Accelerating Best Practices in Peer Support Around the World
2.21.14

CHW Integration in a PCMH

J Ambul Care Manage. 2014 Jan-Mar;37(1):82-91. [Pubmed Abstract]

Community health worker integration into the health care team accomplishes the triple aim in a patient-centered medical home: a Bronx tale
Findley S, Matos S, Hicks A, Chang J, Reich D

Community health workers are ideally suited to the care coordination niche within the patient-centered medical home (PCMH) team, but there are few case studies detailing how to accomplish this integration. This qualitative study documents how community health workers (CHWs) were integrated into a PCMH in South Bronx, New York. Results show that integration was linked to clear definition of their care coordination role within the care team, meticulous recruitment, training and supervision by a senior CHW, shared leadership of the care management team, and documented value for money. By helping the team understand patients’ backgrounds, constraints, and preferences, they helped everyone genuinely focus on the patient.

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