of 18 should do this. It's really what we believe because you just never know what's going to happen, right? God forbid, there's A plane, sadly, that falls from the sky, right? God, how horrible that was just a few weeks ago or a few days ago here in our Philadelphia community. You don't know what's going to happen.

And so we want you to be able to give some thought that if You had an end stage condition. And it's funny, there's also a myth out there that people think if you have an advanced directive that you're not going to get care. And that is not at all true. Advanced directives only come into play when someone already has an end stage medical condition, which I know you are aware of as a physician, but I think the general community doesn't know that all the time.

And so in someone who's had to make some of these critical decisions for family members. Having this document that says, this is what I would want, gives me such peace of mind that I don't have to make that decision and in a perfect world, everybody that would be involved in that decision is also involved in writing your advanced directive.

Quickly, the story that I tell that I think is the best is I had a friend who agreed to do this when I first started with BCHIP because I was. Torturing all my friends to help me with the system and I said, can you fill out an advance directive? And we went to her house and she had her mother, her adult children, one whom included her, his fiance, her and her husband.

It was right before Big Eagles game. And we passed around all the advanced directives. We had a great conversation for about one hour and we started it with saying no one lives forever. And while thinking about end of life can be sad. No one in this room right now is experiencing any illness that we think that's going to happen tomorrow.

And so let's talk about it when you don't have all that emotionality of illness and the stress of the severe aging end of life decisions. Let's talk about it now. What does everybody want? And the family had an incredible conversation for about 90 minutes. They were amazed at what each one of each other said because it was very different than what some anticipated.

They discussed it. Everybody heard it. They wrote it all down. We collected the advanced directives. We got them into their electronic medical records for them with their permission. And like, that's a wrap, right? And so in a perfect world, that's what that program looks like. So that now it's 6 months from now, a year from now, 10 years from now.

You are at an end stage medical condition. All can refer back to that document and say, we know that this is what, our mom wanted, our grandma wanted. And it really does help give peace of mind. And it also gives peace of mind to the clinicians that are taking care of them. 

I will agree. It really takes off the stress during those really critical times and allows family to just be together, which is what's important.

So, agree. So, can you speak to the collaboration between BCHIP and local health care providers such as the Wellness Partnership, Behavioral Health Collaboration? How do these partnerships help improve health care access and coordination in the community? 

So it's interesting. We just had a board retreat last Friday and what came out of the retreat to me that was so important is just that true value of working together.

What I have learned, I spent half my career in the public health sector and half in the healthcare setting and there are such silos and yet they have such shared vision and such shared goals. And so for instance, when I went to the board a year ago and said, what are your priorities? Behavioral health is always a priority.

So we launched a behavioral health committee and that's so that we can bring our county folks with our health care folks and our behavioral health providers all in the room. One, just so they can hear what each other is doing, to hear what successes or challenges they've had work out improved communication between them.

And then, if they can ideally collaboratively on in the future. So. Another example is the health care staffing is a huge problem. And so we brought together the VPs of the organizations. I'm sorry, the HR VPs. And said, what can we do? And they all talked about what successes they've had, challenges they've had, shared best practices, and they've identified they want to really do a campaign around careers, helping people.

So BCHIP will move forward in the future with trying to secure some funding around doing a career in our, campaign in our community around careers, helping people. And so I think the importance is really just that bringing the stakeholders to the table so they can be aware of what each other are doing on at least a semi regular basis.

That really is the value. 

Yeah, absolutely. So last question, looking ahead, what are some of the key goals for BCHIP over the next few years? And how do you plan to continue addressing both immediate health concerns and long term health issues in Bucks County? 

It just gets more challenging every day, right?

Yes. So what I can tell you is that having the commitment of our health systems is And just incredibly valuable and having the buy in of our county is incredibly value are valuable. Our commissioners and the leaders in this county, those leading the health department and the human services sector.

And they are really committed to that collaboration. And so. I think the continued communication and working together is really important. I think the things that we'll be looking at are access for mental health violence in health care staffing, and when I say violence in health care, I mean acts of violence against health care workers.

How can we bring all those best practices into play without it costing each one of our hospitals, more resources than they have. So just as these key issues come along, Addressing them, I think we have to keep looking at those social determinants of health, right? If we don't have affordable and attainable housing in Bucks County, we're not going to have anyone that can live here to serve the roles that we need them to in our health systems, right?

Someone needs to be able to cook the food and someone needs to be able to clean the room and change the sheets and all those good things. And so. They are things that we will continue to be involved in, and I believe advocacy will be a big piece of that, really working toward things like zoning reform and stuff like that, because we don't think about it, how that influences health in our communities.

And I think making folks aware of that is really important. So I believe advocacy and addressing some of those social determinants of health will be some of the long term plans. 

Excellent. Thank you so much for joining us today, Kim. I truly enjoyed the conversation. I wish you the best if with your initiatives in the future, if people want to find out more about BCHIP, which is the Bucks County Health Improvement Partnership, how can they do that?

Well, I would first tell them to go to our website, which is bchip. org, which is B as in boy and then CHIP, C H I P dot org. We also are on social media. Our hashtag is BCHealthEquity. So you can find us there or under BCHIP. And then our phone number, should anyone still like to dial in and find out about our programs, is 267 291 7882.

But truly, our website is the most valuable resource for gaining that information. 

Excellent. Kimberly Everett, thank you so very much for joining us today. 

Thank you so much for having me. I really appreciate this opportunity.

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website. We would love to hear from you.

So, until next time, stay curious, stay compassionate, and keep taking healthcare by storm.