The Common Good
August 2013

The Power of Partnership

by Bob Smietana | August 2013

Memphis' Congregational Health Network has become a model for how hospitals and faith communities can work together.

THE CONGREGATIONAL HEALTH NETWORK began with a simple request from the largest hospital network in Memphis to a group of local pastors: Help us take better care of your people.

Ten years ago, officials at Methodist Le Bonheur Healthcare were worried that chronic diseases such as hypertension, diabetes, and obesity were threatening the well-being of local residents and sending health-care costs through the roof.

“People in their 20s were coming to the emergency room in end-stage renal failure,” said Rev. Bobby Baker, a Baptist pastor and director of faith and community partnerships at Methodist Healthcare. “That person is going to be using critical care resources for the rest of their life.”

Hospital officials knew something had to change. They wanted to focus on preventive health care—getting people in to see their doctor long before they were in a crisis. So in Memphis, a city where faith remains a powerful force and more than 60 percent of the population has ties to a religious group, they turned to churches for help. It started small, with a group of about a dozen pastors at churches near Methodist South hospital, in the city’s Whitehaven neighborhood. Those pastors recruited church members to serve as liaisons to the hospital, while the hospital assigned staff to work with churches. That small pilot, first called the Church Health Network, began in 2004.

Two years later, Methodist CEO and president Gary Shorb, along with Rev. Gary Gunderson, the former senior vice president for Methodist’s faith and health division, decided to expand the project system wide. That was the only way to make a significant impact on health outcomes, said Baker. “The thought was that it can’t be a pilot, it can’t be a research project—it really has to be broad reaching,” he said.

Today, the Congregational Health Network (CHN) has become a model for how hospitals and faith communities can work together. More than 500 congregations, including Baptist, Methodist, and Church of God in Christ, have signed up to be part of CHN, representing more than 15,000 patients. Eleven hospital employees, known as navigators, work with congregational volunteers, known as liaisons, to help congregation members make their way through the health-care system. The network offers weekly classes ranging from “Caring for the Dying” to “Mental Health First Aid.” More than 2,000 people have taken at least one class.

All of this has helped congregations such as Oak Grove Baptist Church in the Riverview-Kansas neighborhood of Memphis keep their people healthier, said Rev. James Kendrick. It begins with preventive measures, such as healthy eating, and goes all the way through to aftercare. Church members who leave the hospital are tied into a support network when they get back home. Kendrick was one of the first pastors to sign on with the network. He said that like most people, his congregation’s members hate going to the hospital. But being part of CHN has made Methodist seem like a more welcoming place. In the past, he said, the hospital seemed like an impersonal institution. That’s no longer the case. Church members have met doctors and other hospital staff while taking classes through the network.

“Methodist is not just a place anymore,” Kendrick said. “It has a face and name.”

Hospital president Shorb and board members also held one of their meetings at Oak Grove Baptist, which is in one of the poorest neighborhoods in Memphis. It’s a community where abandoned buildings and vacant lots are commonplace, where a nearby store sells beer and junk food but no fresh produce, and where there are no primary- care doctors. By coming out to his neighborhood, Kendrick said that hospital officials got a better view of the context people live in.

Methodist hopes to get people to go see their primary-care doctor early on, instead of going to the emergency room. But that’s made more difficult if there’s no doctor in your community, said Kendrick. He believes hospital officials now have a better understanding of how other factors, such as crime, unemployment, and lack of access to good food, also affect a community’s well-being.

“Those are all health issues,” he said.

The input of pastors such as Kendrick has been an essential part of the success of the CHN. He was one of a dozen or so pastors who helped shape the program from the beginning. Back in 2006, Baker, who was then a hospital chaplain, convinced Kendrick and some of his other pastor friends to join what was known as the covenant committee. The idea was to have pastors serve as a kind of steering committee for planning the network. They drafted the covenant agreement that every church signs when they join CHN. They also designed some of the early programs, said Baker. That way pastors had ownership in the network.

“THE REAL POWER of the partnership is trust,” said Baker. “The first thing we did was let pastors in on the design of the program. We didn’t just put it in a can and roll it out to them, and say, ‘Hey, go do this in your congregation.’”

 Teresa Cutts, director of research at Methodist’s Center of Excellence for Faith and Health, said that the network was built on trust and friendship. Baker and a number of the other hospital chaplains were bivocational ministers. That means while they had a day job at the hospital to pay the bills, they also served as pastors to congregations out in the community. In a sense that made them bilingual, able to speak both the language of pastors and that of hospital administrators. They could also draw on their relationships with other ministers to build CHN. Those pastors trusted Baker and other chaplains and so were willing to give the hospital a chance.

“We called it trust by proxy,” said Cutts.

