There is nothing quite like autumn in New England, the leaves a perfect demonstration of the beauty and inevitability of change.
Our communities here in New Hampshire and Vermont have experienced many changes in recent years, including changes in population, landscape, economic base, and the technology that connects us all. But our health care systems have been slow to change and adapt to the needs of patients and communities.
As you know, Dartmouth-Hitchcock is actively working to bring about a transformation in how care is delivered and paid for, to make it more convenient, more accessible, lower cost, and higher quality. A recognition that our communities needed to be linked to and involved with this transformation led to the decision to create a larger role for what had been the Assembly of Overseers, renamed the Partners for Community Wellness (PCW).
We need to interact with and understand communities, their health care needs, and match our services to their needs. Creating a sustainable health system is about using a population based approach, not a market-based approach; it’s about how we take care of people, not just when they’re sick, but before illness strikes. In a sustainable health system, health care is about ensuring wellness at all stages of life, keeping people healthy and out of the hospital. Our schools, homes, businesses, and recreation are all vitally important factors in our own health and wellness.
With the help of PCW, Dartmouth-Hitchcock can become a partner in bringing forth the change we need.
The Assembly of Overseers played an important role in the governance of Dartmouth-Hitchcock. PCW has an even bigger role to play – for our communities and for Dartmouth-Hitchcock. We must be ambassadors for the change we need in our health care system.
Help us learn from each other about the best way we can give and receive care in New Hampshire and Vermont. Let us show the nation what it looks like when a region makes health and wellness a community priority.
Join us at our annual meeting on November 7th to learn more about the important role PCW has to play. We need your help and support as we embrace this change and make plans for the future health of our towns and cities.
Jane Stetson, PCW Chair
James Weinstein, DO, MS
PCW Ex Officio
CEO of Dartmouth-Hitchcock
Register for the November 7th Annual Meeting here →
A Conversation with Jane Stetson and Karen Borgstrom
Jane Stetson (right) and Karen Borgstrom. Photography by Mark Washburn.
The Partners for Community Wellness (PCW), describes Karen Borgstrom, PCW's new (and first) full-time director, is Dartmouth-Hitchcock's (D-H's) "action arm" reaching into the communities and regions D-H serves. PCW was established from what had been called the Assembly of Overseers, an advisory group for D-H leadership that dates back to 1983, but PCW is much more than a re-branded committee.
"The idea is to tap the energy and enthusiasm of PCW's members in their own communities to help fulfill D-H's mission to promote the health and wellness of the communities we serve through communication and education, advocacy, action strategies and philanthropy," she says. "PCW members remain trusted supporters of D-H, but in this new role, the opportunity for direct impact and action will be greatly increased."
"D-H's leadership has a vision to move health into the communities," adds Jane Stetson, PCW's chairperson. "PCW will be a conduit between communities and D-H. It's a way of leveling the playing field shared by doctors and their patients and the communities the patients live in."
Dartmouth-Hitchcock has been charged in implementing a system-wide initiative to facilitate advance care planning at all Dartmouth-Hitchcock locations, affiliates and health care partners throughout the region as part of our vision to improve population health.
This initiative – called Honoring Care Decisions – will be implemented throughout Dartmouth-Hitchcock and expanded throughout the community in partnership with multiple stakeholders to promote advance care planning to all residents of New Hampshire and Vermont.
PCW has four volunteers actively engaged in the Honoring Care Decisions pilots and planning. We caught up with two of them.
Volunteer Q & A
PCW Volunteer Bill Helm
Bill Helm - New London, NH
Orthopedics Pilot Project Team Member
Q:What is your role in the HCD Pilot Team?
A: I am the community representative on our Advance Care Planning/Honoring Care Decisions orthopedics clinic pilot project team. I am also being trained to be a facilitator of ACP discussions.
Q:What has been your favorite part of this process thus far?
A: I am enjoying getting to know my D-H teammates and better understanding the workings of the ortho clinic.
Q:What is the most interesting thing you have learned?
A: The amount of careful planning needed to be successful in implementing the pilot.
Deb Holmes - Grantham, NH
Communications Committee Member
Q:What kind of work is the Communications Committee doing?
A: This committee, with members from several different branches of Dartmouth-Hitchcock, is looking at ways of communicating to patients and the public the importance of making arrangements for one's health care decisions to be carried out, even if one is unable to speak. There are various materials being made available to address this topic, and at this time the PCW committee members are reviewing those for readability, clarity and content.
Q:Why do you think it’s important to have a community member on this committee?
A: Community members can be voices from outside the organization to help the organization understand 'the view from outside,' and make suggestions for possible changes.
Q:What does the Honoring Care Decisions dandelion symbolize to you?
A: The passage of time and the hope of seeds for the future.
Learn more about Honoring Care Decisions
Photography by Mark Washburn
Q & A with Dorothy Bazos & Sanders Burstein
D-H Today: What is Honoring Care Decisions, and what is Dartmouth-Hitchcock’s role in the project?
Burstein: Honoring Care Decisions is a new program with the goals of improving and supporting advance care planning at Dartmouth-Hitchcock and in our communities. Dartmouth-Hitchcock has already established a reputation for promoting shared decision-making, helping patients make decisions based on medical evidence in the context of their goals and values. Honoring Care Decisions brings this to the next level for patients to plan ahead for possible and probable scenarios for a time when they cannot speak for themselves. This new program will develop and continuously improve a system of care that supports good decision-making and that honors those decisions during serious illness and at the end of life.
Bazos: HCD is the first system-wide population health program formally initiated by the D-H Population Health Task Force. The Task Force is composed of D-H medical directors from Concord, Keene, Lebanon, Manchester, Nashua, Bennington, VT, and New London. These passionate leaders want the best for their community members and feel that the health system can do a better job in honoring patient care decisions when they are faced with a medical crisis. The HCD program is being designed to support health system improvement in this regard. HCD promotes patient and community education and engagement and supports patients in making their care decisions known to their family, to a designated agent and to their health care providers.
As part of a new partnership between Dartmouth-Hitchcock’s Center for Telehealth and Dartmouth College’s Department of Athletics and Recreation, a telemedicine robot will be on the sidelines for all five Dartmouth home football games this fall. The robot is just one of the telemedicine technologies that will be supplied by the D-H Center for Telehealth for a remote concussion assessment pilot program that kicked off at the first Big Green home football game on September 20. This pilot is part of a more far-reaching Dartmouth Athletics initiative in which the D-H Center for Telehealth will provide real-time, emergency clinical support via virtual technologies to a variety of Dartmouth sports.
Sarah Pletcher, MD, MA, director of the D-H Center for Telehealth, said Dartmouth-Hitchcock Medical Center’s section of neurosurgery will be providing remote assessments of Dartmouth players with suspected concussions. “In addition to a telemedicine robot, we will also integrate tablet and smartphone solutions that will offer reliability and flexibility as we expand the program to other Dartmouth sports in the very near future,” she said, noting that physicians from the D-H emergency department will be participating in future clinical service offerings.