Posted March 2, 20223:36 pm
By Robert Higgs
CLEVELAND, Ohio – It began as an experiment at the MetroHealth System’s Buckeye Health Center to encourage patients to come to their appointments by providing wraparound services that meet patient needs beyond medical care.
It worked. No-shows declined from 50% to 30%.
And in the process, MetroHealth discovered the approach fit so perfectly into the hospital system’s mission to improve the community’s overall health and wellness, that it now plans to incorporate the model into an affordable housing complex the hospital is building at its main campus.
A variety of wraparound services will be housed in the Via Sana apartment building, a $15-million project under construction adjacent to the hospital system’s main campus along MetroHealth Drive between Scranton Road and West 25th Street.
The building, which will add 72-affordable housing units to the Clark-Fulton neighborhood, is expected to open later this year.
The apartment construction and new services are connected to a $1 billion plan to overhaul the hospital’s aging main campus, with a new hospital in an 11-story tower – and to change how health care is delivered in Northeast Ohio.
“Really what we want to do is look beyond the walls [of the hospital] to improve patient health care,” said Susan Fuehrer, the president of MetroHealth’s Institute for H.O.P.E.
The idea is to go beyond delivering medicine and connect people to services that can help address some of the underlying causes of poorer health, such as joblessness, poverty, food insecurity and lack of safe and secure housing.
“Many people don’t understand how important the social determinants are,” Fuehrer said. “We are purposefully working to move out beyond the walls of the hospital and address these social determinants.”
Exactly which wraparound services will be located on the first floor of Via Sana has not yet been determined, Fuehrer said. Cuyahoga Community College will have a presence there, as part of an empowerment center that will include job skills and computer literacy training. There will be a test kitchen to help teach healthy meal preparation. Other offerings will mirror those at the Buckeye Health Center.
Challenge to the community
MetroHealth CEO Akram Boutros has long advocated that the medical giants in Greater Cleveland need to refocus. For too long, Boutros argues, hospitals have measured their success by the size of their buildings and the prestige of those who work inside them.
Speaking to the City Club of Cleveland in June 2019, Boutros challenged the hospital systems and community to step up and address the pervasive social problems that are detrimental to health outcomes.
Addressing those conditions can have long-lasting consequences on community health, particularly for children. How a child fares in the first 2,000 days of life -- an age at which brains are developing at astonishing speeds -- can have lifetime repercussions.
“It’s time for health care executives’ deeds to match both their rhetoric and the needs of the community,” Boutros told the City Club. “It’s time for us to address the social determinants of health … It’s time to focus on promoting health, rather than fighting illness.”
Shortly after that speech, MetroHealth created its Institute for H.O.P.E. -- which stands for Health, Opportunity, Partnership and Empowerment -- and launched the project at the Buckeye Health Center on East 116th Street.
A new approach
At the time, half of the clinic’s patients were skipping appointments. Either they lacked transportation or childcare, or other matters were just more dire, such as food scarcity or housing insecurity. The neighborhood is home to one of Cleveland’s most vulnerable populations, where more than 70 percent of children are being raised in poverty, mostly by single mothers, and the infant mortality rate is about four times higher than the national average.
So, in June 2019, MetroHealth radically changed how it delivers services at the clinic, in keeping with Boutros’ call to action. They offered free space on the clinic’s first floor to a menu of service providers -- food, domestic violence support, legal counseling, and personal developmental skills, among others – in the hopes that while meeting a patient’s most pressing needs, MetroHealth could meet their medical needs too.
Today eight organizations have a presence at the Buckeye Clinic – Greater Cleveland Foodbank, Goodwill Industries, Legal Aid Society of Cleveland, CHN Housing Partners, College Now of Greater Cleveland, Benjamin Rose Institute on Aging, Family Connections, and Seeds of Literacy.
Doctors can refer patients to sources of help for non-medical issues while they are in the building.
For example, a mother might mention to a doctor during an appointment that her child is struggling in school. The doctor might recommend, based on screenings, that the child has special learning needs that could be addressed by an individual education program. Legal Aid Society can then link with the mother to help make sure that happens.
A doctor might learn that a patient’s electrical service has been shut off at their home, exacerbating a medical condition. CHN Housing Partners can provide emergency help toward getting service restored.
Also screenings can identify patients who lack access to adequate grocery sources and face nutritional issues from food insecurity. Greater Cleveland Foodbank can help those folks get signed up for SNAP supplemental assistance on sight, eliminating the need to find transportation downtown to fill out paperwork. The foodbank also operates a food pantry two days a week.
MetroHealth says the Buckeye model develops a symbiotic relationship with service providers, whose presence in the clinic has increased their exposure within the community, and it connects patients to the resources they need.
“It’s really a complete full-person service that we offer at Buckeye,” Fuehrer said.
Original story can be found at cleveland.com: From experiment to working model: MetroHealth to offer wraparound services at new Via Sana apartments - cleveland.com