BY: SR. BARBARA HAHL, CSC
Providing care in a community setting has been at the core of Mount Carmel Health System's efforts since its founding in Columbus, Ohio, nearly 130 years ago by the Sisters of the Holy Cross, Notre Dame, Indiana. The sisters brought with them a commitment to compassionate care and the community, and the organization works to remain true to those values in a modern health care setting.
Mount Carmel Community Outreach developed from a door-to-door immunization program in 1995. Mount Carmel staff, along with a number of volunteers, went up and down the streets of low-income neighborhoods to identify children who had not received immunizations. It was a huge success and helped to double vaccination rates among Franklin County toddlers.
Like the immunization program, Mount Carmel Community Outreach services target populations that have limited access to basic health services and little or no ability to pay for them. It has blossomed into a dedicated outreach department with numerous programs, including assistance for victims of crime and other traumas, the mobile coach, street medicine and "Welcome Home" for mothers and their newborns. The formation of Mount Carmel Community Outreach helped build upon Mount Carmel's many successful, mission-driven programs and brought the community outreach efforts into one functional unit.
"Our outreach efforts are focused on connecting people with resources," said Brian Pierson, regional director of outreach population health. "Mount Carmel started with the immunization program, and we continue to develop new services that can help people who have limited access to care."
In 2013 Mount Carmel opened the $1 million Community Health Resource Center on the campus of Mount Carmel West, located just over a mile from the center of downtown Columbus in a neighborhood that has been identified as health vulnerable. Residents there face many barriers to health care. They have the lowest median household income in the city of Columbus and rank highest in Franklin County in rates of homicide, domestic violence, human trafficking, teen pregnancy and children with mental health disorders. After assessing the needs of this population, Mount Carmel determined that the residents would benefit from a facility that focused on prevention and wellness rather than acute treatment.
Mount Carmel developed the Community Health Resource Center using space that already was available on the campus of Mount Carmel West. The system partnered with neighborhood members to develop a design for the facility so it would reflect area needs. It features a state-of-the-art community kitchen, meeting rooms and a health resource library that all are free and open to the public.
"We want the center to be a collaboration between Mount Carmel and the community," said Pierson. "We want it to be a place where people can come to improve their health and the lives of their families."
The resource center's first goal is to engage the community and provide education, health and wellness services, with a particular focus on the vulnerable communities surrounding Mount Carmel West. In expanding health care education beyond the traditional hospital setting, the center's second goal is to better prevent and manage chronic medical conditions, encourage healthy lifestyle habits and promote holistic wellness — resulting in a healthier community.
Ami Peacock, manager of the Community Health Resource Center, joined Mount Carmel just two months before the facility officially opened. With her enthusiasm and the community's interest, the center has been able to gain a strong foothold. It has seen nearly 10,000 visitors, established dozens of community partnerships and hosted more than 650 activities. Many of the participants in the program now are active volunteers with the center.
"Every day we're looking for new ways to bring people into the CHRC," said Peacock. "We have received an incredible response from the community. They have welcomed us with open arms, and we are grateful to be a neighborhood partner."
Wellness programming is the resource center's focus and reflects Mount Carmel's overall mission to serve as a transforming and healing presence in the communities it serves. The center offers classes ranging from nutritional cooking to stress management. It also serves as a meeting place for a number of organizations such as the Franklinton Area Commission, the Ohio Food Bank Association and committees from Columbus Public Health.
COMBATING INFANT MORTALITY
A major community concern in Ohio, especially in the central Ohio area, is infant mortality. According to Columbus Public Health, 145 babies died in Franklin County during 2014, which puts the area's infant mortality rate at 7.7 deaths per 1,000 live births.1 The national average is 6 deaths per 1,000 live births.2 City leaders, local agencies and health care organizations are banding together to address infant mortality, and Mount Carmel has taken a leading role in these efforts. Claus von Zychlin, president and chief executive officer of Mount Carmel Health System, serves on the Greater Columbus Infant Mortality Task Force, a collaborative effort that began in 2014 and is charged with reducing infant mortality in central Ohio. Mount Carmel also has supported parallel efforts by the administration of Gov. John Kasich and in the Ohio General Assembly by providing testimony regarding the system's "Welcome Home" program.
