Accountable Community of Health

Olympic Community of Health (OCH) is an accountable community of health (ACH), one of nine in the state, designed to be able to address the major health priorities in our region, focusing on health equity and social determinants of health. The OCH region includes Clallam, Jefferson and Kitsap Counties as well as the Sovereign Nations of the Hoh, Jamestown S’Klallam, Lower Elwha Klallam, Makah, Port Gamble S’Klallam, Quileute and Suquamish Tribes.

The OCH Board of Directors consists of leaders from tribal nations and health sectors. Together they strive to steward a participatory process to identify the greatest areas of need and sustainably align resources and services to achieve the highest attainable level of health and well-being for all members of our communities. The Board’s vision for transformation is:

  1. Accessible, patient-centered healthcare system that effectively integrates physical, behavioral and dental health services
  2. Effective linkages between primary care, social services and other community-based service providers
  3. Common data metrics and shared information exchange
  4. Provider adoption of value-based care contracts

OCH’s regional health improvement project is a tri-county Opioid Response Coordination project.

Navigators Working Extended Hours

Night Owl

Calling all Night Owls!!!!!!

Our Affordable Care Act Navigators will be working Extended Hours at our 6th Street and Wheaton clinics on Mondays starting December 7, 2015 through January 25, 2016. (Open Enrollment ends January 31, 2016.)

If you need help signing up for insurance and need an evening appointment, you can call and schedule one at 360-377-3776 or just walk in to either clinic (at least 30 minutes before closing) on Monday evenings during our Extended Hours:

6th Street Clinic – 4:00pm to 7:30pm
Wheaton Way Clinic – 5:00pm to 8:30pm

ACS Great American Smoke Out

ACS Great American Smoke Out 2015

Olympic Community of Health

Update on the Olympic Community of Health

Guest blog by Barbara Malich

 

The Olympic Community of Health (OCH) is moving through the early formative steps required by the Washington State Health Care Authority and currently we are defining a governance model, developing program activity ideas with aspirational goals that might be relevant to our three county region (Kitsap, Jefferson, and Clallam), as well as preliminary work on developing sustainability models for this new organization.

The more inspirational work is being done by the Peer Learning/Leadership Group in defining how the work can be accomplished given substantial differences in population, level of engagement, and capacity for change.  I am representing our region to this statewide leadership group.  It is, in many ways, quite daunting.

A first step is to better understand the “over-arching” goal/purpose the state envisions for the leaders of the Accountable Communities of Health (ACHs):

The ACH leader must commit to this statement—

     “I am an architect and steward of a participatory process that sustainably aligns resources to achieve equitable health and wellbeing for all members of my community.  I cultivate diverse partnership where we authentically engage with our communities to set health priorities and act on our commitments.  We embrace a holistic approach to transcend, disrupt and transform the complex, multiple, funding streams and delivery systems to optimize the impact of resources.”

At OCH we define this in conjunction with the Institute for Healthcare Improvement’s Triple Aim:  Better Health, Better Care, Lower Cost.

So let’s back up a little to consider how we define health:

The most commonly quoted definition of health is that formalized by the World Health Organization (WHO) over half a century ago; “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.”  This definition is by its very nature HOLISTIC. I have lived by this concept throughout my work-life in community based healthcare here in Kitsap County at PCHS.

I believe by holistically approaching all elements of society, we generate a thoughtful, tolerant, and engaged society. I see the importance of holistic engagement in education, in community visioning, and especially in governing.

Looking at life through the lenses of all the factors present results in understanding, compassionate realism, and may open the door to the potential of change.

I do believe we must be cognizant and sympathetic to the health care systems issues that surround us.  Health care delivery is a major part of our national, regional, and local economies.  It pervades our systems of higher education.  It is the economic engine that is driving conversation in our country.  But even that is a complex concept—it is not just health care systems, it also includes big pharmaceuticals, big insurance companies, and big universities/churches/ and other fundamental/foundational elements of our society.

