Author: DW Admin

By Andy Hernandez, Community Development Manager

Health starts in our homes, neighborhoods, workplaces, schools and churches. Health happens where we live, work, play and pray. It happens in the material and social conditions in which we live. These elements combined shape—for better or worse—our well-being and health outcomes.

Social Determinants of Health

How much money do we make? Do we have health insurance or not? What is our level of education? Do we live in a low-income or high-income neighborhood? How safe is our home and workplace? The answers to these questions help explain the health of a community by determining connectedness. These factors determine what opportunities we have to be healthy. This is generally referred to as the, "social determinants of health." They account for over 40 percent of all health outcomes, twice as much as access to medical care (20 percent). Social, environmental and economic factors contribute more heavily to the health and well-being of individuals than anything else.

Where We Live

Methodist Healthcare Ministries of South Texas, Inc.'s (MHM) mission is "Serving Humanity to Honor God" by improving the physical, mental and spiritual health of those least served in the Rio Texas Conference of The United Methodist Church. Overwhelmingly the underserved are the working poor. Simply put, poverty adversely affects your health as does being underemployed, undereducated and uninsured. If we want to create conditions that nurture healthy people, we have to change the social and material conditions that make people and communities unhealthy. This means helping those in need gain access to health care services, obtaining insurance coverage through the health insurance marketplace, help raise education and income levels, and help make their communities safer. Ultimately, it means helping people lift themselves out of poverty.

Healthy Communities

Community engagement and development strategies found in asset-based community development initiatives, youth sports leagues, family-strengthening programs, strengths-based nursing practices, and "upstream" clinical care protocols are linked to improving the social determinants of health. To create healthy environments, you have to develop healthy communities. We all play a part in this process. We are where health happens. We have the power to collectively impact the conditions of our community. My team, the MHM family, does this everyday. How do you play a part in improving the health of your community?

By Dominica Garza, Communications Manager

Language is something many of us take for granted – the ability to communicate with others, to read, to write. Communication helps us to create shared meaning between two or more parties. But, what happens when there are barriers to communication like the inability to read or to understand the native language of the country in which you reside, or much worse, what if you cannot speak the language?

A PBS special titled, "Do you speak American? Texas English," asserts that English is, historically, the second language of the state. Even setting aside the languages of Native Americans in the area, Spanish was spoken in Texas for nearly a century before English was. According to the Modern Language Association's Language Map Data Center, more than 90 languages are spoken in Texas. Of that, English is spoken by 65.80 percent of people over five years old in Texas, while languages other than English are spoken by 34.20 percent.

This diversity makes it especially difficult to provide education, and diagnose and treat health conditions. Language differences can be a huge barrier in providing effective healthcare.

Diabetes, obesity and mental illness – some of the more prevalent conditions faced by Texans – don't discriminate based on language. Because of this, it's important for healthcare providers to acknowledge the importance of language when interacting with their patients or clients. At Methodist Healthcare Ministries (MHM), we understand the vast landscape of spoken language in South Texas. To help our healthcare providers and team members performing outreach, we contracted with LanguageLine Solutions® to provide us with access to their over-the-phone operating system. The system provides team members with access to a LanguageLine interpreter to listen to a patient or client, analyze their message and accurately convey its original meaning to the MHM staff person.

It's been a great tool to help remove language barriers and address health concerns. Many patients or clients who seek our help are already in distress. They sometimes fear hospitals and clinics because they do not have the means to afford treatment or they are coming to us as a last resort and are in dire need of assistance. In this state of heightened distress, we want to eliminate obstacles that slow down or hinder our ability to provide care or treatment. LanguageLine is a resource to help us provide care in the communities in which we serve.

by George Thomas, Chief Operating Officer

The Wesley Theological Seminary, a teaching seminary and service-oriented community located in Washington, DC, has identified a variety of health ministry models to include:

1. Congregational Health & Wellness Ministry – Health ministry seeks to find common ground among other congregational ministries, such as social justice, religious education, volunteer visitors, hospitality and youth ministries.
2. Health Ministers – Health ministers are healthcare professionals, barbers, stay-at-home parents and lawyers to accountants. They can take be health navigators, wellness coaches, outreach workers, health educators, and health ambassadors, promoters de salud and health promoters.
3. Faith Community Nursing – The American Nurses Association, working with the Health Ministries Association, approved a new registered nurse certification program for Faith Community Nurses. Faith Community Nursing, formerly known as parish nursing, is a process for active licensed registered nurses to obtain a specialty practice certification by portfolio beginning in 2014. Some of the key roles of a faith community nurse may include health education, health counseling, referrals, health ministry team coordinator and volunteer coordination.
4. Hospital/Primary Care Based Congregational Networks – With the Affordable Care Act healthcare legislation emphasizing population-based care and improved health care continuity for patients, the health minister and faith community nurse roles shows promise. From a hospital's and primary care provider's perspective, these roles are valuable in that they provide linkages and connections into the community, especially faith communities.
5. Community Based Congregational Networks – Health ministry teams from different places of worship often join together in local or regional networks to share resources and support each other through regular meetings.