Since 1998, Mount Carmel has offered "Welcome Home" to mothers and babies. The program provides a free home visit from a registered nurse to check on the health and wellness of mother and baby after discharge from any Mount Carmel birthing hospital.
Mount Carmel's "Welcome Home" program also has established a valuable partnership with Moms2B, a local group developed by The Ohio State University Wexner Medical Center to help women deliver healthy babies. Moms2B opened a site at the Community Health Resource Center, and all women who participate in Moms2B — even those who are not seen at the resource center — are eligible to receive a "Welcome Home" visit regardless of whether they delivered at a Mount Carmel Hospital.
"Whether we're reaching that mom through Moms2B or ‘Welcome Home,' it's important that she's hearing about nutrition and safe sleep," said Mary Jo Dickinson, director of outreach operations. "As public health resources, we're all committed to the same goal: saving babies in the communities we serve."
"Welcome Home" visits typically happen within 14 days of discharge, or as quickly as possible if the mother has a breast-feeding issue or other concerns. The "Welcome Home" nurses serve as important resources for new mothers, many of whom have lots of questions. The visits are more than just a health checkup with a question-and-answer session; nurses also evaluate for potential issues. Each mother is asked about her baby's sleeping environment, and the nurse makes sure the mother is educated on safe sleep. If the infant does not have a safe place to sleep, Mount Carmel will provide a free pack-and-play playard.
"The infant mortality rate in Columbus is devastating, and when people first learn how high it is, they're shocked," said Dickinson. "We work to provide new moms with resources when they leave the hospital, specifically through our ‘Welcome Home' program, because we've learned that extra involvement can make a difference."
The partnership between Mount Carmel's "Welcome Home" and Moms2B highlights an effort to reduce racial disparities and infant mortality. The Community Health Resource Center is the third site for Moms2B, which serves women across Columbus.
The Community Health Resource Center, Moms2B and "Welcome Home" work together in a vertically integrated model to provide care for high-risk, pregnant women in a community setting. In addition to providing mothers with maternal-fetal services, they also can connect the women with social workers, therapists from the Mount Carmel Community Outreach crime and trauma assistance program, primary care providers and numerous resources, along with cooking classes where moms can learn to make healthy meals, a separate room for sibling care and a meeting space.
Participants meet once a week for two hours. During that time, expectant and new mothers receive individualized attention to ensure that they and their babies are meeting healthy milestones. Moms2B staff, along with Mount Carmel Outreach staff and "Welcome Home" nurses, work with the expectant mothers to measure their progress, schedule visits with physicians, have group discussions on pregnancy-related issues and eat a healthy lunch.
"The CHRC provides a unique and efficient meeting place for Moms2B. The location provides a consistent and reliable resource for the program and mothers and the organization," said Dickinson. "The addition of Moms2B has been a great partnership for ‘Welcome Home' and has bolstered Mount Carmel's efforts in curbing infant mortality and promoting health and wellness for mothers and their newborns."
CREATING NEW RESOURCES
The mission of the Community Health Resource Center follows the legacy of Mount Carmel's original award-winning integrated care resource: the Outreach Mobile Coach. Each week the mobile coach, a 40-foot-long urgent care facility on wheels, visits nine sites throughout Columbus providing free mobile urgent care to those without insurance or who are underinsured and cannot afford co-payments. Patients often are homeless and either living in the shelter system or "on the land" with limited abilities to manage their health. Patients at these visits are triaged, seen by providers and, if appropriate, receive a 30-day supply of medications. Most importantly, patients receive appropriate referrals for follow-up care and linkage to a medical home. All of this is provided at no cost to the patient.
The care the mobile coach provides is the model for all the programs in Outreach. "For nearly two decades, it's been a reliable source of care for at-risk populations in Columbus, and it will continue to serve the most vulnerable for years to come," said Ladonya Brady, clinical manager of the Outreach mobile coach.
