title: Community health worker integration into the health care team accomplishes the triple aim in a patient-centered medical home: a Bronx tale.
abstract: 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.
authors.affiliation: Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York (Dr Findley); Community Health Worker Network of NYC, New York (Mr Matos); True North Consulting LLC, New York (Ms Hicks); Center for Minority Health Equity, New York University, New York (Ms Chang); Department of Family Medicine, Bronx-Lebanon Hospital, Bronx, New York (Dr Reich).
authors.forename: Sally
authors.initials: S
authors.lastname: Findley
authors.forename: Sergio
authors.initials: S
authors.lastname: Matos
authors.forename: April
authors.initials: A
authors.lastname: Hicks
authors.forename: Ji
authors.initials: J
authors.lastname: Chang
authors.forename: Douglas
authors.initials: D
authors.lastname: Reich
mesh_terms: D003150:Community Health Workers / Q000458:organization & administration*; D005194:Family Practice / Q000458:organization & administration; D006786:Hospitals, Urban; D006801:Humans; D009519:New York City; D019982:Organizational Case Studies; D010348:Patient Care Team / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration*; D036301:Qualitative Research