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Implementing and monitoring high-quality community health worker care in adult primary care at New York City Health + Hospitals.
- Source :
- BMC Primary Care; 9/2/2024, Vol. 25 Issue 1, p1-7, 7p
- Publication Year :
- 2024
-
Abstract
- Background: This study describes how New York City (NYC) Health + Hospitals implemented a large-scale Community Health Worker (CHW) program in adult primary care clinics between January 2022 and December 2023 and established metrics to monitor program implementation. This study is timely as healthcare systems consider how to scale high-quality CHW programs. Methods: We collected metrics in the following areas: (1) Workforce demographics, team structure, and training; (2) Enrolled patient demographics; (3) Patient-centered metrics, such as patient counts (e.g. patients outreached and enrolled) and engagement (e.g. median time in program, caseloads per CHW), and goals (e.g. median number of goals identified and completed). Metrics are based on standard data elements captured through CHW documentation in the electronic health record collected during program implementation. Data cleaning is completed using SQL queries and R scripts. Results: In June 2023, there were a total of 97 CHW and 22 CHW Supervisor staff lines in adult primary care across 17 healthcare sites. There were 4.6 CHWs to 1 CHW supervisor on average though this ranged by facility from 1:1 to 1:6. Compared to the population that receives primary care at NYC H + H, CHWs served more African American/Black patients (40% vs. 32%) and an older patient population (35% older than 65 vs. 21% older than 65). From January 2022 to December 2023, 13,812 patients were outreached by CHWs. Of these, 9,069 (66%) were referred by clinicians, 7,331 (53%) were enrolled, and 5,044 (37%) successfully graduated. The median number of goals identified by patients was four, and the median number of goals completed with a CHW per patient was three. The top three goals were primary care engagement (47%), specialty care engagement (46%), and food insecurity (45%). Conclusion: Establishing clear implementation and process metrics helps to ensure that CHWs embedded in health systems can meaningfully engage adult patients in health care, address patient-centered goals, and connect patients to community and government services. [ABSTRACT FROM AUTHOR]
- Subjects :
- SUPERVISION of employees
MEDICAL quality control
HUMAN services programs
DATABASE management
MEDICAL specialties & specialists
SOCIAL determinants of health
PRIMARY health care
EVALUATION of human services programs
MEDICAL care
FOOD security
OUTPATIENT medical care
POPULATION health
HOSPITALS
GOAL (Psychology)
DESCRIPTIVE statistics
PATIENT-centered care
ORGANIZATIONAL structure
WORKING hours
RACE
ELECTRONIC health records
QUALITY assurance
HEALTH facilities
COMMUNITY services
PUBLIC administration
LABOR supply
PATIENT participation
TIME
MEDICAL referrals
Subjects
Details
- Language :
- English
- ISSN :
- 27314553
- Volume :
- 25
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Primary Care
- Publication Type :
- Academic Journal
- Accession number :
- 179394642
- Full Text :
- https://doi.org/10.1186/s12875-024-02571-6