The ACHs are, by design, intended to disrupt this—through a redistribution of funds, a refocusing of priorities, and by intensely and consciously listening to the community voice as it emerges.  It will take us far beyond our traditional definitions of public health, community/behavioral health, specialists, hospitals, and the other integrated factors of daily life— access to affordable housing, living wage jobs and reintegration of those at highest risk (the homeless, those emerging from incarceration, and those confused/immobilized by mental health and chemical dependency).  We will need to manage chronic and acute conditions as we disrupt the very systems on which people depend.  We need to engage with providers—they have the most access to the patients who will become the community voice—and the providers and the systems employing them are speaking loudly against change.

Holistic means all-encompassing—beyond the traditional barriers, beyond the existing institutions, and beyond our current horizon.  The OCH Vision:  engage our communities in plans for innovation, integration and transformation—all while keeping an eye on cost-reduction, maintenance of the systems needed  to support our populations as we move towards this transformed system, and to help our communities to “connect the dots” to understand why this work is important.

The focus on “winners” and “losers” has to stop.  We all may win if the transformation is allowed to occur.

Washington Health Benefit Exchange Customer Support Program

Kitsap Public Health District to continue as local lead organization for

the Washington Health Benefit Exchange Customer Support Program

 

KITSAP COUNTY, WA– The Washington Health Benefit Exchange announced this week the selection of the Kitsap Public Health District to continue providing in-person assistance as part of the Washington Healthplanfinder customer support network.

Kitsap Public Health is one of nine organizations, which include public health agencies, regional health networks and other community organizations, chosen statewide to help residents enroll in health insurance on the Washington Healthplanfinder for the next open enrollment period, which runs from Nov. 1 through Jan. 31, 2016. Kitsap Public Health will serve residents in Kitsap and North Mason Counties.

“Our continued partnership with these knowledgeable and trusted organizations makes it possible to reach Washington’s uninsured population and support customers already enrolled through Washington Healthplanfinder,” said Pam MacEwan, CEO of the Washington Health Benefit Exchange.

Kitsap Public Health has Navigators on staff, and is responsible for building and overseeing a network of Navigators including Peninsula Community Health Services. Navigators provide free, in-person support to help direct residents through the Washington Healthplanfinder enrollment process in an effort to reduce the uninsured rate in Washington.

Assistance is available from Navigators at Kitsap Public Health in person or via phone during the week from 8:30 a.m. – 4 p.m.  Appointments are strongly encouraged and can be made by calling 360-337-5235. Assistance is also available in Spanish. Those requesting assistance will need to have the following information available to sign-up:  Social Security number, gross monthly income before taxes, tax filing status, and copies of insurance information if the enrollee or other family members have other insurance.

Kitsap Public Health and Peninsula Community Health Services will be at the Kitsap Mall near Kohl’s from 10 a.m. – 2 p.m. on Sat., Oct. 31 to promote open enrollment and answer questions about open enrollment and other agency services.

Washington Healthplanfinder allows individuals, families and businesses to compare health insurance plans side by side, determine if they are eligible for free or low-cost coverage, and choose the plan that fits their needs and budget. Washington residents can begin enrolling Nov. 1 for coverage starting Jan. 1, 2016.

Visit wahealthplanfinder.org to learn more about Washington Healthplanfinder.

About the Washington Health Benefit Exchange

The Washington Health Benefit Exchange is a public-private partnership established in accordance with the Patient Protection and Affordable Care Act of 2010 (ACA) to implement a new health insurance marketplace for individuals and small businesses. The Exchange is separate from the state and governed by an independent 11-member board. For more information, visit www.wahbexchange.org.

National Health Center Week Video Contest Submission

Peninsula Community Health Services Clinic Coordinators put together a great video of the services PCHS offers and submitted it to the National Health Center Week video contest. Here’s their wonderful and informative creation:

HPV Vaccine

HPV Vaccine Is Cancer Prevention: Protect Your Kids

If there were a vaccine against cancer, wouldn’t you get it for your child? The HPV vaccine prevents cancers caused by human papillomavirus (HPV), a very common infection.

Doctors recommend the HPV vaccine for both boys and girls at age 11 or 12, before risk of exposure to the virus. HPV is spread through skin-to-skin sexual contact, and is the most common sexually transmitted infection in the United States. It is important to vaccinate preteens because the HPV vaccine produces the most infection-fighting cells, or antibodies, during the preteen years.