The mobile coach continues to evolve to meet changing needs of its patients. As in many areas across the country, Columbus has a growing need for mental health services. A large number of the patients who visit the mobile coach, especially the homeless, suffer from chronic mental health issues that may have contributed to their current homeless status, as well as to their current physical condition. Providers on the coach are able to diagnose and prescribe for limited mental health conditions within their scope of practice; therefore the need for on-site mental health professionals was great.
Mount Carmel reached out to Southeast, Inc., a respected mental health provider in Columbus, to develop a partnership that could serve patients using the mobile coach. Southeast, Inc. quickly agreed, and in November 2010 a psychiatric nurse practitioner and a case worker began partnering with the mobile coach. As part of the agreement, patients are seen by Southeast, Inc. at four mobile coach sites until they either are released from the program or transitioned into ongoing treatment at the Southeast, Inc. main site. Many of the patients in need of mental health services have an established relationship with providers on the mobile coach. The strong relationships between the staff and patients can help make the transition of care to Southeast, Inc. move more smoothly.
The partnership between Mount Carmel and Southeast, Inc. continues to grow. In 2010, clinicians working in the partnership performed 568 visits. From that time to the end of 2014, the Southeast, Inc. team has been able to complete more than 2,500 visits.
WORKING TOGETHER
Creating valuable and sustainable partnerships is important to ensure Mount Carmel can continue to offer more services to groups throughout the area. The addition of the Community Health Resource Center allows the system to work with organizations that aren't traditionally seen as health organizations, but still play a vital role in the wellness of the community. One of the resource center's most successful collaborations is with Franklinton Gardens, a nonprofit urban farm located within five blocks of Mount Carmel West. Its volunteers cultivate gardens in vacant lots throughout the neighborhood, turning eyesores into important and healthy community resources.
Mount Carmel and Gladden Community House have developed a partnership that teaches people in the neighborhood how to use the food grown in their gardens. The cooking classes feature Mount Carmel chefs demonstrating how to cook with the fresh, healthy ingredients. Many people in Franklinton do not have extensive experience cooking with fresh ingredients, and they are more motivated to use the fresh fruits and vegetables in their daily meals when they know how to incorporate them into recipes.
When the produce is in season, participants from the food pantry and the senior programs go home with a bag of groceries that contain items from Franklinton Gardens.
"The cooking class allows Mount Carmel to address health and wellness issues from a preventive standpoint. People don't hear a lecture about what they're doing wrong, instead we give them the tools and knowledge to invest in their own well-being and make healthy decisions," said Peacock.
Mount Carmel has found that engaging residents and inspiring a passion for personal and family wellness is the most effective means to serve the community. It has been able to forge a number of critically important partnerships since the Community Health Resource Center opened in November 2013. The facility has served as an example of how the health care industry is transitioning from a system focused on treating people who are sick to one that concentrates on keeping people well. Using mission and Catholic values as a guide, Mount Carmel will continue to be a leader in the health care community.
With the support of the Mount Carmel Foundation, Mount Carmel Health System continues to focus on improving and expanding its community outreach efforts. On Feb. 14, 2015, the Foundation hosted its annual Champagne and Diamonds gala, the largest fundraising event of the year to support mission-based community programs at the health system. This year's gala raised more than $600,000 to benefit the Mount Carmel Community Outreach department in its mission to be a compassionate and transforming healing presence to central Ohio communities.
SR. BARBARA HAHL, CSC, is senior vice president of system mission for Mount Carmel Health System, Columbus, Ohio. Mount Carmel is a member of Trinity Health.
NOTES
- City of Columbus, Office of Epidemiology, "Infant Mortality and Birth Surveillance." columbus.gov/publichealth/programs/Office-of-Epidemiology/Infant-Mortality-Reports/.
- Centers for Disease Control and Prevention, "FastStats: Infant Health." www.cdc.gov/nchs/fastats/infant-health.htm.