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Expanding our media capabilities as we compile a video for our practicum presentation.

#goteamcommwell

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During our practicum experience, we worked closely with CommWell Health in preparation for their Joint Commission accreditation. “The mission of The Joint Commission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. Its vision is that all people always experience the safest, highest quality, best value health care across all settings” (https://www.jointcommission.org/about-us/). Our contribution to The Joint Commission Accreditation primary involved consolidating, writing, and editing policy. It is clear from their mission statement, that the goals of The Joint Commission coincide with foundational competency six “Discuss the means by which structural bias, social inequities and racism undermine health and create challenges to achieving health equity at organizational, community, and societal levels.” CommWell Health aims to provide uniformity in the standard and quality of care at all of their locations, and The Joint Commission helps ensure this consistency. When asked about the value of Joint Commission accreditation, CommWell Health staff cited the convenience of clear and consistent expectations was a valued part of the Joint Commission. In addition to standards available for reference, staff members also cited an increase in resources available through the Joint Commission accreditation. Members of CommWell health understand the importance of the Joint Commission accreditation and apply it in their daily interactions with patients. This emphasis on consistent standards of care across different locations helps address health equity for various disadvantaged populations. This is also made clear by The Joint Commission’s “goals of increasing diversity and inclusivity” (https://www.jointcommission.org/about-us/joint-commission-officers/ana-pujols-mckee/ ). Both CommWell Health and the Joint Commission are contributing to a more health equitable society.

CommWell’s accreditation from the Joint Commission ensures they are providing a standard of quality care. “Joint Commission standards are the basis of an objective evaluation process that can help health care organizations measure, assess, and improve performance. The standards focus on important patient, individual, or resident care and organization functions that are essential to providing safe, high quality care. The Joint Commission’s state-of-the-art standards set expectations for organization performance that are reasonable, achievable, and survey-able” (https://www.jointcommission.org/standards/about-our-standards/). This is especially beneficial to the rural communities in which CommWell sites are located. We have discussed throughout this semester the layers of health disparities experienced by rural individuals. CommWell Health is uniquely located to combat these access and availability barriers. The consistent quality care provided by CommWell to rural communities correlates directly with the rural foundational competency two, “Analyze the governmental, social, economic, and professional factors that influence the availability and quality of health professionals in rural areas—including public health professionals as well as health care providers.” Although the system remains flawed, CommWell Health is doing their part to provide quality care to disadvantaged rural populations. Despite their attempts to bridge access and availability gaps, the CommWell staff still noted significant barrier to care for their community. The most commonly mentioned challenge to their patients was transportation. Being rurally located drastically improves access for countless individuals; however, for those without transportation it still proves a significant obstacle to seek care. Cindy Britt (CommWell Health, McGee’s Crossroads) mentioned existing transportation options, but noted they simply do not have enough resources for everyone, and it can be a timely process. Another recurring challenge mentioned by CommWell health staff was medication cost. CommWell Health attempts to serve as many individuals as possible by treating insured and uninsured patients alike; they also offer extensive assistance for seeking out payment options and aids. CommWell health has several resources available to aid in the insurance application process and are even willing to assist patients through the process. However, the cost of medication is out of their control, and this often times prevents their patients from acquiring and maintaining proper treatment following an appointment. These two concerns mentioned by CommWell Health staff is consistent with the themes we have discussed at great lengths in rural health this semester. It was so enlightening to see these challenges mentioned by providers.

The opportunity to work with CommWell Health this semester opened my eyes to the importance of standards within healthcare. The Joint Commission offers a way to ensure the best standards of quality care are implemented within a facility. In addition to providing information for reference, The Joint Commission provides accountability to those it accredits. This accreditation is valuable to CommWell Health and the communities it serves. Through this experience I also have a better understanding of the time, effort, and consideration that goes in to operating a healthcare facility.

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Really enjoyed the opportunity to see our policy efforts in action! So grateful for the experience to visit a CommWell Health Site!! Go Team CommWell!

