1. Workforce Diversification through the Integration of CHWs in Clinical Teams
Lanxin Jiang
Yale School of Public Health &
Southwestern Area Health Education Center

2. Integration can improve patient-centric care
What is a clinically integrated team?
Clinically integrated CHW-inclusive team:
Community Health Worker is a core element of the clinical team, sharing understanding of patient perspectives with clinicians.
Integration can improve patient-centric care
30 s
Methods: 20 semi-structured interviews with CHWs and health practices engaging CHWs in Connecticut were conducted and thematically analyzed in a partnership between the Yale School of Public Health and the Southwestern Area Health Education Center

3. The role of diversity in clinical integration
Perspective
Diverse backgrounds shared with patients helps CHWs understand patient needs and challenges
Placement
CHWs location the community helps them reach patients outside of the clinic in ways that doctors cannot; positioning within clinical team lends ability to provide clinical and non-clinical support
Efficiency
Integration of CHWs enables doctors and nurses to focus more on the clinical aspect of health care
40 s

4. The role of diversity in clinical integration -Perspective
“I think that the health outcomes you will get for those patients when you have a navigator or community health worker part of the team….is a very different outcome, or at the very least the provider having a better understanding of why the patient behaves the way they do.” - Care Coordinator
20 s
“I think it would relieve a lot of stress off the nurses. And a lot of you know hospital employees if navigators were there. And it would give social workers more time to do what they need to do, and it would give nurses more time to do what they need to do as well. I mean a lot of these nurses and social workers are doing a lot. They're doing paperwork, they're doing translation services, they're reminding patients about appointments, and I feel like if a patient navigators were there yeah. “

5. The role of diversity in clinical integration -Placement
“So we all do come from different fields, and we come from different areas. I think it makes us stronger. It makes us work better. Just because obviously we all have different skills…I just think that we just makes a great team because we bring all of the experiences that we had.” - Patient Navigator
20 s
“I think it would relieve a lot of stress off the nurses. And a lot of you know hospital employees if navigators were there. And it would give social workers more time to do what they need to do, and it would give nurses more time to do what they need to do as well. I mean a lot of these nurses and social workers are doing a lot. They're doing paperwork, they're doing translation services, they're reminding patients about appointments, and I feel like if a patient navigators were there yeah. “

6. The role of diversity in clinical integration -Efficiency
“And it would give social workers more time to do what they need to do, and it would give nurses more time to do what they need to do as well. I mean a lot of these nurses and social workers are doing a lot. They're doing paperwork, they're doing translation services, they're reminding patients about appointments, and I feel like if a patient navigators were there yeah. “ - Patient Navigator
20 s

7. The challenges with managing diversity
Can reduce team cohesion, lead to miscommunication, reveal biases, and impact patient care
Mutual commitment to the mission can strengthen and harmonize intra-team relationships
CHWs must manage their relationships with one another & with other members of the healthcare team to be effective
Altruism
Desire to help patients
Motivation
Effective negotiation
Trust building
Playing to individual strengths
45 s

8. The challenges with managing diversity -Mutual Commitment
“I mean this is a working relationship, we're working and trying...to reach people. All of us have the same goal, you know.”
- Community Health Worker
“I think that we all have different backgrounds but we can all relate to each other in a way, not just because we're all Hispanic, but I think that we also all understand…that this job is about us working together to help people.”
- Patient Navigator
40 s

9. The challenges with managing diversity -Relationship Management
So at that point because we're so -- we have a close-knit relationship, we work so close with each other….. And so then, we all sort of understand that there are certain people that if they call, just given to such and such. And no one feels any way about it, because we all have that one specific person or those people that ask specifically for one person, and we kind of know how to work around it.
-Patient Navigator
“So we each bring like a different perspective to the table, with the one thing we have in common
is the knowledge of community resources, resources on our own roof. So that if we're dealing with
something we're not accustomed to, we know who to go to get help and ask.”
- Patient Navigator
40 s

10. Questions?
30 s