The Community Health Worker: Getting to the Heart of Health Care Looks Like This

December 09, 2020
Community health worker blog
For the better part of three years, we’ve talked about “community health,” but what exactly does that look like?

New Hanover Regional Medical Center will always provide the best medical care to those who are sick and injured. It’s who we are, and that will not change. Our mission has challenged us to find ways to transform from hospital-based care and move into the community where our patients live, work and play.

Figuring out how to do this has been a challenge, requiring teamwork, trial, some failure, and some innovation. But we’re starting to see it. And it looks like this:

A patient can’t make her doctor appointments. She has no transportation. She cannot afford Uber. Her diabetes is getting worse. And she’s wary of the bus system.

A Community Health Worker, a new position at NHRMC, visits her and doesn’t just give her a bus schedule. She rides the bus with her. The patient now knows the stops, the route, the process of riding the bus. Now she’s making her appointments. Her A1c level is getting better.

This is health care in the modern era. This is how NHRMC transforms our community.

“Community Health Workers” are a relatively new trend in American health care, with its roots in African nations where the system needed someone to explain to patients, who typically lived far from the doctor, the plan of care and how to address social barriers. Someone who spoke the patient’s language, understood the culture and could relate to the patient in ways health care providers never could.

It’s the same concept here. Lauren Bullock, our first Community Health Worker, is a Wilmington native and has the ability to connect with people on their own terms, as well as recognize barriers and, most of all, address them.

Through the work of Lauren and our Community Paramedicine program, there are more stories to tell.

There’s the pregnant patient whose 2-year-old acted up during diabetes education. So Lauren sat with the child – and was able to listen to the education so she could amplify it later for the patient.

A patient is grieving the loss of a brother and has let his health deteriorate. Lauren gets him to open up, express his grief, and is able to schedule needed appointments. A patient confesses to Lauren that he cannot read or write, so she arranges a family member to accompany him on doctor visits. A patient is experiencing domestic violence, so Lauren connects her to a clinic to get help.

Lauren is part of our “Community Health Team,” pairing with NHRMC’s Community Paramedics to visit mostly diabetic patients in our community, often helping them overcome barriers that often have nothing to do with diabetes. But everything to do with their health status.

“I put myself in the shoes of the patient, shoes that for many of those patients, I’ve been in myself,” Lauren says. “I relate to them and give them the help that I would want to receive and can be a bridge to the often confusing system of resources and benefits and medical professionals.”

The team is funded by a grant from the N.C. Office of Rural Health. New Hanover Regional Medical Center has agreed to fund two more Community Health Workers and an additional social worker to help this team grow and provide more of this type of care.

This is not our only partnership addressing the social side of health. Through a partnership with UNC-Wilmington, we have six Social Work interns from the College of Health and Human Services who are based at four of our clinics.

These students, most of them preparing for their master’s degree, have been a revelation, delving into patient issues the clinical staff doesn’t have time to address. They have worked to keep a grandmother who takes care of her young grandchildren from being evicted. They have found mental health services for patients who presented for medical care. They have worked with patients’ employers to provide counseling, and found free summer camps for kids who have similar disabilities.

Then there’s the mother with diabetes who shares a disability with her daughter, while also caring for her own mother. They struggled to manage it all, including the process of getting needed supplies. Our social work intern worked with FedEx to fix the routing of diabetic supplies to get them to the appropriate place. She linked the mother with Step Up to look for a first-shift job instead of third shift so she could be present more with her family. She worked with the child’s school to get the nurse there to connect the child with services.

When the family returned a couple of weeks later, every suggestion the intern had made had worked. The mother had a new job, had the medical supplies she needed, and the child had services in school. As they told the story, all of them – providers and patients - cried. Diabetes was the disease, but the need was so much more.

Our resources are falling into place, and our community is partnering with us on this journey. The transition to Novant Health will only accelerate this process. This is how New Hanover Regional Medical Center is going to transform health care in our community.

Scott Whisnant is Administrator of Community Engagement of New Hanover Regional Medical Center.

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