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Really enjoyed the opportunity to see our policy efforts in action! So grateful for the experience to visit a CommWell Health Site!! Go Team CommWell!

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Educating myself on all the different awareness initiatives for each month! Discovering there are way more than I had initially realized! I need to consult my preceptor to confirm which ones they want included on their calendar!

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A major facet of Public Health work is assessing the needs of the community. This is emphasized in foundational competency seven, “Assess populations needs, assets, and capacities that affect communities’ health.” Although COVID-19 limited the team’s ability to interact directly with the community, I was still able to glimpse the beginning stages of what will become a social media awareness campaign. Increasing community awareness is a vital part of improving a communities’ health. Throughout our semester, it has become apparent that health literacy and knowledge is especially sparse in rural environments. With this information in mind, foundational competency eight became apparent as we moved forward, “Apply awareness of cultural values and practices to the design or implementation of public health policies or programs.” Although my participation was cut short by the close of the semester, it was still a wonderful learning experience to see the skeleton of how these foundations are applied in healthcare.

Health awareness is necessary for all communities; however, it is especially lacking in rural areas. Therefore, it is of significant importance to emphasize awareness in rural communities. Awareness is a vital part of every step of the healthcare process. Health literacy can impact when an individual seeks treatment (or if they seek treatment at all). Additionally, an individual’s understanding of their symptoms and ability to properly convey them to a provider can impact the accuracy and efficiency of diagnosis. Lastly, adherence to medications and other treatments can be significantly impacted by an individual’s understanding and awareness. These impacts of limited awareness are very evident in rural communities, especially in reference to chronic conditions like diabetes, hypertension, and cardiovascular disease (Warren and Smalley). These chronic conditions have significant impact on rural populations, and an increased awareness of prevention and treatment could have monumental benefits. Of additional concern is minority populations residing in rural communities. The barriers to awareness and health literacy are compounded. Especially for minority populations that may speak limited English, which adds an additional language barrier to their information access.

CommWell is aware of the community in which they reside. They understand their rural location indicates the community they serve may have decreased health literacy, limited understanding of relevant health information, and insufficient awareness of pertinent illnesses and disease. With this understanding of their communities’ culture and makeup, they have emphasized an importance in disease awareness and health literacy. This progression highlights foundational competency eight. In order to address this deficiency, they first focused on educating and involving their own staff. I helped organize a health awareness calendar that would be displayed and used at all CommWell locations. This calendar utilized preexisting awareness months and capitalized on this existing schedule. The posted calendar would act as a reminder to staff and encourage them to be more proactive in their awareness efforts. This increased emphasis on awareness months within CommWell and their staff will hopefully result in a spillover effect. After involving and informing staff, it became necessary to involve the community at large.

In order to encourage and spread awareness into the community, CommWell will continue working on corresponding awareness flyers for each month. These flyers will be available to print and display within CommWell sites and other locations. In addition to printable versions, these flyers will be available for online sharing and social media display. This is a small-scale project, but it is hoped to increase awareness and curiosity within the community. An additional goal of this project is to reinspire the staff to incorporate these awareness months into their patient interactions. It is hoped that increased awareness and health literacy on important and relevant health topics will result in better health outcomes for the communities CommWell serves.

Although my involvement in this project has been limited to the beginning stages, it has been a valuable learning experience to see the startup of a social media awareness campaign. I was able to enact both foundational competencies seven and eight, as I worked with CommWell to identify an area for improvement and began implementing a potential solution. I hope that the ultimate goal of the project is realized, and the awareness of health topics in the community increases over the next year. Awareness is an important part of improving and individual’s and subsequently a community’s health. CommWell understands the value of knowledge in the community and is working to do their part in improving health outcomes through information and understanding. I think the most unique lesson I learned from this experience is that sometimes changes starts from within. It was an important step for CommWell to re-inspire their staff in order to enact effective change.

