Integrating Community Health Workers on Quality Improvement
Including CHWs on a quality improvement team is a great way to maximize their potential. While they don’t receive formal government employment, they’re outsourced and paid a small stipend for six hours of work each day. They also face challenges connecting with their private payroll company and traveling to outlying areas without reliable transportation. And, before the fieldwork began, CHWs had gone on strike for two months.
The introduction of community health workers in health care organizations has several benefits, including improving patient outcomes and culturally sensitive care. In addition to addressing the provider shortage, CHWs can also increase patient access to quality care. While scholarly interest in CHWs has increased in recent decades, studies have tended to focus on CHWs’ effect on patient outcomes rather than their role in the health care system. Hence, in this article, we describe some of the advantages of integrating CHWs into quality improvement teams.
By integrating CHWs into healthcare quality improvement projects, health systems can better serve the needs of the community and reduce unnecessary health care use. The use of CHWs helps to reduce health disparities, which is a related aim of the Triple Aim. In Massachusetts, the DPH is committed to widespread integration of CHWs into health care. Further, CHWs are capable of analyzing data and designing improvements for quality improvement.
Community health workers are vital members of a community. They serve as the link between patient care providers and community services, bridging cultural and communication gaps and providing health education. Community health workers are trusted members of the community, often having close knowledge of the community and working with social service agencies to help patients access needed services. They help advance health equity for historically marginalized populations. It’s also important to note that CHWs are not limited to health care delivery.
The purpose of the cooperative agreement between the Center for Innovation in Social Work and Health (CISWH) and the Department of Health and Human Services (DHHS) is to increase CHW utilization in HIV care settings and improve access to health care services for minority populations. The Center will evaluate the impact of CHWs on quality improvement, as well as their integration into HIV care systems. The findings of these studies will be shared with other organizations that seek to integrate CHWs into their services.
Integration of CHWs on quality improvement efforts is important in reaching remote and poor communities, especially in rural areas. Community health workers have many duties and need effective supervision. The chief provider of a health center in Madagascar reports monthly to a CHW, while a community health worker in a rural community is usually not directly responsible for implementing quality improvement efforts. This collaboration is vital to achieving quality improvement, but it requires careful planning.
Implementation of CHWs into clinical care teams has a strong evidence base. Several research studies conducted on this intervention have demonstrated both strong internal and external validity. The Community Preventive Services Task Force concluded that CHWs improve health outcomes while reducing costs, especially for high-utilizers. The evidence base for CHW integration is strong and implementation guidance is available from various sources. In addition to research studies, the Community Preventive Services Task Force has recommended integration of CHWs as a quality improvement approach.
