Post on 08-Oct-2020
transcript
Redesigning the Health Care Team:
Integrating Community Health Workers within Affordable Care Act Implementation
May 9, 1013
Institutional Buy-In
May 9, 2013
Romelia Corvacho, CHW AdministratorFamily Medicine Department CHW Program
Bronx Lebanon Hospital Center
Department of Family Medicine Community Health Worker Program at Bronx Lebanon Hospital Center
Department of Family MedicineBronx Lebanon Hospital Center
BLHC Family Medicine CHW Program Leadership
Douglas Reich, MD, Family Medicine Department Chair
Romelia Corvacho, CHWCHW Administrator
Maria Murphy, CHWCHW Supervisor
CHW Program at the Department of Family Medicine
BLHC needed to create a more innovative and coordinated
approach to address the health problems of the South Bronx
community.
“Old Model of Care”
Past methods ineffective
Clinical approach to patient interaction is limited
RNs, LPNs, PCTs were all bringing the same clinical approach
to the care team.
Clinicians have limited time
CHWs Responsible for Care Management
Nurse Care model was too costly
Nurses tend not to be from the community they serve
Ideally CHWs should be employees, not contractors
The Beginning of the Model
Family Medicine Department CHW Program:
This program was started by Dr. Douglas Reich and Dr. Paul Beach in 2008. The program started with five CHWs. It was funded by a two-year grant by the New York State Health Foundation.
The Community Health Worker (CHW) program assists in patient management of chronic illnesses through community based education and support, including home visits and shared medical visits (SMV).
How to Begin a CHW Program
Leadership & Supervision
Creating the policy and procedure infrastructure
Establishing CHW Position and Recruitment
Identify roles and members of the Interdisciplinary Team
Operational Leadership & Supervision
Program Director or Administrator
Skilled Manager essential
Former CHW’s ideal
Policy & Procedure Infrastructure
Drafting a Policy & Procedures Manual
Objectives & Goals using S.M.A.R.T.E.R. criteria
Compliments existing HR policies and in-force Collective Bargaining Agreements
It’s a “living document”, responsive to change
Semi-Annual Work Productivity Analysis provides on-going evaluation.
Establishing CHW Positions
Establishment of CHW position within the hospital
Development of job descriptions
Ideally CHWs should be employees not contractors
Recruitment of CHWs
CHWs with attributes for communication, advocacy, and
support
Experience more desirable than traditional education
credentials
Communication and diplomacy sought after
CHW Training
Core Competency Training
CHW training in adult education Participatory Experiential Interactive
CHWs receive targeted in-service on disease topics by our physicians
On Going Training
CHWs receive “coaching” and support
Organization Culture
Commitment to CHW by Administration
CHW programs financed by grants and hospital budget
CHW provided with initial & ongoing training
CHW part of Residents and Attendings training
CHW career ladder provided
CHW supervision and support provided
CHWs Recognized Members of the Care Team
CHWs viewed as a primary part of the medical team
Fully integrated in planning and operations
Department of Family Medicine Interdisciplinary Team
Departmental Hierarchy