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Beginning to think about how to integrate our individual projects into a cohesive presentation!

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Working with CommWell Health has demonstrated numerous public health competencies, but experiencing management, collaboration, and decision making firsthand will be most applicable in future projects and positions. Working with others is ubiquitous within the field of public health. This was made evident by our guest speaker Steve Pfaff. As a meteorologist his primary concern remained communication within the organization, between other organizations, and with the public at large. Competency F16 states, “Apply principles of leadership, governance and management, which include creating a vision, empowering others, fostering collaboration and guiding decision making.” At first glance this principle seemed straightforward and self-explanatory, but as the semester has progressed it became evident this can be a significant challenge to productivity if not applied correctly.

As a result of our teams uniquely independent projects, collaboration has been key to successfully accomplishing mutual goals within our practicum. Despite working on separate tasks, it has been important to coordinate our efforts. We successfully discuss and identify necessary goals for our practicum as a team. It has also been very important to work together to distribute assignments. There has been zero conflict among our group regarding who intends to accomplish what tasks. We have fairly divided and conquered the various goals CommWell has provided us. Similarly, once we have completed an assignment, we share our experiences with the group. This has allowed our group to acquire a big picture understanding of the importance of our contributions. All our seemingly separate projects work together to prepare the organization for the Joint Commission. By sharing our individual projects with one another, we are better able to understand how it all works together towards that goal. These debriefing sessions with the team have also better prepared us to begin to approach the final project. It will be vital to our final project to connect our individual tasks in a meaningful way; we are better prepared for this after sharing our independent projects with one another. As a team, we have successfully collaborated and communicated to accomplish our goals.

In addition to successfully working together as a group, it is equally as important to coordinate with the preceptor. This aspect of management and collaboration has been more of a challenge; however, this challenge has given us a better understanding of the meaning of competency F16. The first obstacle to overcome is scheduling. It is a difficult task to orchestrate five different schedules to align on a regular basis. Our preceptor contact is exceptionally busy given the upcoming Joint Commission visit, which has at times made regular contact between our group and the preceptor difficult. This is relevant to real world public health work. Healthcare workers are often overworked and understaffed, especially in rural environments. Future work may involve international partners, in which time zones impact meeting availability. Whatever the reason may be, meeting with a team can pose lots of challenges. It is important to manage your time in an effective way and to be creative in your coordination efforts. Technology has created a plethora of options for distance communication. It may not be possible for every member of the team to attend every meeting. In these instances, collaboration within the team is vital to keeping each member informed.

As a result of communication barriers, our team encountered some miscommunications between our preceptor and our faculty advisor. These disconnects within the project inadvertently created tension. This only acted as an opportunity for our team to practice professionalism in uncomfortable situations. It is likely disagreements will occur in any future public health work, so experiencing that mishap within this practicum was a valuable and useful experience. It allowed us to utilize valuable resources and contacts within the public health program to help resolve the issue. Addressing the issue and overcoming the tension required collaboration, leadership, and management on the part of our team. Although it was not the best aspect of teamwork, it was an unavoidable part of the collaboration experience that I will be able to learn from and apply in future projects.

The practicum experience has allowed me to better understand the importance of collaborating with a team, as well as the potential difficulties coordinating with outside organizations. I am appreciative of the realistic experience. It has also put into perspective the potential challenges of public health work. The challenges we have faced have been on a minor scale, but these challenges exist with even greater significance in all organizations and public health projects. The difficulties we have faced make the success of our project even more enjoyable.

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Excited to potentially visit the organization we have been working with this semester! Team CommWell is waiting on approval for an on-site trip to CommWell Health!

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Working with CommWell to consolidate their various nutritional health assessments! Enjoying the opportunity to apply some of the concepts discussed in community health assessment to the real world!

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Team meeting to discuss the direction of our practicum presentation! We also addressed the ways we intend to get more hours!