Boys and girls should get the vaccine at age 11 or 12—or as soon as possible if they’re older.

PCHS is proud to partner with the Washington State Department of Health to encourage parents to get their children vaccinated against HPV. Parents are the key to protecting adolescents from HPV cancers.

The HPV vaccine is free. Talk with your child’s doctor about the HPV vaccine today, or visit doh.wa.gov/HPV to get the facts.

The Dental Checkup

• By Krisha McCoy, MS | Medically reviewed by Pat F. Bass III, MD, MPH

Maintaining good oral health is important to your overall health as well. Learn what to expect from a basic dental checkup.

You can help protect your oral health by seeing your dentist regularly for checkups. It’s recommended that most people get a dental checkup every six months, but your dentist may recommend more frequent or fewer visits, depending on your dental health history.

The Dental Checkup: What to Expect

In most cases, a dental hygienist and dentist will perform your dental checkup. Not every dentist operates the same way, but a dental checkup typically involves:

  • Cleaning and polishing. Your dental hygienist will use a special instrument called a hand scaler or ultrasonic dental instrument to scrape and remove the tartar from your teeth. He or she will then polish your teeth, often with a rotating rubber cup or brush, to remove any remaining plaque or stains.
  • Education. After the cleaning, your hygienist or dentist will discuss any dental hygiene problems that were detected, and show you how to brush and floss more effectively, if necessary.
  • Examination. Both your dental hygienist and dentist will examine your teeth, gums, and mouth, to look for changes or signs of a problem (for example, a cavity or gum disease or early signs of oral cancer). During the examination, your dentist may also use a special probe to measure the “pockets” between your teeth and gums, an explorer tool to poke at your teeth and determine if any cavities are present, and a mouth mirror to get a better view of the sides and back of your teeth. If you have any visible problems, your dentist may recommend a particular treatment or may refer you to a specialist, such as a periodontist or orthodontist, for further treatment.
  • X-rays. At some of your dental visits, your dentist may decide to take X-rays of your teeth to look for decay, gum disease, or other dental problems. X-rays expose you to radiation so in order to avoid having them done more than necessary, bring copies of previous X-rays with you when you’re visiting a new dentist.

Sometimes you may have a more thorough dental checkup, which is called a comprehensive examination. You will probably have a comprehensive examination the first time you see a dentist, and periodically thereafter. During a comprehensive dental examination, your dentist will:

  • Thoroughly examine your mouth, head, and neck
  • Discuss your medical history with you
  • Take a series of X-rays

Getting the Most Out of Your Dental Checkup

Since your oral health is closely related to your overall health, it’s important to communicate any concerns or problems you are having with your dentist. Be sure to:

  • Tell your dentist about any new health problems you have been diagnosed with since your last visit (for example, diabetes or heart disease).
  • Make a list of all medications and supplements you take, including their dosages. Take this list with you to your dental checkup so your dentist can review it.
  • Let your dentist know if you suffer from dental anxiety. Fear of the dentist is common, and your dentist can work with you to make you more comfortable during your checkup.
  • Talk with your dentist about any problems or changes you’ve noticed with your teeth, gums, or the inside of your mouth. The earlier your dentist knows about pain, sensitivity, or a suspicious lump, the earlier he or she can diagnose and treat it.

Saying Goodbye

I’m saying Good-bye after 22 years!

Retirement comes the end of July for Barb Malich, CEO. As I look back over the years it is with very mixed emotions—looking back at how far we have come, I’m filled with pride. It has been a tremendous privilege to work with such amazing people – the PCHS staff, many Boards of Directors, and with my colleagues from community health centers across the state.

Watching this chapter of my life close—amidst a period of tremendous growth and development for PCHS is daunting. A new PCHS dental program is opening in late summer in Port Orchard, the administrative offices are going to consolidate and relocate to the 2nd floor in the KPS building—which will then lead to some additional space for our incredibly effective integrated Behavioral Health and Chemical Dependency screening/treatment programs.

It feels like I am walking out on a work in progress, but that has always been the story for PCHS. I walked in on a work in progress 22 years ago….and just look at what we have accomplished!

