Blog Archives
By Amanda Jepson | Categories: | Comments Off on Optimizing Access and Management for Opioid Use Disorder
JPS Health Network developed a bridge clinic to respond to pervasive under-treatment of opioid use disorder (OUD). It is a low-barrier model for enhancing linkage to long-term care and optimizing transitions to outpatient care for patients who screen positive or self-identify for OUD.
Key activities for the bridge clinic include treatment initiation, where patients identified with OUD receive immediate treatment; referral to the bridge clinic; and wraparound support services that address clinical, behavioral, and social needs. The clinic connects patients to appropriate follow-up care and provides harm reduction education. The bridge clinic is co-located within the emergency setting to reduce delays and increase efficiency. Screening, treatment, and referrals are all streamlined into the electronic health record system. The Substance Abuse and Mental Health Services Administration procured funding for the bridge clinic to support initial development, which became sustainable through program-generated revenue and cost savings.
The bridge clinic involves an interdisciplinary team of emergency medicine clinicians, behavioral health specialists, case managers, peer navigators, primary care providers, hospital administrators, researchers, and community partners. The team works outside of traditionally siloed departments, allowing them to identify and remove barriers to program development and implementation rapidly. The program involves multiple partners, internal to the health system and external community organizations.
Since initiation in January 2021, the bridge clinic has served more than 1,100 patients. Linkage to long-term care within 120 days increased 25 percentage points for patients referred to the bridge clinic compared with usual care. Inpatient admissions within 120 days decreased by 8 percent among patients without severe mental illness.
By Amanda Jepson | Categories: | Comments Off on Advancing Hypertension Control in Disparate Populations
ECMC, in Buffalo, N.Y., developed the Advancing Hypertension Control in Disparate Populations through Comprehensive Remote Patient Monitoring program in response to a community needs assessment that showed high rates of hypertension among patients, including 56 percent of Black patients. Needs assessment data also demonstrated that this patient population faced significant barriers to hypertension treatment, such as lack of transportation. By leveraging self-measured blood pressure monitoring, telehealth, and coordinated care, the program aims to improve patient engagement, enhance health care access, and achieve better clinical outcomes for individuals at risk for and diagnosed with hypertension.
Participants receive a validated blood pressure cuff at no cost and attend telehealth visits to assist with monitoring health behaviors. Resources allocated to sustain the program include dedicated hospital staff and funding from multiple organizations, including The Buffalo Center for Health Equity, Highmark, Univera, and Independent Health. A partnership with the American Heart Association supported blood pressure kiosks and community screenings.
Patients and families played a key role in developing this program by providing feedback on behavioral intentions, perceived control of access to care, and hypertension management. To reach beyond patients attributed to the health system, ECMC partnered with community-focused organizations, such as the Independent Health Association, to identify individuals with unmet health care needs and provide accessible health services to underserved Buffalo neighborhoods. Together, these organizations and ECMC hold community events to educate individuals on hypertension and familiarize the community with this program.
Since 2022, ECMC has enrolled more than 900 primary care patients in the program. More than 50 percent of enrolled patients have experienced a significant reduction in their systolic blood pressure. The hypertension control rate among ECMC primary care clinics increased from 44.2 to 69 percent. Additionally, patients with hypertension who are not enrolled in the program utilize emergency services 56 percent more often than program participants.
By Amanda Jepson | Categories: | Comments Off on Curbside Care
Boston Medical Center (BMC) recognizes how critical the first six weeks of life are for birthing people and babies. Forty percent of publicly insured birthing people never return for a postpartum appointment. To close this gap, BMC launched the Curbside Care program in January 2023 with the goal of mitigating barriers to postpartum care through a mobile unit.
Curbside Care is a mobile health delivery program that provides high-touch, comprehensive wraparound services for birthing people and their infants in the first six weeks of life outside of their homes in Boston—at the curb! Funded by the Boston Celtics Shamrock Foundation, Curbside Care replaces traditional postpartum visits in this hospital and eliminates the need for transportation and childcare for postpartum appointments. Our clinical staff of doctors, nurse practitioners, certified nurse-midwives, and an international board of lactation consultant examiner provide a range of services including feeding assessments, lactation support, jaundice evaluation, postpartum depression and hypertension screenings, and contraceptive services all on the mobile unit. A community wellness advocate recruits pregnant patients and performs a needs assessment for each dyad. Patients receive material needs, such as diapers, strollers, and food, at each visit.
Curbside Care is an interdepartmental initiative run by the pediatrics and OBGYN departments at BMC. Other hospital partnerships include the Breastfeeding Equity Center, the Economic Justice Hub, and the Center for the Urban Child and Healthy Family. Community partners also include Brewster Ambulance Service, the Vital Village Network, and New England Mothers First.