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My first task assisting Commwell Health addressed policies for their Behavioral Health Service facilities.  They have two residential locations; Harvest House serves males who are suffering from substance abuse and Angelic House serves females who are struggling with substance abuse.  As facilities that house patients, there are a plethora of required policies that are not directly related to treatment and health.  For example, both Angelic House and Harvest House must have fire safety protocol, visitor procedures, and admissions processes documented.  Although gender specific, these behavioral health living houses have almost identical policies, yet they each have them documented separately.  This dual record of identical policies is unnecessary and confusing for those who may need to reference the policies.  I was instructed to blend the similar documents into one cohesive policy for each topic.  By consolidating the various copies, it will simplify record keeping for the organization and make the policies more easily assessable.

Although the policies I have been working with do not directly relate to health and treatment, it has already become apparent to me the vast resources required to operate substance abuse houses like Harvest House and Angelic House.  The admission process alone required involvement from team members and substantial resources.  For each patient these facilities assist, there is an extensive checklist required before treatment can even begin.  Almost every step of the process requires the attention of a nurse or a physician.  In addition to the high demand of resources required by Commwell Health, seeking treatment can also place a large burden on patients.  Even in the mundane policies I have been working with, these challenges are apparent, and it only began to scratch the surface of the demand treatment can have on a patients homelife.

As mentioned in class readings, substance abuse has significant implications on individuals living in rural areas, especially for individuals who are minorities or have low income.  One of the policies mentioned above addressed Commwell Health’s willingness to coordinate with legal aides regarding custody battles.  This brought to my attention that the patients seeking assistance at these facilities are potentially mothers and fathers.  What implications does their seeking treatment have on their family life? It requires a support system to step away from your home for treatment, especially for individuals who may have children.  What if an individual is unable to obtain long term childcare? In order to focus on ones’ sobriety, they must have a network of individuals helping them and substantial resources.  Another policy addressed this week was the visitor procedures.  Although the opportunity to see friends and family is likely beneficial to one’s morale during treatment, the family of patients must have transportation to utilize visitation sessions.  This is another example of the barriers rural low-income residents may have seeking treatment in a residential facility.  Unfortunately, not everyone has a social support system in place and not everyone has the financial resources to utilize the services Commwell provides.  

In addition to the barriers patients must overcome to make use of treatment facilities, they must also overcome limited access, a problem that is exacerbated in rural areas.  Commwell Health attempts to bridge this gap, by providing locations in rural areas; however, they are still limited in the number of people they can help at one time.  In addition to their finite resources, they are one of few available treatment centers, which indicates a high demand for their services.  One of the policies I blended referenced a waitlist protocol.  Our readings briefly addressed the potentially long waitlists for facilities in rural areas.  This brought to my attention that individuals seeking help may be temporarily turned away as a result of limited capacity.  Delaying treatment could potentially have adverse effects on their sobriety.  In an effort to alleviate this limited access to rural residents, Commwell Health does prioritize individuals from rural counties in their waitlist considerations.  Commwell Health is a vital resource to rural residents, but the barriers for rural residents seeking treatment remain a challenge.  

It is my hope that consolidating these policies simplifies the lives of those directing these vital facilities.  These policies are important to the daily functioning of Harvest House and Angelic House, and it is important they are easily understood and accessed.  These policies have only given me a glimpse into the work and maintenance required for residential facilities to function.  Treatment centers such as these are a valuable tool to increase access for rural individuals struggling with behavioral health issues such as substance abuse.  Although rural residents may still encounter financial and social barriers to seeking treatment such as childcare, treatment payment, and transportation, Commwell is providing a valuable resource to rural communities.

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I’m grateful for our $50 dollar printing allowance as I review and blend policies for Commwell Health’s Behavioral Heath Service facilities!

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Team Commwell’s first meeting with our preceptor! Excited to hit the ground running! Please ignore my excessive snack collection!

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Team Commwell “smiling with our eyes” as we exchange contacts info in preparation for the semester! @Taylor@Mallory@Will