Healthcare in the Shadows

When Community Voices Called Out for Help

Posted by on Monday, July 27, 2015 in News.

In 2004, women in Snohomish County, Washington who were participating in the Welfare to Work program, had newly acquired Medicaid insurance.  When they tried to access primary and preventive healthcare services, there were no providers willing or able to see them.  Other Medicaid patients in the region and the uninsured had no access either.  A group of the Welfare to Work women began to raise their voices to local community leaders and they wrote letters to the local newspaper, pointing out this healthcare crisis that drove them and many others to their community hospital emergency room for care that certainly cost more and was highly inefficient.  Physician leaders at the emergency room saw the same problem and added their voices to the call for help.

Community and local hospital leaders heard these cries and began crafting solutions.  One strategic move was to ask the University of Washington School of Nursing in Seattle (a 30 minute drive away) for assistance.  The School of Nursing saw an opportunity to help alleviate the crisis while also gaining a clinical practice site for the training of NP students and baccalaureate students.  The SON’s core values of collaboration, social responsibility and diversity were well aligned with the goals of this community to better serve its citizens.

More than 10 years later the nurse managed primary care clinic that was born from community advocacy and community need serves over 1000 patients a month in a modern, 20 room facility.  The local medical group manages the clinic and paid providers and staff are employees of their group.  Many physician specialists volunteer at the clinic 1-2 days per month and there is a volunteer nurse midwife.  The School of Nursing, under Dr. Eleanor Bond’s leadership, has greatly influenced the collaborative care model through grant funding over the past decade.  Bond and her team have implemented evidence based collaborative practices, training clinic staff and providers in team based care and evaluating the results.  Over 150 students have received clinical training at the site.

Chronic illness management, behavioral health, and dental services are common challenges.  Through an intricate and fairly robust set of partnerships among and between the local hospital, the clinic, the University of Washington School of Nursing and local community providers, patients are able to access needed services.  Non urgent care in the emergency department has been reduced and when a patient needs to find a healthcare home, the ED physicians know just where to send them.

This community solution is working and illustrates the very best in how communities can come together to address the healthcare needs of their residents.  This model in suburban Washington State can be replicated and should serve as a model for others.

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