One of Their Own

chw

In 2010, Medicare paid more than $17.5 billion dollars for unplanned hospital readmissions as almost one in five Medicare patients returned within a month of discharge.

October 2012, the Affordable Care Act began adjusting hospital payments according to it’s value-based purchasing program (VBP) which rewards value over volume and bases performance on quality measures such as readmission rates.

Among others, a recent study by Hong Tao from the University of Wisconsin found in the journal, Advances in Nursing Science, suggest social environment factors like whether a patient had a primary informal caregiver and the frequency of care provided, had an impact on readmission rates.

Rightfully, more hospitals are now looking at Community Health Workers as a way of connecting with patients and preventing readmissions.  Perhaps the best strategy for improving health outcomes exists outside hospital walls.

Knowing a patient’s pulse and blood pressure numbers are good indicators of health status but they won’t tell you if a patient will misplace their discharge instructions, understand when and how to take their medications or if they will be able to find child care to attend their follow-up appointments.  These issues require a different kind of help and this is where Community Health Workers show incredible value.

To connect with and build trust in an underserved community, an outsider who neither understands the culture nor speaks the language will be ineffective.  Community Health Workers are typically recruited from and reflect the populations they serve. Often bilingual and bicultural, they are the glue able to keep the healthcare system and the patient together by promoting understanding and compliance.

With a lack of educated medical professionals in many developing countries like Sub-Saharan Africa, China, Brazil, India and Iran, Community Health Workers have been improving health outcomes and research for underserved populations worldwide for decades, though only 35% of healthcare settings use them to reach patients in the US.

While having translated brochures, interpreters and culturally-trained staff in-house to serve minority patients improves the quality of their time in the hospital, support received after they leave is just as, if not more, important.  Involving Community Health Workers to guide underserved minority patient populations through the healthcare system provides a myriad of benefits and improves outcomes for everyone involved.

Sherry Dineen

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