A Unique Model of the Community Health Worker

Abstract

With current trends in legislation around the delivery of patient care, the role of a community health worker (CHW) is gaining growing and much deserved attention. However, a system needs to be built for any CHW program to be successful and sustainable. This article describes a unique approach to community health work at the Massachusetts General Hospital Chelsea HealthCare Center where a well-integrated CHW model provides support for everyone involved in patient care: patients, providers, the community at large, and the internal CHW staff.

Implementation and maintenance of patient navigation programs linking primary care with community-based health and social services: a scoping literature review

“…Of 34 included papers, most originated in the United States ( n = 29) [ 8 , 22 , 23 , 25 , 27 – 51 ] followed by the United Kingdom ( n = 2) [ 52 , 53 ], Canada ( n = 2) [ 54 , 55 ]; and Australia ( n = 1) [ 56 ]. The majority were descriptive papers ( n = 12; 34.3%) [ 23 , 28 – 30 , 32 , 40 , 43 , 44 , 47 , 48 , 50 , 54 ]. Of the seven qualitative studies ( n = 20%) [ 27 , 35 – 37 , 46 , 53 , 56 ], there were: three grounded theory studies [ 56 ], one phenomenological study [ 35 ], and one inductive qualitative study [ 53 ].…”

“…One paper recommended identifying a clear vision of patients’ needs and determining priorities to support implementation [ 22 ]. Some papers reported that clients’ basic needs, such as affordable housing, should be addressed before navigation programs would work [ 30 , 31 , 54 ]. Challenges arose for nurses in a Guided Care Program for complex seniors as caregivers were often patients themselves and this likely hampered attendance at workshops and support groups offered by the program [ 42 ].…”

“…Five papers specifically addressed issues related to role clarity of navigators. Spiro and colleagues highlighted the value in setting clear boundaries for CHWs that they are not to provide any clinical advice [ 30 ]. Layne et al, [ 43 ] also highlighted the value of role clarification in relation to the importance of patients’ roles as partners in their care.…”

“…Facilitators included careful development of planning processes [ 50 ] and support from steering committee members to review cases and service data [ 46 , 54 ]. Other facilitators included policies and procedures that were well articulated [ 50 ] and supported program activities, such as: problem solving around cases, decision-making around clarifying boundaries of work and referrals (when to refer on), safety procedures for home visits, communication strategies between partners to conduct planning activities, and documentation [ 30 , 42 , 50 , 54 ]. Decision-making processes that carefully thought through models of service to meet community needs and consensus decision making was also valued [ 54 ].…”

Help-Seeking Behavior and Health Care Navigation by Bhutanese Refugees

“…Training topics (Table 4) were selected by the research team based upon prior experience, review of existing patient navigator curricula [13, 14, 15, 16], consultation with health care providers serving the community, a community needs assessment, and other literature [17, 18]. Resources available to the HFPs comprised an office, telephone, computer, printer/scanner/copier, internet connection, and consultation with program supervisors, as needed.…”