Baylor Scott & White Health Community Advocates program tackles health care inequalities


When Sana Iqbal enrolled in first year at the University of Texas at Dallas, she had no idea what she wanted to major in. The only thing she knew for sure was that after graduation she wanted to be a part of some kind of cause – something that went beyond personal ambition. These feelings eventually led her to major in healthcare management with a minor in public health.

Iqbal then learned Baylor Scott & White Community Advocates Program, which connects inpatients in underserved communities with vital social services available in their communities. Realizing that participating in such a program would complement her academic work, she volunteered and was accepted.

Following her initial training, she worked in the emergency department of Baylor Scott & White Medical Center – Carrollton. There, Iqbal came under the tutelage of Anne Horton, a primary care social worker at the medical center, and learned about the complex, day-to-day challenges of providing patient care in a busy emergency department.

During the three semesters that Iqbal spent at Baylor Scott & White – Carrollton, she encountered situations impossible to reproduce in the classroom. She found that while it is one thing to study the medical needs of underserved people in an academic setting, it is quite another to deal with a desperate mother who cannot feed her newborn baby, or to a father in tears because he is unable to take care of his family.

“Serving as a community advocate has allowed me to discover what it really means to provide compassionate and comprehensive care,” says Iqbal. “Helping patients find a way to pay their bills, get a doctor’s appointment they couldn’t get before, or get a meal for their family for the next month was the best feeling. . “

Iqbal’s experience is the result of a comprehensive work of several decades Baylor Scott & White Health initiative to study existing health care inequalities in North and Central Texas and strengthen these communities by improving access to health care, especially among traditionally underserved sectors of the population. To this end, Baylor Scott & White Health has established relationships with 750 organizations in its service area – from McKinney in the north to Austin in the south – fostering collaboration and innovation to best meet the needs of the people of the region. .

Baylor Scott & White Health’s ultimate goal is to use this vast array of information to design new, innovative programs to improve the delivery of health care to individual communities. “We want to think globally but act locally to find the health care programs that suit a particular community and its specific needs,” says Niki Shah, vice president of community health for Baylor Scott & White Health.

This nearly 20-year effort has led to the creation of several new Baylor Scott & White Health community impact initiatives, including the multi-faceted Community Advocates program.

The origins of the Community Advocates program

The seeds for the Community Advocates Program were planted in 2016, when Baylor Scott & White Health officials collaborated with a national healthcare organization. The organization had developed a model program to connect inpatients to a range of social services available in their communities and create better health care outcomes.

Baylor Scott & White Health adopted this model, adapted it to staff needs, and became the first hospital system in the country to implement the revised version of this program in emergency departments, among other clinical settings. The Community Advocates program brings together student volunteers, clinical and frontline staff, academic collaborators, and key community organizations to meet the basic social needs of a vulnerable patient population and create a pool of future professionals to serve in the community. health care field.

Connect with the community

Baylor Scott & White Health’s Community Advocates program is focused on achieving multiple outcomes. First, the program seeks to connect patients – especially those from traditionally underserved communities – with the many social and government services available to them outside of hospitals, food banks, and homeless shelters to health centers. advice, as well as detailed support and instructions for accessing these benefits. Without this essential service, these patients may go hungry, be unable to find shelter in a safe place, or face hardship or danger. By creating sustainable, high-impact, and cost-effective interventions, Baylor Scott & White Health hopes to lower ED readmission rates.

Additionally, the program serves as a training ground and career development pipeline for future healthcare professionals. Ideally, the experience of working as a community advocate will lead some student volunteers towards careers in health care. Even if they do not become health professionals, their volunteer experiences will greatly enrich their educational life and make them aware of the most urgent health needs of communities at risk.

Recruitment and training of volunteers

Community Advocates volunteers are all students attending area universities, including the University of North Texas, University of Texas at Dallas, Baylor University, and the University of Mary Hardin-Baylor.

All volunteers, undergraduate and graduate students, must be at least 17 years old. They come from diverse academic backgrounds, from mathematics to theology, but all share a passion to serve their community. To be accepted into the program, each aspiring community advocate must submit an application and resume, undergo a background check, and pass a rigorous interview during which they must demonstrate a high level of professional judgment. Finally, all volunteers are invited to commit to the program for two semesters.

Those who are admitted go through an intense one-day boot camp, accompanied by role-play scenarios that replicate the types of encounters they are most likely to have with patients. Next, program volunteers spend approximately six weeks observing experienced clinicians in the emergency departments at Baylor Scott & White Health to gain invaluable knowledge about the demands and challenges of patient care while mastering screening for patients. social needs, navigation processes, ongoing contact with patients and documentation in the electronic medical record.

First successes

Twenty-six student volunteers currently participate in the Community Advocates Program, and their work goes beyond typical volunteer activities, such as office or office work. Instead, they have direct contact with patients, perform in-depth social needs screenings, and provide detailed information that will help patients obtain food, shelter, counseling, access to primary care, and other vital services, such as transportation services, ID card services and working to meet the needs of the patient’s home.

Patients in emergency rooms in underserved areas are often reluctant to talk to clinical staff about their difficult life issues, a phenomenon known as “white coat syndrome”. This is not the case with Community Advocate student volunteers, however. About 90% of patients from underserved communities voluntarily interacted with community advocates.

Of the approximately 800 patients screened by volunteers to date, 80.3% had at least one social need and 56.3% accepted the help of student volunteers to put them in touch with external social service organizations. Even more impressive, the readmission rate of people receiving help through the Community Advocates Program has plummeted, with just 19% of patients returning to the emergency department within 30 days of their first visit with an advocate.

To look forward

In light of the initial success of the Community Advocates Program, Baylor Scott & White Health intends to place Community Advocates in other emergency departments in their system. It will also work with other healthcare organizations across the country to establish programs based on the Baylor Scott & White Health model.

In addition to the Community Advocates program, Baylor Scott & White Health has launched a variety of other community outreach initiatives, including an ongoing assessment of community health needs, a community health worker program, and the establishment of a network of community / charity clinics. All of them are rooted in Baylor Scott & White Health’s commitment to providing quality care while reducing costs in order to invest in its mission and reduce the financial burden on patients.

For more information on the latest advancements in patient care and the many services Baylor Scott & White Health provides to its patients, subscribe to the Baylor Scott & White Scrubbing In blog.


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