“Patients have many needs that go beyond what medical care can provide,” says Clarissa Hsu, Ph.D., Group Health Research Institute assistant investigator. So she, along with physician Dr. Dan Delgado and a team of Group Health patients and staff, set out to learn how best to connect patients with community resources that can support their health goals outside of the doctor’s office.
Their pilot project, Learning to Integrate Neighborhoods and Clinical Care (LINCC), has created the role of community resources specialist to serve as the “link” between primary care and community resources at Group Health’s Rainier and Puyallup medical centers. The pilot project was awarded grant funding in 2012 by Washington, D.C.–based Patient-Centered Outcomes Research Institute (PCORI), and patients have been helping Group Health shape that role via workshops.
The specialist helps patients create a plan for better health and then locates places that can help put that plan into action, such as the YMCA for exercise, farmers’ markets for nutritious food, and community centers for child care or childbirth classes, events and senior programs. Hsu says that expanding the primary care team to include a community resources specialist helps “ensure [patients] are getting the support they need to improve or maintain their health.” The pilot is funded through 2016, and the LINCC team is working to find additional funding to keep the project going and to collect data about how the role is working for patients.