In the early days, said Baker, trust was all he could offer. “In the beginning, all we had was a promise,” he said. “We did not have a program. We went to pastors and said, ‘This is what we are going to do—will you help us do it?’ And we have been able to live up to what we promised. I am very thankful to God for that.”

Hospital officials made one other important decision early. That was to use electronic medical records to track all the patients who register with the Congregational Health Network. Every church or house of worship in the network gets a card with the patient’s name on it and the name of their church. When they are admitted to the hospital, the network navigators use the information on the card to let a pastor know that their church member might need a pastoral visit. Those navigators also fill out a spiritual care plan form, which lists practical information—such as if the patient needs a meal dropped off or a ride to a follow-up visit, or someone to pick up their medication. The card also lets the hospital track the health outcomes of church members.

So far, CHN seems to have a positive effect. In fact, being part of a network church just might save your life. For a research project, Cutts compared 2,281 participants in the network with 4,522 nonparticipants who were not part of the network from 2008 to 2011. Mortality in the network went down by half, meaning that those who were part of a network church were less likely to die during that time frame. “We like that statistic,” said Cutts.

Network members also averaged about $8,700 less in hospital costs. And patients with serious illnesses such as congestive heart failure were far less likely to have to be readmitted after leaving the hospital. That’s good for everyone, said Cutts. “If we can lengthen the span that they are out of the hospital, it is better for the patient and it is better for the hospital,” she said. Those statistics are even more impressive given that most of the network members are older and many were already patients of the hospital.

A report for the Health Systems Learning Group, a collection of 40 health systems around the country, touts the experience of a patient known as “George.” George, who is in his 80s, has been in the program for two years. The year before he signed up, he’d been admitted to the hospital eight times for congestive heart failure. After signing up, his church’s liaison helped him plan his diet, get his medication, and watch for signs such as weight gain that could show his condition was worsening. “In the first year of CHN community caregiving, George’s admits decreased in half to only four admits, and in this past year, George has only been to the hospital one time,” said the report.

Early returns show that not only is patient health improving, but also the cost of caring for them has gone down. One report, which looked at some of the first patients in the network, cited a savings of about $4 million. That’s enough for the hospital to keep funding the program, which costs between $750,000 and $1 million each year. “This is an investment in our future,” said Methodist CEO Shorb. “It’s telling us what could work and what doesn’t work.”

Rev. Eric Winston of Mt. Zion Baptist Church said that one reason the network works is that the hospital and the churches have formed a safety net for people when they get sick.            

Church members can keep an eye on one another, and they know who to call at the hospital when a member has a health crisis. He points to the Comprehensive Sickle Cell Center at Methodist as an example. A longtime member of his church named Keisha was diagnosed with sickle cell as a young girl. The condition can cause excruciating pain when it flares up. Winston said that the first time he visited Keisha in the hospital, all she could say was, “Pastor, just pray.”

Children with sickle cell in Memphis get great care at St. Jude Hospital, but that falls off when they become adults, said Winston.          

Methodist started a new sickle cell center to help those adult patients. They are able to register with the center, and if their condition flares up, they’re able to get immediate treatment. That’s important because treating a crisis early means patients can avoid a hospital stay. “It’s the difference between six hours in the center or seven days in the hospital,” he said.

LAST FALL, WINSTON organized an annual fundraiser for the sickle cell center called the Clergy Chase. It’s a 5k run at Overton Park in Memphis, where the pastors start running and church members chase them down, said Winston. The run not only raised funds for the center but it also helped get the word out to pastors about the center, so they can tell their church members who might be affected by the disease.

One side benefit is that the run helps pastors get in better shape. When they sign the covenant to join the network, pastors promise to model good health to their parishioners. Winston said that he’s lost 20 pounds in recent years, mainly by better diet. “I am trying not to dig a grave with my teeth,” he said.

Winston, who’s also a professor at Memphis Theological Seminary, said the network shows that the hospital understands the change in U.S. church culture. In the past, churches were tied to institutions such as hospitals along denominational lines. Now denominations are declining, and churches work together out of friendship and a shared sense of mission. Church members aren’t just getting medical care as part of the network. They are also joining a kind of family. “That’s what you have to have today—community,” said Winston. “Because that is what we don’t have much of.”

That community is a two-way street. Churches benefit from the network, but they also help the hospital. As part of the network, the hospital started a faith and health committee on its board and invited pastors such as Winston to serve on it. They get access to the hospital’s financial reports, like all other board members, and a vote in how the hospital is run.

“That showed the church community that the hospital was genuinely concerned and let us have voice—where we never had voice before,” he said. “That really showed that they care.” 

Bob Smietana is a religion writer for The Tennessean in Nashville.

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