PCHS is driven by the mission “to provide accessible, affordable, compassionate, quality health care services to our community” and accelerated by the vision that “PCHS is a premier Medical Home providing exceptional individualized health care”.

I was always particularly focused on reflecting our core values –to be Patient Driven, Respectful, and Empathic—and I am deeply committed to our GUIDING PRINCIPLE “To see and value every person who comes through our doors”.

It has been amazing over these 22 years to lead PCHS through unstoppable growth from a single site on Pacific Avenue in Bremerton to five beautiful clinics across the county. I take tremendous pride in the fact we achieved accreditation with AAAHC on the first try with NO findings. The spirit of quality, safety and commitment are reflected in every patient visit we provide. But what has been most amazing, to witness, is the pride in our achievements reflected in the most incredible staff of any health care facility—anywhere! What a team!

Patients will continue to demand more services and our capacity to respond be measured by continued growth. As a result, the health of the community will improve unabated. PCHS saw a huge jump over the past two years in patients served as the full benefits of the Affordable Care Act became reality in Kitsap County. With coverage for so many Kitsap residents comes regular care, screening, support, and improved health outcomes because of access to preventive care. The challenges will continue be overwhelming at times as healthcare access and health care economics drives changes for our community. “Transformed” is the operative word for the future of healthcare in Kitsap County!

PCHS is on the right track—now the leadership baton passes to Jennifer Kreidler-Moss, PharmD, CEO, and a new era for PCHS will begin. I will miss it all, but I’m very excited to see what my future holds! Until we meet again!

Barb

Warfarin/Coumadin Patient Support

Why we work so hard to support our patients on Warfarin/Coumadin

 

Warfarin (Coumadin) is a medication that is prescribed for patients that have blood clots or heart conditions that can lead to blood clots. Warfarin can be a dangerous drug if it is not properly managed by a healthcare professional shown by the high number of Emergency Room visits for side effects each year. The Peninsula Community Health Services pharmacists have been working with patients on warfarin for over 7 years to ensure that our they are safely managed to prevent blood clots and side effects. Nationally, about 50% of warfarin patients are in the goal range when they are followed by a healthcare professional. Our pharmacists’ dedication to providing a high level of care is shown by our patient’s being 20-30% above this national average with a very low rate of side effects and hospital visits caused by warfarin.

Dental Care for a Beautiful Smile

By Peter Jaret
Reviewed By Louise Chang, MD

Given all the chewing, crunching, biting, and gnashing they do, our teeth are surprisingly resilient. Still, everyday wear and tear and the natural aging process take a toll.

Here’s what happens to teeth as we age — and what you can do to keep your teeth strong and sparkling for a lifetime.

Preventing Acid Erosion

By far the biggest threat to teeth is sugary and starchy food. These carbohydrates ferment, causing the bacteria in the mouth to produce acids. Those acids can quickly eat away at the enamel of teeth. As a result, this creates tiny pits where tooth decay can form.
Most of us assume that sugary candy is the worst offender. But sweetened carbonated beverages, such as colas, can be even more dangerous, since carbonation increases acid levels in the mouth. Some recent studies have singled out sports drinks as a particular threat to tooth enamel.

What to do:

  • Go easy on sugary foods, especially carbonated soft drinks and sports drinks.
  • Avoid frequent snacking, which causes acid levels in the mouth to remain high over an extended time.
  • If you get a craving for something sweet, chew sugarless gum. Chewing increases saliva production, which helps cleanse the mouth and neutralize acidity.
  • Brush your teeth at least twice a day for two minutes and floss daily. Daily dental hygiene reduces bacteria levels in your mouth.
  • See your dentist every six months for a regular checkup that includes removing plaque buildup.

Preventing Mechanical Wear and Tear on Your Teeth

The function of teeth is mostly mechanical — to mash and grind and otherwise break up food to make it more easily digested. For the most part, our teeth are resistant to cracks and chips.

“Contrary to what many people assume, teeth do not become more brittle with age,” says Steven E. Schonfeld, a private practice dentist and spokesperson for the American Dental Association. “Still, we see patients all the time who have cracked or chipped a tooth biting down hard on something like an olive that still has a pit or a kernel of unpopped popcorn.”