BMC has cared for 519 patients in the last 12 months, with an average of 3.7 visits per patient. Of the patients seen, 63.97 percent identified as Black and 31.17 percent identified as Hispanic/Latino. All patients received lactation support and were screened for material needs and postpartum depression. All patients reside in Boston ZIP codes, primarily in the Dorchester, Mattapan, and Roxbury neighborhoods. Curbside Care patients have a 2.9 percent “no-show” rate, compared with 15.3 percent in BMC’s pediatric clinic and 18.8 percent in the postpartum OBGYN clinic.
By Amanda Jepson | Categories: | Comments Off on Mobile Wellness Clinic
The Casey Foundation, an organization that works to improve the well-being of children, youth, and families in the United States, conducted an analysis of the Opelika community in 2017 that revealed areas with a lack of access to care. The foundation engaged the City of Opelika and East Alabama Health to begin a mobile medicine program to increase access to primary care within the community. First Transit donated the mobile bus in 2017, and the program officially launched in December 2022.
The mobile wellness clinic visits communities in the greater Opelika area once a week. Staff provide disease prevention resources and screen patients for chronic conditions at the designated site each week. mobile unit social worker connects patients to resources within the community through screening for social determinants of health. The clinic is funded through multiple sources, including the Casey Foundation and the local housing authority, which allows the clinic to prioritize communities with the most need.
Beyond the City of Opelika and the Casey Foundation, mobile wellness clinic partners include charitable clinics that allow referrals for patients to be seen more quickly, local schools and universities from which students work and learn in the bus , and other local community-based organizations that help the program build trust with community members.
The mobile clinic has served community members with all-encompassing care since beginning operations in December 2022. Many personal stories illustrate the clinic’s importance to the community; for example, a care-reluctant patient sought care at the mobile wellness clinic and discovered dangerously high blood sugar levels. Fortunately, the clinic staff were able to quickly intervene and saved the patient’s life.
By Amanda Jepson | Categories: | Comments Off on Street Health Outreach and Wellness
During the COVID-19 pandemic, NYC Health + Hospitals recognized that New Yorkers experiencing unsheltered homelessness faced unique challenges accessing COVID-19 testing and vaccination. As the city’s public hospital system and the largest municipal health care system in the nation, the health system had a unique opportunity to leverage its size and spread to bring street medicine services across New York City. NYC Health + Hospitals launched the Street Health Outreach and Wellness (SHOW) program, which quickly evolved to include basic medical care, harm reduction education, and links to other care and services.
SHOW aims to meet patients where they are, build trust, and use longitudinal care relationships to drive positive outcomes in both health and housing. NYC Health + Hospitals currently operates five mobile street medicine units, each connected to one of the system’s facilities and staffed by providers from within those facilities’ primary care safety net (PCSN) clinics. Mobile units, based within communities those hospitals serve, each are staffed with a medical provider, registered nurse, social worker, addiction counselor, peer counselor, community health worker, and registration clerk. The program provides primary care, wound care, mental health support, harm reduction services, and basic material necessities to unsheltered residents in New York City, while connecting patients with the health system’s larger continuum of care via PCSN clinics, specialty care, and other services.
The health system works with multiple partners in this effort, including the New York City Department of Homeless Services, as well as numerous community-based organizations and service providers. These partnerships drive the program’s ability to link patients to services and shelter, as SHOW and NYC Health + Hospitals work to support and strengthen the ecosystem of care for people experiencing unsheltered homelessness.
Since the program’s April 2021 launch, SHOW teams have had more than 233,000 engagements with community members and provided 21,000 medical consultations, 9,000 vaccinations, and 60,000 social work engagements. , as the program evolved its model, more than 1,000 unique patients established care with the SHOW teams, and the program connected nearly 200 individuals with PCSN clinics for ongoing care. All this work feeds into systemwide goals of improving chronic condition outcomes for patients experiencing homelessness, and ultimately, connecting patients into housing.
By Amanda Jepson | Categories: | Comments Off on Rooftop Farm
Boston Medical Center’s (BMC’s) Rooftop Farms opened in 2017 as part of the Nourishing Communities program, which includes the Preventative Food Pantry and Teaching Kitchen. A second farm will open in the spring of 2024, bringing the total growing space to approximately square feet. With two farms, the program will yield 10,000 pounds of fresh, organically grown produce annually to distribute throughout the food pantry, a low-cost farmer’s market, and our kitchens. The farm partners with internal departments and organizations in the Boston area to host team–building, volunteer, and educational opportunities focused on growing food, nutrition, and green infrastructure.
