BY: RHODA WEISS
Ms. Weiss is a Santa Monica, CA–based health
care consultant and speaker.
A major goal of Catholic health care is to improve the community's
health through community relations, health education, and outreach.
But efforts in health status improvement are also increasingly
becoming part of business development and marketing.
A good example of this strategy change can be found at St.
Joseph's Mercy of Macomb, MI, a member of Trinity Health and
Henry Ford Health System, where they are working to save lives,
improve health, develop awareness, reduce costs, and generate
funds. St. Joseph's has developed initiatives that expand its
influence in the community and support the organization's core
business and financial imperatives.
Going Beyond Health Education
For the past 15 years, St. Joseph's
has been a community leader in health education through offeringsfrom
complementary medicine to physician-led classes on joint replacementthat
have had an impact on various clinical programs. But in the
mid-1990s, St. Joseph's began evolving its community-based programming
beyond health education.
According to Scott Adler, St. Joseph's vice president of community
integration, the planning process began with a simple question:
How can we facilitate the connections that allow neighbors to
care for neighbors in a way that typical fee-for-service health
care cannot?
"In his book The Careless Society, John McKnight argues
that there has been a 'professionalization' of service to the
point that neighbors feel inadequate in helping others through
difficult times, such as the death of a loved one or dealing
with heart disease or cancer," explains Adler. "McKnight argues
there is a fundamental difference between paying someone to
provide a medically related service and caring support where
no payment is necessary or expected." Within this framework,
St. Joseph's developed two community-based nursing partnership
programs.
An Affordable and Sustainable
Parish Nursing Network
Parish nurse programs usually follow
one of two models. The first involves hiring nurses and assigning
churches to be their "territory." However, "This model is self-limiting
because health care organizations cannot always afford the numerous
staff required, especially if the desire is to reach many different
churches," explains Ameldia Brown, RN, BSN, who directs St.
Joseph's parish nursing network.
The second modelat the other end of the spectrumis the all-volunteer
parish nursing program. But, according to Brown, an ordained
minister with a master's degree in divinity, this model lacks
quality controls necessary for an effective program and the
structure to ensure ongoing commitment from volunteers.
Instead, St. Joseph's developed a community-based, institutionally
supported model that combines the deep caring of volunteers
within a structure and quality framework to ensure the best
care possible and maximum hours available from volunteers.
A core group of coordinators now manages relationships with
the churches. They provide education required for network inclusion
(30 contact hours) and continuing networking support. "The result
is nothing short of remarkable," says Brown.
Last year alone, 55 network churches had more than 30,000
parish nurse contacts. An online documentation system allows
the nurses to list their contacts electronically, thus saving
time and ensuring appropriate follow-up and quality monitoring.
Additionally, the network received a $350,000 grant from the
state of Michigan for a pilot study to demonstrate how increasing
the independence of older adults translates into a decrease
in Medicaid spending for nursing home care.
The network also developed an "at home and safe" program.
The program's home visits to hundreds of seniors help ensure
a safe living environment and aim to reduce falls and other
injuries. The network works with hospital discharge planners
to facilitate post-acute support for discharged patients. In
addition, the two network-developed free clinics for the homeless
and uninsured are projected to have more than 3,700 visits this
year.
The Parish Nursing Network also continues to focus on seniors
through disease management and creation of a Parish Nursing
Network card that alerts caregivers to support that can be accessed
through the network and in the community.
Next Step: Schools
Because of its early success in
parishes, St. Joseph's is expanding offerings into the schools.
As with the churches, each school establishes a health team
based on the assets available at the school or in the school
district.
Annual planning occurs within each school, with goals set
and programs implemented. Programs vary from basic health educational
classes to case management and support of asthmatic children
or those with food allergies. There are now more than 90 schools
(nearly half of those in the county) in 19 of 21 school districts
in Macomb County, the third-largest county in Michigan.
Last year alone, the School Health Program had more than 170,000
contacts with students and parents, according to Deanna Culberson,
RN, St. Joseph's director of school health and the Center for
Health Management.
The School Health Program has been recognized as a "Best Practice
Vocational Educational Program" by Michigan's Department of
Career Development. Each year, 50 high school students do rotations
in more than 40 hospital departments, including nursing units,
emergency departments, and human resources. In the three years
since its inception, more than 25 students have been hired by
St. Joseph's, and many more changed their career choices to
nursing and other health professions.
The School Health Program also offers weight management for
obese adolescents. (Macomb County is the most obese county in
Michigan, which is the second heaviest state in the country,
behind Wisconsin.) This program is expected to help thousands
of students and generate revenue for St. Joseph's.
Tying It All Together
The average cost of each contact
through these initiatives is about $2. Despite a reduced marketing
budget, St. Joseph's continues its position as a wellness leader
based on a recent community survey.
"Marketing, public relations, health education, and community
outreach should remain connected and synergistic," advises Adler.
"These activities must support the entire enterprise and not
exist solely because of some abstract sense that they are good
things to do in and of themselves."
For information on these programs, contact Scott
Adler at 586-263-2889. Rhoda
Weiss can be reached at 310-393-5183.
Copyright © 2002 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.