Mecosta County Weight Management Clinic Melissa Burleson, Angela Ekema, Sarah Elser, Gena Furgeson, Lai Harper, Rhonda Jones, & Vinitha Manuel

61% of 382 respondents reported the importance of obesity education and 72% expressed the need for wellness and prevention programs (Mecosta County Medical Center, 2013). Spectrum Health System merged with Mecosta County Medical Center in July 2013 becoming Spectrum Health Big Rapids Hospital. Spectrum Health announced that obesity and wellness programs would not be included in the expansion of access to health care services. Community Grants and corporate partners will drive program development with a commitment to promoting community health (Blue Cross Blue Shield of Michigan Foundation, 2012) Internal Environment Assessment of Need

Current obesity rates, declining health, and chronic diseases necessitate the development of a weight management clinic. 32.3% of residents in Mecosta County are overweight and 28.7% are obese (District Health Department, 2013). 25.7% of Mecosta County residents reported no leisure- time physical activity (District Health Department, 2013). 45% of restaurants in Mecosta County serve fast food and 10% of low income populations have limited access to healthy food at grocery stores (Robert Wood Johnson Foundation & University of Wisconsin, 2013). External Environment Assessment of Need

Access to recreational facilities are limited in Mecosta County - there are 9 facilities per 100,000 residents (Robert Wood Johnson Foundation & University of Wisconsin, 2013). Unemployment rates from in Mecosta County was 12.1% (District Health Department, 2013). 48.1% of people live below the poverty line from 2007 to 2011 in Big Rapids at Mecosta County (United States Census Bureau, 2013). The underinsured population is 17% compared to 14% in Michigan and 11% nationally (Robert Johnson Wood Foundation & University of Wisconsin, 2013). External Environment Assessment Continued

External Environment Assessment

Mission Statement Our mission is to promote a healthy lifestyle through high quality, compassionate, and cost- effective care through a partnership of staff in the fields of medicine, counseling, exercise, and nutrition, alongside volunteers who empower and support Mecosta County in managing and maintaining their weight while setting attainable goals.

Committed to the pursuit of quality by providing education, exercise programs, healthy eating classes, and emotional support to clients in a safe and comfortable environment. We use an interdisciplinary approach to create individualized care plans for patients. Excellence in care occurs through shared decision-making and the utilization of evidenced-based practice. Philosophy

Organizational Goals Help clients set, achieve, and maintain their weight management goals across the continuum of care. Ensure every client has access to weight management resources that will aid in achieving desired goals and objectives. Incorporate an interdisciplinary approach through shared decision- making and utilization of evidence-based practice. Develop a judgment-free zone where clients feel comfortable attending and fully participating in the services the clinic offers to achieve their highest potential. Ensure goals are consistently being met in an effective and efficient manner by continuously monitoring our performance and impact on our clients and community. Provide community education that will enhance the skills and knowledge needed to become healthy individuals emotionally, physically, and as a community.

To isolate three reasons for weight management by the end of the client’s first session. To help the client create three personal goals that will be specific, measurable, attainable, realistic and tangible by the end of the client’s first session. To help the client create three personal clear concise objectives by the end of the client’s first session. To identify three barriers to weight loss and healthy eating by the end of the clients second session. To identify two emotional support needs and learn two coping skills by the end of the clients second session. To identify three resources the client may access to assist in healthy eating, exercise, and support by the end of the second session. To collaborate weekly with members of the interdisciplinary team to ensure the client is meeting and maintaining their goals and objectives. · Organizational Objectives

To collaborate weekly with a member of the interdisciplinary team to establish a positive relationship/connection within the clinic. To provide monthly education to clients on the importance of therapeutic relationships. To increase the proportion of adult clients who engage in leisure-time physical activities by 10 percent at the Mecosta County Weight Management Clinic by the end of To reduce the proportion of adult clients who are obese or overweight by 10 percent at the Mecosta County Weight Management Clinic by the end of To evaluate the effectiveness and progress of the clinic, including needs assessment, economics, outcomes, and client satisfaction quarterly and annually to ensure organizational goals are being met. Organizational Objectives Continued

Organizational Chart Volunteers Administrative Assistant Director Social WorkerDietician Medical Assistant Registered NurseAthletic Trainer

