Integrating community health workers into mainstream health systems through partnerships

Background: Health system leaders are often unaware of the potential value realized when including community health workers (CHWs) in healthcare delivery models. A group of RWJF Executive Nurse Fellows, recognizing this knowledge gap, developed a resource guide to facilitate implementation of polyvalent CHW programs in health systems and to achieve the “Triple Aim” of improved individual care, improved population health, and decreased healthcare costs.

Description: The purposes of this presentation are to discuss changes in the healthcare delivery environment, to identify opportunities for partnerships between advanced public health nurses and nursing leaders in healthcare systems, and to describe the usefulness of the CHW resource guide.

Lessons Learned: Strategies including intra- and inter-professional collaboration can address the skepticism that may exist about CHWs, their roles and competencies; how to integrate them into healthcare systems; and how to attain smooth transitions of care. Challenges include the potential clash between acute care and community-based care approaches and the lack of consistency in CHW selection criteria, training, scope of practice, roles, responsibilities, workload, reimbursement, and outcome measures. Facilitators of program success include meaningful engagement of community and other key stakeholders. Champions are critical from the beginning phases of CHW program planning to phases of program evaluation and outcome measurement.  

Implications: Key partnerships to integrate CHW services into healthcare systems using existing community/population programs whenever possible will leverage the potential for program success. Monitoring CHW services with feedback from stakeholders will assure best chance to address problems and revise program plans on an ongoing basis.