At Methodist Healthcare Ministries (MHM), we have adopted a Faith Community Nursing approach to health ministry. This model is carried out through our Wesley Nurse Program, which was established in 1997 and has grown to serve 80 sites throughout South Texas making it MHM's largest geographic outreach program. All Wesley Nurses are Registered Nurses – an aspect unique to MHM. Currently, all Wesley Nurses are in the process of becoming certified in Faith Community Nursing. The certification is awarded through the American Nurses Credentialing Center in partnership with the Health Ministries Association.

From a primary care perspective, Wesley Nurses are an invaluable link in the healthcare delivery continuum. They connect people, congregations and community to health and wellness. They motivate others to action while remaining grounded in faith. We could not operate successfully without this important ministry.

By George Thomas, Chief Operating Officer

The American Medical Association describes clinical integration as:

"The means to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, and patient-focused." Similarly, one of the principle mandates of the Affordable Care Act is to encourage or promote methodologies for reducing costs, increasing efficiency and enhancing the quality of care."

My interpretation of clinical integration and this mandate is that healthcare providers need to find innovative ways to provide a higher quality of care. Far too often, the news is blanketed with stories of malpractice, mismanagement, or – far worse – news of tragedy that could have been prevented.

While Methodist Healthcare Ministries of South Texas, Inc.'s clinics (Wesley Health & Wellness Center; Bishop Ernest T. Dixon, Jr. Clinic; and School Based Health Centers in Schertz and Marion) are not accredited by The Joint Commission – a leader in accrediting and certifying health care organizations in the United States – we do abide by a very strict and well-formulated set of standards in order to provide high quality care to low-income families in South Texas.

The American Medical Association understands the value of clinical integration, and the Affordable Care Act specifically addresses the need for improvements in the delivery of care. We at Methodist Healthcare Ministries, too, must look at ways to improve our operations.

It reminds me of the 'pot roast story' many of us have heard: One day after school a young girl noticed that her mom was cutting off the ends of a pot roast before putting it in the oven to cook for dinner. She had seen her mom do this many times before but had never asked her why. So this time she asked and her mom replied, "I don't know why I cut the ends off, but it's what my mom always did." So the young girl called her grandmother on the phone and asked, "Grandma why do you cut the ends off the pot roast before cooking it?" Her grandmother replied, "I don't know. That's just the way my mom always cooked it." Undeterred, the girl called her great grandmother and asked her the same question – why did you cut the ends off the pot roast before cooking it? She said, "When I was first married we had a very small oven, and the pot roast didn't fit in the oven unless I cut the ends off."

I hold this story very close to me. I want to always question our practices: Are we being good stewards of our resources? Are we looking for innovations to improve our operations? Do we have a safe environment for our patients? Are we providing quality care?

Far too often, health care providers practice in silos. They lack meaningful connections and their information exchanges with other health care entities or providers is limited. Without coordination, patients are more likely to receive duplicative diagnostic tests, have adverse prescription drug interactions and get conflicting care plans.

Clinical integration is a continuous process of alignment across the care continuum that supports the Triple Aim of health care: Improving quality of care; reducing or controlling the cost of care; and improving access to care and the overall patient experience.

Knowing that this is a continuous process, I am going to continuously ask questions, measure outcomes and look for improvements because I believe our patients' well-being is of the utmost importance.

By Kathy Crosby, RN, Wesley Nurse

I have been a Wesley Nurse since 2013. Early on, I learned a main function of the Wesley Nurse profession is assessing the needs of the community in which I serve. Although I work for Methodist Healthcare Ministries of South Texas, Inc. (MHM), headquartered in San Antonio, my actual work site is at First United Methodist Church in Bastrop. Bastrop is located about 30 miles southeast of Austin and is situated in the Capital District of the Rio Texas Conference of The United Methodist Church – the Rio Texas Conference defines MHM's service area.

During my time in Bastrop, I witnessed the need for a respite program in Bastrop. The caregiver and elderly community was large in heart and might, but severely lacking in support and resources.

I worked with the Alzheimer's Association and Bastrop First United Methodist Church to form a partnership to address the need. Brenda Zimmerman, who later became the volunteer director for the soon-to-be group, made the program a reality. Through her leadership and the commitment of 24 volunteers, the Bastrop New Hope Respite program officially launched on September 25, 2014.

The program is 100 percent volunteer-driven and funded by the generous donations of community members. Bastrop New Hope Respite provides a safe, faith-based environment for persons in the early to middle stages of Alzheimer's and dementia-related diseases, and is offered every Thursday from 10:00 a.m. to 2:00 p.m. at no cost. Attends receive a snack and home-cooked lunch.

In a relatively short period of time we have already twelve regulars to the group. Volunteers support the group by playing games, making crafts, conducting sing-a-longs, exercising, and bringing in special guests.

To support volunteers and caregivers, I facilitate a Caring for the Caregiver Support Group with Dorothy Williams, LBSW. The group meets every Thursday from 10:00 a.m. to 11:00 a.m.

I can't put into words the joy I feel when I observe first-hand the fulfillment members of the group receive. Some who were once withdrawn are now socializing with others and now have a place and network to belong to. I believe God's work is at hand in the city of Bastrop.