Sunday, March 18, 2012

What? How? Who? Why? (When?)

It's been a big week in Memphis, mostly in spite of me (due to the announcement of my move to Wake Forest this coming July). It has been a good week to remind everyone that the smartest, most resilient and viral aspects of the work has roots deep in the Delta mud, not me.

On Monday a group from the hardscrabble Appalachians came to see if the Congregational Health Network was tough enough for those bitter hills. Staff from Mountain States Health Alliance in Eastern TN and Methodist Hospital in Henderson, KY were the core of the regular "adaptation" workshops. (Not "replication" because every community has different assets to weave with.) Here Valerie Murphy explains how our volunteer CHN Liaisons work with Navigators, their clergy, our chaplains and all sorts of community agents to help people navigate their life journey. She models a common CHN characteristic: multiple identity order. She is one of the lay pillars of Friendship UMC church, sings in the choir and is quality officer at Methodist North hospital. CHN manages extraordinary complexity because most of the people involved all permitted to bring the full complexity of their lives to bear on the opportunities.
Dr. Deborah Minor teaches in the Innovation Studio

On Saturday the Innovation Studio was filled for an all day train-the-trainer workshop led by the University of Mississippi Medical School. Fifty One people were trained to teach and certify  "community health workers"-- the workforce on which the health of the community utterly depends. We need good cardiologists and all the other 21st century oligists, too. But they are helpless to advance the health of the community down on the streets where things matter. The content of the training is not rocket science. It is way more important: nutrition, how to talk to the doctor and understand prescriptions, take blood pressure and such. Who needs to know this stuff? Every grandmother, sister, wife, girlfriend and church caregiver in Memphis. And who can train them? This room has all of our CHN Navigators and most of our chaplains, as well 9 people from the Memphis public health department, some liaisons our churches, staff from the Church Health Center and one executive mainly drinking coffee (me).

Michael Jones, RN, MBA teaches Russel Belisle, Navigator.
We tell our Board of Directors that the point of all this is to "build and align community health assets to improve access to services and to improve health status over time." This is what the building part looks like; beautiful, really. While the stupid storms about religion and politics swirl in cynical circles, in this room a public medical school doctor and nurse teacher people of faith how to to fulfill part of the promise God makes about abundant life. It is work not magic, but still astonishing.

And all the while the number of congregations grows, drawn by the hope they can play their role in fulfilling God's promise, too. We thought we'd reach about 400 and then taper off, but the surge only quickens, lifted in the past year by two hundred Church of God in Christ members.

In between these two events the Memphis Model built on CHN was honored by AHRQ--the federal Agency for Healthcare Research and Quality. They include CHN in their Innovation Exchange: tools to improve quality and reduce disparities. They don't write poetry, titling the piece on CHN : "Church-Health System Partnership Facilitates Transitions from Hospital to Home for Urban, Low-Income African Americans, Reducing Mortality, Utilization, and Costs." It really does do all that.(http://www.innovations.ahrq.gov/content.aspx?id=3354) This is the best short description of CHN and the Memphis Model there is, so I urge you to read it. But you have to come look at it to really see how.


What do you have to know in order to spread the model? The model is preposterous in its complex blending of intelligence and partners so it take a while to even understand the "what." And the "how" continues to elaborate, too, taking all of two days to unpack the detail for groups like our new friends from Appalachia. 


It is the who and the why that are the magic. The "who" includes nearly everybody relevant to God's hope for wholeness in this tough town. And the "why is closely related. To many, even including the AHRQ, the thing looks like public health. This isn't exactly wrong, since it functions at the scale of the public and is advancing health big, fast and wide. However, the congregations are not becoming little public health agencies and the public health department is not becoming a church. To nearly everyone involved it feels more like a movement. 


So when does it move? It moves only at the speed of trust which is not just one person at a time. Trust  is caught, too. You can catch it from Michael Jones, for instance, even as he teaches. You can catch it from Valerie Murphy, too. And the CHN Navigators and the original agents of trust, the chaplains. A movement is the thing that moves us, not the thing that we move.  They are, as Jonas Salk and Heather Wood Ion suggested, more like a virus than a todo list. Movements are not taught; they are caught.

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