Teeth that have fillings or root canals are particularly vulnerable, since they don’t have the strength of structurally intact teeth.

ReThink The Way We Drink

Dr. Mike Evans, a staff physician at St. Michael’s Hospital and an Associate Professor of Family Medicine, and a research team led by Dr. Katharine Bradley of Group Health, put together this informative video about society’s views on alcohol and health.

https://www.youtube.com/watch?v=tbKbq2IytC4&feature=share

Infectious Disease Spotlight on Happiness

Infectious Disease Spotlight on Happiness

A warm smile, a compliment, and positive energy infect every person you spread it to. As caregivers we work hard to infect all our patients with happiness even though many are coming in probably not feeling their best that day. Sometimes our patients turn the tables and infect us with their happiness by writing and submitting comments about their positive experiences at PCHS. Your positive comments are always shared with the person you wrote about and that person’s supervisor. Some exceptionally outstanding remarks are shared at staff meetings or posted on our web page. The time you take to tell us about your good experiences really boosts our moral and increases the level of happiness so we can continue to infect our patients more and more. It is a cycle! Thank you for being our patients and for bringing that baton back around to our staff to keep us going.

Patient Voice

What’s this Patient Voice link all about?

It seems everywhere you go there is a survey to fill out whether it’s about your coffee, your grocery shopping experience, or even your visit to the doctor.  Why is every business so attracted to surveys?  Interestingly, surveys help tell businesses about their own strengths and weaknesses as perceived by YOU, the consumer.  The feedback indicates what improvements need to be made and where that really matters to the people already using that business.  A thriving organization must strategize to keep the customers it has as well as attract new ones.  Surveys are normally short and anonymous so the feedback pipeline gets more responses than simply an open invitation to comment in general about one’s experience.

In healthcare a positive patient experience seems to carry with it a little more depth and meaning than people’s ordinary experiences in the retail environment.  Research is teaching us that people who have a positive healthcare experience have better health outcomes.  It is not 100% clear yet why this happens.  It could be that having a good experience builds trust in the care recommended.  It could also be that a positive interaction with a doctor might increase a person’s likelihood to take the medication prescribed or to return for a follow up appointment.  Whatever the ingredients are behind the magic, we want to make your visit the best so we can carry out our mission of providing high quality care.

We just launched an electronic survey and linked it to our home page. The link is called “Patient Voice”.  There are two ways you can tell us how we are doing.  One way is through our anonymous, secure, patient experience survey and the other is securely through a simple open comment form.  The Quality department at PCHS directly receives this information. You can actually trust real live people are behind that firewall and we are very interested in what you have to tell us.

Why Do We Ask So Many Questions

Why All The Questions

Why do we ask so many questions?

Today, more than ever, when you visit us you are asked a series of questions. Some of them are focused on preventive care and some are screening tools that give your provider insight into what is going on in the rest of your life. We care about you and want to be sure we are providing all the support available for you to enjoy a healthy life. Primary care settings have become the gateway to the behavioral health system, and primary care providers need support and resources to screen and treat individuals with behavioral and general healthcare needs.

The unfortunate truth is people suffering with mental and substance abuse disorders may die decades earlier than the average person — mostly from untreated and preventable chronic illnesses like hypertension, diabetes, obesity, and cardiovascular disease that are aggravated by poor health habits such as inadequate physical activity, poor nutrition, smoking, and substance abuse.

The solution lies in a blended approach to caring for people with multiple healthcare needs called integrated care. Integrating mental health, substance abuse, and primary care services produces the best outcomes and proves to be the most effective approach to caring for people with multiple healthcare needs. We want to have an entire team to support you in your pathway to a healthier life.

When you come to PCHS we may ask you about…

  • How have you done on changing your diet and exercise or other activities?
  • Do you still smoke? Or do you use tobacco? What can I do to help you find resources to support you in stopping?
  • Over the last 2 weeks how often have you been bothered by any of the following problems?
    • Little interest or pleasure in doing things?
    • Feeling down, depressed, or hopeless?
  • How many times in the last year have you had 4, 5 or more drinks in one day?
  • How many times in the last year have you used a recreational drug or used a prescription drug for nonmedical reasons?
  • When were your last flu shot, Tdap, and/or pneumonia vaccine?
  • When was your last well exam, pap test, or physical exam?
  • When was your last colon cancer screening test?
  • When was your last mammogram?
  • When was your last blood work done?