The hospital employs two part-time farm staff who focus on food production, education, and community outreach. The program also sponsors two to four interns per year who assist the farm staff and earn experience in rooftop farming and community engagement. The program’s educational component reaches a wide swath of the community, from public school students to immigrant groups, to patients, employees, and clinical staff. For example, the farm reported more than 1,300 visits in 2023. in 2023, 50 percent goes to patients facing food insecurity who visit the food pantry, 41 percent goes to the general community through the low-cost farmers market, and 10 percent goes to the kitchens.
Since opening seven years ago, the rooftop farm has grown approximately 30,000–35,000 pounds of food for community members, with approximately 75 percent directly reaching those who are low–income or experiencing food insecurity. The original farm also has engaged individuals in tours, volunteer days, and educational events more than 9,000 times, providing community members with a forum to connect with each other, learn about green innovation, and experience a hospital space that builds healthy communities in multiple ways. With a second farm opening, BMC expects to double its impact and continue to grow its community partnerships, aiming to support fair Boston food system that provides workforce development, climate resilience, and nourishing food for all people.
To learn more about the Rooftop Farm, please visit this link.
By Amanda Jepson | Categories: | Comments Off on Sustainability Program
Boston Medical Center (BMC) began its sustainability journey in 2012 after recognizing that the communities it serves are disproportionately affected by climate change. Implementing sustainability efforts is part of the health care the hospital provides, with a focus on improving energy efficiency, reducing carbon emissions, decreasing operating costs, and increasing access to care. BMC first reassessed its real estate portfolio to maximize the impact of every square foot, which led to the sale of several real estate assets. The proceeds then were used to upgrade other buildings for increased energy efficiency. BMC reduced 300,000 square feet while increasing its capacity to care for patients: patient volumes increased by almost 30 percent.
BMC’s climate mitigation work covers a variety of entities that all aim to serve the local community. BMC is the largest safety net hospital in New England; 73 percent of the hospital’s patients are covered by public insurance, and many reside in communities facing environmental inequalities. In 2022, BMC opened the Brockton Behavioral Health Center, the first net-zero behavioral health facility in the United States. The center is powered by solar energy and heated by geothermal wells. Since spring 2017, Boston Medical Center has generated much of its own electricity and heat through a natural gas–fired, two-megawatt combined heat and power plant, also known as cogeneration. The plant operates at 70 percent efficiency compared with a typical gas-fired power plant’s 35 percent efficiency. It also has “black start” capability, meaning that if the electric grid goes down, the hospital can use the cogeneration plant in combination with a recently-installed Tesla battery system to heat and power its inpatient units on an “island” for months at a time, as long as it has a natural gas supply.
In 2016, BMC took a major step toward a carbon-neutral campus with an innovative solar purchase and partnership with the Massachusetts Institute of Technology and the Post Office Square Redevelopment Corporation. Through this partnership, BMC invested 255,000 solar panels across 650 acres in North Carolina. BMC purchases 26 percent of the power the solar facility produces, which is equivalent to 100 percent of BMC’s electricity consumption.
BMC’s reduced physical footprint and efforts to improve energy efficiency reduced utility costs significantly which generated savings that were reinvested back into patient care. Between 2011 and 2022, BMC reduced carbon emissions by 91 percent and electric consumption by 29 percent. These savings have enabled the reinvestment of funds in patient care and other sustainability projects, such as the opening of the Brockton Behavioral Health Center.
To learn more about BMC’s sustainability efforts, please visit their website through this link.
By Amanda Jepson | Categories: | Comments Off on Feed1st Program
In 2010, a group of University of Chicago Pritzker School of Medicine medical students, University of Chicago faculty, and Comer Children’s Hospital staff started the Feed1st program after one of the hospital Chaplains discovered many parents were going hungry at their child’s bedside during a hospital stay. The goal of the Feed1st program is to address hunger in the healthcare setting and minimize the stigma surrounding food insecurity.
The Feed1st program operates 11 food pantry sites throughout UChicago Medicine’s facilities, including the adult, pediatric, inpatient, and outpatient areas of academic health system’s South Side medical campus. The pantry sites are strategically located in emergency departments, patient waiting areas, family lounges, and a hospital retail cafeteria. The program primarily serves community members from the South Side of Chicago, which has some of the highest food insecurity rates in the city; however, the pantry sites are available to everyone in the UChicago Medicine community, including staff.
It takes a village to operate a hospital pantry program at this scale. The hospital and individual departments provide Feed1st with funding support and space for pantry shelves and storages; Clinical staff champions, medical students, undergraduates, and other volunteers keep the pantry sites and storages stocked regularly and well maintained.
