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Patients in medically underserved communities benefit from Northwestern Memorial's philosophy that everyone should have access to quality medical care. Partnerships with neighborhood-based health centers ensure that the full continuum of care - starting with prevention - is available regardless of a patient's ability to pay. Specifically, Northwestern Memorial is working with its community partners to fight disparities in breast cancer and diabetes.
Avon Foundation Breast Cancer Initiative
Based on multiple social and economic factors, low-income and minority women are less likely to get mammograms, more likely to have undetected breast cancer, and suffer higher rates of breast cancer mortality. Working with Erie Family Health Center, Northwestern Memorial strives to improve access to mammograms and quality breast cancer care for women in underserved communities through tracking and education. The effort is funded through a grant from the Avon Foundation's "Supporting the Safety Net" initiative, which was written and secured by the Northwestern Memorial Foundation.
Through this collaboration, Northwestern Memorial makes it possible to screen more low-income and minority women for breast cancer, while establishing an electronic tracking model that can be replicated in other community health centers to save lives across Chicago.
The patient database tracking system, designed and implemented with help from Northwestern Memorial's Information Technology specialists, allows Erie to document the number of women who are referred for screening, how many receive mammograms, the rates of abnormal mammograms, and the number of women who need and receive appropriate care. This information is vital to assuring that Erie staff can follow up with patients and provide the necessary care.
Through the program, Northwestern Memorial Physicians Group provides free and discounted mammograms at its Bucktown facility, located a short distance from Erie Family Health. While mammograms are also offered at Northwestern's main Streeterville location, the Bucktown location eliminates transportation barriers faced by many Erie patients.
Sharing the expertise of physician-researchers David Baker, M.D., M.P.H. and Mita Goel, M.D., M.P.H., Northwestern Memorial helped design the patient education program to simultaneously address factors that make it more difficult for Hispanic women to get mammograms and proper follow-up. Efforts include focus groups to deepen understanding of barriers to care; culturally appropriate educational materials, developed with input from Erie patients; a promotora de salud - "health promoter" - to follow up with women who have not had a mammogram within 30 days and those who have abnormal results; and group appointments providing a supportive environment, education from the promotora and transportation to and from the mammography office.
Specially trained and certified health educators, promotoras de salud easily establish trust and open communication with patients who might be more agreeable to talking to a peer - "someone like me" - rather than to a doctor or nurse. Research has found that when working with promotoras, Hispanic patients tend to receive more routine care, ask better questions and ultimately take better care of their health.
The Diabetes Care Project
Near North Health Services Corporation, along with Northwestern Hospital, Northwestern University and the Northwestern Memorial Foundation, has embarked on a comprehensive five-year collaborative effort to improve healthcare for people with diabetes and help them better manage the disease in their daily lives. Ultimately, the project will become a model of care for chronic disease that has a measurable positive impact on the health of underserved people.
Along with the rise in obesity, diabetes is becoming increasing prevalent in this country. Studies show this is especially true among African Americans and Hispanic populations, who are also less likely to receive proper care and more likely to develop life-threatening complications from the disease.
Since 1999, Near North Health Services Corporation has participated in the National Diabetes Collaborative, a national project of the U.S. Department of Health and Human Services' Bureau of Primary Health Care. Near North Health Services Corporation is one of several participating Federally Qualified Health Centers that is collecting and reporting clinical data, which will be used to create national benchmarks for standards of care and treatment of diabetes. The local collaborative has been modeled after the national project's Health Disparities Chronic Care model, which emphasizes "self-management" - teaching patients how to care for their condition and how to be more active participants in their own healthcare.
Limited resources and other barriers make this endeavor especially challenging for community health centers. As a result, Northwestern partners with Near North Health Services Corporation to provide salary support for the diabetes care team at NNHSC, including internists, nurses, dietitians, case managers and data analysts.
The project also leverages Northwestern's academic expertise in diabetes and the use of technology to improve care. Specifically, Northwestern's Feinberg School of Medicine Department of Internal Medicine researchers are developing and testing innovative materials to educate patients about diabetes and what patients themselves need to do to control the disease in their daily lives. Materials include both plain-language, enhanced print materials, as well as multimedia tools for diabetes education and interactive learning. These materials can be used by patients and providers to discuss and document treatment goals, such as hemoglobin A1c, blood pressure monitoring, LDL cholesterol, exercise, and foot and eye exams.
Northwestern has also offered expertise and support regarding process improvement, guiding diabetes care team members through the Six Sigma DMAIC (Define/Measure/Analyze/Improve/Control) method. This is a proven process improvement method adopted by Northwestern Memorial that helps to reduce costs, increase revenues and increase customer satisfaction while maintaining a high level of quality.
To enable the ongoing success of the Diabetes Care Project, the Northwestern Memorial Foundation continues to seek funding to support the five-year initiative.