Director: Will plan, organize, direct, and control the daily overall operations of the clinic. Administrative Assistant: Answers phones, disperse messages, schedule client appointments, and accepts payment for services rendered. Registered Nurse: Provides educational instruction to clients for wellness promotion and illness prevention programs, as well as creates an individualized plan with clients to establish treatment plans, interventions, and goals. Registered Dietician: Provides nutritional education and counseling to clients in conjunction with nursing, physical fitness staff, social work, and medical staff. Evaluates the effectiveness and appropriateness of the nutritional plan. Athletic Trainer: Collaborates with interdisciplinary team for the assessment, development, implementation, and evaluation of the clients wellness program for increasing physical activities. Job Descriptions

Social Worker: Will assist clients and families at the clinic in understanding the illness/disability and the process of resolving complex personal, financial, and environmental difficulties which may affect their daily lives. Provides consultation to the interdisciplinary team regarding the impact of psychosocial factors on patients’ care and assists patients and families with insurances and medical supply needs. Medical Assistant: Works under the supervision of a registered nurse in conjunction with the interdisciplinary team to plan and evaluate care for the client at the clinic. Volunteer: Works under the supervision of the clinic director to assist clients and families with reception/registration, appointment management, clerical duties, staff notification of client arrival, client waiting room management, light housekeeping, and clinic tours. Job Descriptions

Marketing Plan and Strategies

Operating Expenses

Budget: Critical Appraisal

The development of a new weight management clinic provides increased affordable access to neighborhoods previously that were limited by economic factors. The primary focus of the clinic is to help the uninsured, unemployed ​, underemployed, and low-income residents seek weight management solutions. Based on the external environment assessment there is ongoing community need for promoting a healthy lifestyle and reducing the risk of morbidity associated with rising overweight and obese populations. The initiation of the Mecosta County Weight Management Clinic depends on the collaboration of community or corporate partners to obtain sufficient funding for our health promotion and wellness programs Weight management improves overall health and wellness of the community, which translates to fewer chronic health problems and decreases improper usage of emergency department resources. Summary

Blue Cross Blue Shield of Michigan Foundation (2012). Community health matching program: Solving community health problems. Retreived from pdf Blue Cross Blue Shield of Michigan Foundation (2013). Grant programs. Retrieved from Blue care Network of Michigan (2013). Evidence of coverage. Your Medicare health benefits and services as a member of BCN Advantage Elements HMO-POS. Retrieved from elements.pdf Centers for Disease Control and Prevention. (2012, April 27). Overweight and obesity. Retrieved from defining.html Centers for Medicare and Medicaid Services (2011, November 29). Decision memo for intensive behavioral therapy for obesity. Retrieved from memo.aspx?&NcaName=Intensive%20Behavioral%20Therapy%20for%20Obesity&bc=ACAAAAAAIAAA&N CAId=253& District Health Department (2013). Community health needs assessment. Retrived from External environment. (2013). In WebFinance’s online dictionary. Retrieved from environment.html Indeed (2013). One search. All jobs. Salary search. Retrieved from Internal environment. (2013). In WebFinance’s online dictionary. Retrieved from internal-environment.html Lippincott Williams & Wilkins (2013). American Journal of Nursing-Recruitment. Retrieved from References

Mecosta County Medical Center (2013). Community health needs assessment Retrieved from Mecosta County Weight Management Clinic (2013). Job opportunities. Retrieved from Michigan Works (2011). Michigan Talent Bank. Retrieved from Network for Good (2013). The leading giving platform for powering your cause. Retrieved from Robert Wood Johnson Foundation (2012). Local funding partnerships. Funding opportunities. Retrieved from Robert Wood Johnson Foundation & University of Wisconsin (2013). County health rankings and roadways. Retrieved from countyhealthrankings.org/app/michigan/2013/mecosta/county/outcomes/overall/snapshot/sort-0 Siegel, G., Sorensen, J. E., & Richtermeyer, S. B. (2003). Becoming a business partner: Part 2. Strategic finance. October pp Spectrum Health (2013). Implementation plan for needs identified in community health needs assessment for Mecosta County Medical Center d/b/a Spectrum Health Big Rapids Hospital. Retrieved from Stafford, T. B. (2011). Managing costs and budgets. In P.S. Yoder-Wise (5 th ed.), Leading and managing in nursing (pp ). St Louis, MO: Mosby. The Pioneer Big Rapids News (2013). About us. Retrieved from Twedell, D. M. (2011). Selecting, developing, and evaluating staff. In P. S. Yoder-Wise (Ed.), Leading and managing in nursing. (5th ed., pp ). Saint Louis, MO: Mosby. United States Census Bureau (2013, June 27). American fact finder: American community survey, five-year estimates, Big Rapids, Michigan. Retrieved from census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk United States Department of Health and Human Services (2013). Grants.gov Find open grants opportunities. Retrieved from References Continued