The food in the pantry sites is provided by the Greater Chicago Food Depository. The UChicago Medicine Garden Committee also provides fresh produce during harvest seasons throughout the year. The Feed1st Community Advisory Committee, comprised of parents, patients, concerned community members, hospital administrators, faculty, students, and others, plays a consistent role in ensuring the program meets the needs of the people we serve. Feed1st engages clinical staff in individual departments to help monitor and restock pantry shelves and communicate with patients about the program.
the Feed1st program had distributed more than 94 tons of food to more than 88,000 people since opening in 2010. The UChicago Medicine Garden Committee has provided more than 6,000 pounds of fresh produce to the Feed1st pantry sites since May 2022. The Feed1st program also released a toolkit on how to launch a no questions asked food pantry system. To read the newest version of the Feed1st toolkit, click here.
By Amanda Jepson | Categories: | Comments Off on Mobile Medicine Program
Atrium Health launched two Mobile Medicine programs to improve access to care for their patient populations. Three Care Everywhere primary care units, along with Drive to Thrive, a mobile OB-GYN unit, aim to increase access to care by tackling transportation challenges, language barriers, and lack of insurance. Specifically, Care Everywhere brings clinical care to areas where traditional clinics may not be convenient or accessible, provides resources that help meet acute social needs, and connects patients to a primary care medical home. Drive to Thrive works to decrease unintended pregnancies via increased access to education and contraception and to connect patients in underserved communities to prenatal care earlier in their pregnancies to improve overall health outcomes.
The Mobile Medicine units park at different locations each weekday based on patient need. Atrium Health strategically chose locations using a data-informed approach that paired internal patient data with publicly available U.S. census data to target communities with the greatest health needs and social risk factors. Care Everywhere unit services include short-term and long-lasting health concerns, and Drive to Thrive primarily focuses on obstetrics and education. Neither program requires appointments, enabling patients to visit at their convenience. Both programs offer additional wellness services, such as referrals to other Atrium Health facilities and connections to resources for non–health care needs.
The Care Everywhere units were primarily funded by The Tepper Foundation and Truist Foundation, among other community funders. The Drive to Thrive unit received funding from a retired OB-GYN and other community donors. Both units required collaboration with nonprofits, faith-based organizations, and other community organizations to understand patient needs fully.
As a vertically integrated health care system, Atrium Health maintains an extensive inpatient and outpatient database of electronic health records that enables in-depth analysis of health care utilization and health outcomes across the system’s footprint. The Care Everywhere units launched in fall 2022, and the Drive to Thrive unit launched in January 2023. The Mobile Medicine program is expected to serve more than 480 patients by the end of 2023. Key program outcomes include increasing the establishment of ongoing support through placement with a primary medical home and connecting patients to care and social needs support through screening, diagnosis, and referrals to specialty care.
By Amanda Jepson | Categories: | Comments Off on Sustainability Program
University of California (UC) Davis Health recognizes the importance of creating a resilient and sustainable health care model that celebrates the intersection between human and climate health. The goal of UC Davis Health’s sustainability practices is to reduce the health system’s environmental footprint by identifying climate mitigation strategies that meet the needs of patients and employees while preserving the quality of care. Areas of focus include procurement, resource conservation, transportation, expanding outreach and education to increase participation in sustainability efforts, waste reduction, and accountability.
UC Davis Health’s sustainability efforts reach beyond the health system into the community. With a focus on clean energy, the health system is expanding its solar energy portfolio and reducing energy usage in the operating rooms by replacing lights with LED bulbs and implementing HVAC setbacks. Another focus is reducing water use through operational adjustments in the central plant and a turf watering reduction initiative that stopped irrigating non-functional turfs on campus. The health system also provides an emission-free bus service, Causeway Connection, that runs daily between the hospital’s main campus and Sacramento.
UC Davis Health has multiple partners, including the Sacramento Tree Foundation, which helps plan California drought tolerant landscaping throughout the health system’s campus. Other partnerships, such as Copia, a food recovery company, and California Safe Soil, a manufacturer that uses food scraps for high-quality fertilizer, help divert UC Davis Health’s food waste. A partnership with Stryker, a medical technologies corporation, has helped the health system reduce the number of single-use devices used in operating rooms.
UC Davis Health has seen invaluable outcomes from the sustainability strategies. Through HVAC setbacks in the operating rooms, the emissions saved thus far are equivalent to taking 63 cars off the road. Through operational adjustments in the system’s central plant, UC Davis Health saved three million gallons of water between 2020 and 2022.
https://sustainability.ucdavis.edu/goals
