Update From the Field: National Association of Community Health Centers April 2019
The Business Innovation Factory (BIF) team just recently visited Castle Family Health Center in Atwater, California and Lawndale Christian Health Center in Chicago, Illinois where we conducted interviews with the health centers’ leaders, staff, and patients. Our work with the National Association of Community Health Centers (NACHC) is focused on creating more opportunities for transformation within their network. As we began to analyze and synthesize our findings, a few emerging curiosities came to the surface:
How do you create the conditions where people are able to advocate for their own health and wellness – both physical and mental?
What practices, processes, and mindsets are central to creating a culture of trust in a health center?
How are community health centers uniquely situated to be transformative players in the changing landscape of healthcare? Beyond providing health care services, what roles do community health centers play in their ecosystem?
Throughout our travels to Florida, California, and Illinois we had rich discussions with patients that offered insights into their perspectives around these questions. Combined with over 14 years and 70 BIF projects seeking to understand customer (patient, student, and citizen) experience particularly in underserved communities we have a solid design foundation to explore opportunities with NACHC to accelerate patient-centered transformation in the communities it’s Members serve.
Prioritizing Personal Health, Wellness, and Self Advocacy
When individuals have the mindsets, time, resources, and/or support to invest in themselves, they can better advocate and have greater ownership over their healthcare and wellbeing experience beyond their visit to the doctor’s office. Patients will be better agents of their own health and wellbeing when their life experiences are understood in a full context. Health and wellness start by unleashing patient agency to take advantage of the right knowledge, tools, expertise, and resources when and where patients need them.
A patient from Castle Family Health Center explained, “An important decision for me is to take care of myself because I was always worried about other people, what they were feeling, and making them happy….but getting to the point where I had allowed myself to be a little selfish, and take the time for me, that was a big decision. ”
The healthcare system today relies on the expertise of the doctor to provide knowledge or tell a patient what they need to change to improve their health and assumes people will take this advice and act on it. People need to feel empowered and enabled to make these changes in the face of other life stressors, and feel supported by their doctor. Providing the opportunities for patients to be engaged in their healthcare journey, rather than passively being told what they need to do by a doctor, will enable patients to actively sustain the steps towards improved health and wellness.
Cultivating a Culture of Trust
Individuals make important decisions based on the people, places, and information that they trust, which can lead to positive, negative, or neutral health and wellness outcomes in their life. When patients feel that both the staff and doctors truly listen and understand them, it helps build their trust and relationship with the health center they are utilizing. A patient at Castle Family Health Center described, “Right here is where my entire self-care comes from… They listen to what I’m feeling, you know?” This patient has entrusted the health center to help her on a path to taking better care of herself due to the positive experience she has had over time.
When trust is developed, patients are more open and comfortable sharing their experiences and problems, allowing health centers to better help them in reaching their health and wellness goals. In this day and age, there are many different options of providers and services available to individuals that it can be difficult to know who to trust. When health care centers are able to meet the needs of individuals and value them as more than patient X of the day, this moves from a transactional experience to one based on relationships.
This was demonstrated when another patient from Castle Family Health Center explained, “They were kind. They were caring, attentive, and quick. If I came early, they called the doctor to see if there were any slots open or if someone didn’t show….I had two appointments today, and I checked in and they communicated with me and made me feel like I wasn’t just going to be brushed aside until my appointment time.”
Overcoming barriers of distrust within healthcare institutions requires creating a culture of trust where patients know their care is personalized for their life, resulting in a healthcare journey that has their best interests at heart.
Reflecting Community Values and Catalyzing Patients’ Narratives
People want to share their stories and contribute their knowledge and passion to their wider community. As noted before, the healthcare experience is often a one-way transfer of information, knowledge, and values. However, we heard from patients that it is just as important that they are able to see their values and knowledge reflected in the health center. They noted that generosity and collective support kept them engaged in spaces both in the health center and beyond.
A patient at Lawndale Christian Health Center shared that values of the health center help her have trust in the staff and services provided. Those values also made her more likely to share her story with members of her community and support them in living healthier lives.
She shared: “If a testimony was ever required of me I’ll be sure to make some space for it to make people aware that this [depression and other mental health struggles] is a real thing and that there’s help out there and there is proper medication for this… Whenever you guys want to call me to initiate a conversation for me to express my own story, to share with others I’ll make time for it for sure.”
A patient from Bond Community Health Center shared a story where he saw himself reflected in the community. “Today a lady came in and she didn’t have her copayment. Another lady sitting in the waiting room walked up and said ‘I will pay her copayment. If she has any problems I’ll pay it for her.’ These are the people who touch you. She said the copay was $25 and she only had $20. And I looked at the receptionist and she already knew that I had it, but before I could reach to get the five dollars the other lady came up and said ‘I’ll do it.’ So you know, it’s people like me that are here with open hearts and they will do for others. So I feel really comfortable with the people here.”
When patients see a health center emulating the same values and beliefs that they adhere to, it creates a sense of trust and commitment as they are aligned together through a common purpose. Health centers have an opportunity to lift up patients’ narratives and create pathways for patients to become core to their recruitment, retention, and reform efforts.
As we continue our exploration, we look forward to more storytelling and actionable insights from the field to put patient experience at the core of our design and innovation process.
Read Part 1: Emerging Insights from the Leadership Perspective
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