Community Circles: Transforming Care in Downeast Maine
All of these outcomes have helped improve the healthcare delivery system in our county. Perhaps the most dramatic example is the development of a transitions-of-care model with the local county jail, which coordinates medical and behavioral healthcare for inmates with mental illness and/or substance abuse when they are released from jail. The transitions-of-care pilot was conceived in one Circle when a participant wistfully shared her wish to improve the system of care for inmates with mental illness. Eastport Health Care created and implemented the pilot within three months of inception. It was then shared with healthcare colleagues in Washington County.
Gay/Straight/Transgender Alliances Community Circle
Another long-standing Circle is the Gay/Straight/Transgender Alliances (GSTA) Community Circle, whose aim is to improve community alliances in our local high schools. Convening every six weeks since June 2014, this Circle has included over 100 voices from our county, including primary care and behavioral health providers, local university faculty, peers, straight youth, advocates, the local AIDS organization, the Maine Primary Care Association, and others. Outcomes that have emerged from this Circle include demystifying beliefs about individuals who identify as lesbian, gay, bisexual, transgender, queer, or other; newspaper articles to raise awareness about challenges and shame associated with sexual identity; standardized educational posters that define different categories of sexual identity; a palpable sense of trust in a community where significant caution and isolation had been present; development of a private Facebook Web page and Tumblr account; facilitated conversations; and a way to pose questions confidentially. The GSTA Community Circle is planning a major training and education workshop, to be held in October 2016, which will bring educators and healthcare providers together at a common venue. The workshop will be all-inclusive for the lesbian, gay, bisexual, transgender, queer, and straight communities. Two more local high schools have established GSTAs, bringing the total to three as of early 2016.
Caregivers/Palliative Care Community Circle
Established in early 2016, the Caregivers/Palliative Care Community Circle provides a venue of support for caregivers and those who know the journey of palliative care. Though young, the Circle has already made significant contributions to our community. It has developed a library of books and articles that will be donated to the local library; compiled a list of local resources (with contact information); created a lending library of music CDs to support the ease and comfort of those on the palliative care journey; identified gaps in needed resources to contribute to planning; and facilitated a Circle dedicated to Thriving in Place, which is a statewide program sponsored by the Maine Health Access Foundation (MEHAF). MEHAF plans to support communities that seek to improve the access to and quality of resources available to elderly or infirm residents.
Healthcare delivery transformation
Much is at stake as we strive to transform healthcare delivery away from “talking at” and “doing to” patients, instead working toward collaborating with patients to deliver high-quality, cost-effective service. Only in the last decade have we begun to see true team-based care that brings healthcare providers, support staff, advocates, resources, and patients together as active participants. Especially with a goal of improving health outcomes, the current health delivery system must manifest a culture of inclusion by actively engaging patients and families.
This lofty goal appears to be gaining traction. We are, however, far from embracing what the paradigm shift really means. If we are to achieve patient-centered care, we must slow our frenetic pace. This calls for becoming still, honing our listening skills, and modeling the emerging culture change from reactive to responsive. As we shift from managing disease to improving health, this point is critical.
How do we foster responsiveness in a healthcare system as massive as ours? How do we fully embrace societal change? How do we achieve real-life relationships in an industry steeped in tablets and smartphones? How do we combine the logical, evidence-based core of our current healthcare delivery system with mindful heart/spirit connections? How do we become still in the roaring river of change that seeks immediate solutions?
Community Circles reflect a solution others may want to consider. Our work demonstrates that they are an exceptionally effective way to take action. The Community Circle model empowers and honors the peer voice, reflects attentive and responsive listening, and promotes community engagement. It has helped us create transformative change in Eastport and Washington County.
Holly Gartmayer-DeYoung is CEO of Eastport Health Care in Eastport, Maine. She began her career in New York state as a nurse in various settings, including public health, geriatrics, forensic psychiatry, and outpatient dialysis. Gartmayer-DeYoung has also served as an administrator with progressive leadership roles in community hospitals, nursing homes, and federally qualified community health centers. She holds a bachelor of science degree in nursing from Molloy College in Rockville Centre, New York, and a master’s degree in business administration from Long Island University, also in New York. She may be contacted at hdeyoung@eastporthealth.org.
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