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Growing the Health Workforce: Community Based Residency Training

Growing the Health Workforce: Community Based Residency Training. Allen L. Hixon, MD Associate Professor and Vice Chair University of Hawaii Department of Family Medicine and Community Health. Social Determinants of Health. Social determinants of health are:.

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Growing the Health Workforce: Community Based Residency Training

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  1. Growing the Health Workforce: Community Based Residency Training Allen L. Hixon, MD Associate Professor and Vice Chair University of Hawaii Department of Family Medicine and Community Health

  2. Social Determinants of Health

  3. Social determinants of health are: • the conditions in which people are born, grow, live, work and age, including the health system. • these circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. • mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries. • WHO CSDH

  4. How we receive care N Engl J Med 2001; 344:2021-2025 June 28, 2001

  5. Neighbor Island Health • Poor health outcomes • Access to care • Drastic shortage of primary care • Current shortage 150 primary care physicians to meet national physician to population ratios • With aging/retirement of workforce demand will increase • Withy/Sakamoto

  6. Hawaii Island Rural Residency Program • Problem – Physician/provider shortage, limited access to care, rural neighbor island focus • Proposed solution – Increase physician/provider pipeline by developing a rural interdisciplinary FM residency program and collaborative training site • 12 residents (four per year) based in Hilo Hawaii • Collaboration • Hilo community/Hilo Medical Center • UH SONDH • UH College of Pharmacy

  7. Hawaii Island Rural Residency • Principles • Meet real needs of community • Interdisciplinary team based • Financially sustainable • High quality teaching and patient outcomes

  8. Needs Assessment SHPDA Workforce Data NHHS FQHC Alliance Mayor’s Office Others Planning Academic partners JABSOM School of Nursing and Dental Hygiene College of Pharmacy Funding CMS HRSA HMSA Tri-West State of Hawaii HMC Foundation Shipper’s Wharf Individuals Implementation HMC UCERA JABSOM Steering Committee with community partners Collaboration

  9. Medical Students/ Learners Hawaii State Legislature Hilo Medical Center Residents Medical Staff Foundation TriWest Rural Residency HMSA JABSOM Patients/Community Family Medicine Faculty School of Nursing College of Pharmacy HRSA CMS

  10. Progress to date • Collaborative clinical practice site • 2 family physicians (one more coming) • 1 APRN • 1 PharmD • 1 RN • 1 GYN consultant • Telepsychiatry program

  11. Next steps • ACGME FM accreditation • Build clinical practice and teaching • Develop interdisciplinary curriculum • Patient Centered Medical Home • Quality initiatives

  12. What we did well • Solution oriented • Messaging re: workforce shortage and critical need • Created public-private partnership for funding

  13. Barriers to collaboration • Underestimated level of complexity • Created expectations • Timeline • Cost • Did not fully understand objectives, expertise or limitations of the various partners • At times communicated poorly with partners

  14. Engaging the Community • Social determinants are the conditions that exist in the community that promote or undermine good health • Program success linked to level of community support • Be informed • Advocate with lawmakers

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