Submitted by Wendy Schmidt, MBS, BAN, RN, Senior Learning and Development Specialist at Sanford Health
Bismarck implemented a Community Health Worker (CHW) program in January 2021. With almost a year of experience, this role is showing early, but promising, impact on the population served. A CHW is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served.
This trusting relationship enables the worker to serve as a liaison between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.
Sanford Health added three CHWs in North Dakota after receiving a grant from the Administration for Community Living in August 2020, with the goal of addressing social determinants of health and connecting those in need with community resources. The Sanford CHW is also a trained leader in Better Choices Better Health. This evidence-based workshop teaches those with chronic conditions how to self-manage and live life to the fullest.
In January 2021, the Bismarck CHW began meeting with patients to address social determinants of health barriers. To date, 71 percent of patient encounters, both in person and telephone, have been a result of problems related to housing and economic circumstances. Twelve percent have been due to problems with employment and unemployment, closely followed by problems with education and literacy (8 percent). To address these issues, the CHW works closely with the healthcare team and community agencies and walks with patients to navigate the various systems.
These Social Determinants of Health (SDoH) barriers are tracked through the use of Z Codes. Z codes are ICD-10-CM codes which identify non-medical factors that influence a patient’s health status. Z55-Z65 specifically relate to a patient’s social needs and are the codes we are using at Sanford to better capture data related to CHW work. Currently, there is no billing associated with these codes and they need to be entered for every patient encounter.
Within the first year of data collection, a considerable reduction has been noticed in emergency department (ED) visits and inpatient encounters six months before and after a meeting with the CHW. From January through April 2021, the average number of ED visits and inpatient encounters were reduced by 60 percent and 65 percent respectively.
Source: Q Insider; Vol 2, Issue 12 | December 13, 2021