Whooping Cough aka Pertussis

Whooping Cough aka Pertussis

What is Pertussis?

It is a respiratory infection that is also known as Whooping Cough due to the characteristic sound of a whoop after a coughing attack when trying to breathe in.

How is Pertussis spread?

Pertussis is spread through respiratory droplets from coughing and sneezing. Pertussis is VERY contagious.

Why do I care?

Though the incidence of whooping cough has gone down significantly since the 1940s when the vaccine was first made, there have been several outbreaks recently in different parts of the country including Washington State. This infection can be very serious and send people to the hospital and can even lead to death. Infants are especially at risk for this infection and cannot be vaccinated right away, so it is recommended that anyone that comes into contact with infants (daycare workers, healthcare workers, moms/dads/grandparents/etc.) all get vaccinated at least 2 weeks prior to contact with a new baby.

How do I prevent Pertussis?

Get vaccinated. The Center for Disease Control recommends that every adult get a onetime booster dose of Tdap (a tetanus shot with pertussis vaccine in it) to help protect you and others from getting pertussis. Children are vaccinated against it in their DTaP series which is part of their routine vaccines. Pregnant women are recommended to get a Tdap vaccine with each and every pregnancy, so ask your OBGYN for more information.

What happens if I get Pertussis?

The infection itself can take weeks to months to completely resolve. If you are diagnosed with the infection within the first 3 weeks then an antibiotic can help to treat.

Measles

Measles is the MOST contagious airborne illness.

Vaccinated people are very well protected!

Who’s at risk?

  • Infants under 12 months of age (too young to be vaccinated)
  • Any unvaccinated or under-vaccinated person born after 1957
  • Especially unvaccinated pregnant women

Should I get vaccinated?

You do NOT need the MMR vaccine if you…

  • Already had two doses of MMR OR one dose of MMR plus a second dose of measles vaccine
  • Already had one dose of MMR and are not at high risk of measles exposure
  • Had blood tests that show you are immune to measles, mumps, and rubella
  • Were born before 1957

You SHOULD get the measles vaccine if you are NOT among the categories listed above, and

  • Are a college student, trade school student, or other student beyond high school
  • Are a Healthcare Worker
  • Travel internationally, or are a passenger on a cruise ship
  • Are a woman of childbearing age

What’s so special about being born before 1957?

People born before 1957 lived through several years of epidemic measles before the first measles vaccine was licensed. As a result, this group of people are very likely to have had the measles disease. Surveys suggest that 95% to 98% of those born before 1957 are immune to measles. Note: The “1957 rule” applies only to measles and mumps—it does NOT apply to rubella.

E-Cigarette Safety Tips

E-Cigarette Safety Tips

Electronic cigarettes (e-cigarettes) have become remarkably popular in the past few years. Most people believe that e-cigarettes not only are safer than cigarettes, but also are effective tools to aid in smoking cessation. Many are using e-cigarettes with little knowledge of the potential harm to themselves and others.

E-cigarette ingredients are not standard across the industry, and the levels of those substances remain variable from product to product. Research shows that the fluid and aerosol in e-cigarettes contains known toxins, including propylene glycol, heavy metals, volatile organic compounds, and tobacco-specific nitrosamines. If you use e-cigarettes, make sure to research the products before you buy.

Data from the American Association of Poison Control Centers shows that poisoning incidents involving e-cigarettes and liquid nicotine increased by 156% in the past year, and have increased more than 14 fold since 2011. Nicotine poisoning is most likely to occur in small children who tamper with e-cigarette cartridges. More than half the calls to the poison control centers involved a child under the age of six. If you choose to use e-cigarettes, please make sure to keep them in a place safe from small children.

Children, School, and Oral Health

Kids with poor oral health were nearly 3 times more likely to miss school. Click here to get other facts.

Kids, Food, and Their Teeth

What your children eat can affect whether they grow up with healthy teeth. Click here for tips on helping your kids choose the right foods and beverages.