Chelsey, a resident of the Great Beginnings Program of Valley Youth House, and her son receive health care from DeSales University nursing students as part of the Regional Integrated Collaborative for Healthy Youth (RICHY) program
Chelsey was a teenage mother-to-be with her first child when she became a resident at the Great Beginnings facility of Valley Youth House in east Allentown earlier this year.
Not knowing what to expect once her baby was born, she was often anxious that her son was sick and needed medical attention. Her first inclination was to take him to the emergency department at the local hospital, and she’s not alone in that reaction. An increasing number of emergency department visits are by patients who need non-emergency medical treatment and who are uninsured, adding cost to the region’s health services and community.
Two years ago, two local colleges, the region’s largest health network, and two community non-profit organizations came together to spearhead what would become The Regional Integrated Collaborative for Healthy Youth (RICHY) program.
Together these partners developed a unique initiative designed to support these young mothers with health services for themselves and their babies, empower them to become more active managers of their own care and that of their child, and also educate them on how to best utilize the local healthcare system, thereby reducing costs. This novel pilot program is believed to be the first of its kind in the country, which will result in a case study and model for others.
The RICHY Project’s partners include:
- DeSales University Department of Nursing and Health
- The Dorothy Rider Pool Health Care Trust
- Lehigh Valley Health Network (LVHN) Department of Community Healthy, Department of Family Medicine, and the Lehigh Valley Physician Group – Family Health Center
- Marywood University School of Social Work
- Valley Youth House – Great Beginnings independent residential living facility in Allentown
Using an integrated behavioral health model, in January family nurse practitioner students from DeSales and social work students from Marywood began working onsite at Great Beginnings with its at-risk adolescent girls and young mothers and five babies eight hours a week. Supervised by university faculty and LVHN clinicians, the students provide preventive medical and behavioral health services and education all onsite at Great Beginnings. The program provides an access point to primary care for an at-risk teenage population that is difficult to engage. This initiative ensures that every adolescent who resides at Great Beginnings will leave the program with a primary care provider for her and her baby, where applicable.
During the first six months of the 12-month pilot program, LVHN has collected data related to patient health literacy, activism, and utilization of the healthcare system. Data highlights include:
The Valley Youth House Great Beginnings residents attended 41 visits to the Nurse Practitioner-Behavioral Health team during the first six months of the program. Seventy-eight percent of these visits focused on health management, which is a primary goal of the program.
Use of the Emergency Department (ED) was minimal during the first six months. The adolescents went to the ED only one time, and three ED visits occurred for the young children of the VYH residents. Moreover, five ED visits were avoided by having access to the services provided through this initiative.
Eight of the residents have become patients at LVHN’s Family Health Center (FHC), connecting them to a family medicine primary care practice. These eight individuals have engaged in 15 visits at the FHC across five months. All but one resident now has a designated primary care provider, either at FHC or elsewhere.
Two DeSales undergraduate nursing students also conducted group education sessions. All of the residents who attended these sessions reported positive feedback, noting that they enjoyed speaking with the nurses and learning new information about self-esteem and self-image, when to go to the ED or seek medical help, signs of illness in young children, and healthy relationships.
The final 12-month data report will help determine if this unique model can become self-sustaining once The Pool Trust’s $124,669 grant funds supporting it have ended. It will attempt to determine what the value of the program was to the mothers and the organizations involved, if better outcomes were realized for the patients, if decreased healthcare costs were seen, and how it might be possible to fund such a model in other communities.
“One of our primary goals in the Great Beginnings program is to empower young mothers in creating healthy independent lives for their children and themselves,” said Lisa Weingartner, Regional Director of Northeast Independent Living Programs with Valley Youth House. “Providing quality healthcare and supporting youth in using the healthcare system is essential to reach this goal. The RICHY project is a collaborative effort providing the youth with on-site access to healthcare, but more importantly a level of healthcare education that empowers the girls to make their own healthcare decisions. Having this knowledge coupled with access to integrated services has improved their quality of life and given them and their children a better chance at future success.”
“When I came to Valley Youth House I was pregnant and no had experience at being a mother,” explains Great Beginnings Resident Chelsey. “When my son was born I really didn’t know what to expect. It made me really nervous and scared when I thought he was sick. Because I didn’t know much I would become concerned very easily and would want to go to the emergency room. The nurses in the RICHY project have helped me to understand the difference between an emergency and something minor that can be taken care of by his doctor or at home. I know I can go to see the nurse and she will take the time to check things out and let me know what I need to do. There is also a 24-hour hotline that I can call with doctors who are available. This makes me feel like I have someone I can talk to all the time and it helps me to relax and get my son the help he needs. It is like another support system that helps me make better healthcare choices. This makes us both much happier and healthier.”
"This program is about helping young women with a difficult past improve their lives and the lives of their children by emphasizing good health,” said Robert Motley, MD, chair of LVHN’s Department of Community Health. “The early results of this program are promising. They demonstrate a shared commitment to improving care and value through better health, great patient experiences and mindful stewardship of resources —the 'Triple Aim.’”
“In the RICHY project, undergraduate nursing students have a valuable clinical experience,” explained Mary Ellen Miller, RN and Associate Professor, Department of Nursing and Health, DeSales University. “They engage in inter-professional practice with Valley Youth House staff and advanced practice nursing and social work students. This is an educational opportunity that extends beyond the classroom and provides a unique learning environment for our nursing majors.”
"Appropriate and coordinated support to individuals in ways that most benefit and respect the needs of the patient at a reasonable cost is a desirable goal in the brave new world of health care services,” said Edward F. Meehan, Executive Director of The Dorothy Rider Pool Health Care Trust. “The RICHY Project is an excellent approach to that goal. The Pool Trust is pleased to support the effort and we offer our best wishes to the leaders at LVHN, and the local academic and community-based institutions who have worked so diligently to make this effort a reality. We believe it can be replicated and can serve as a model.”
“The project has been a valuable learning experience for Marywood social work student Shannon Lehr, who graduated in May 2015,” said Christina Gigler, Marywood University Clinical Instructor and Director of Field Education for Lehigh Valley and Pocono MSW Programs. “As the field director in the Lehigh Valley location of our MSW program at Marywood I could not have been more pleased with all that she was able to accomplish working with other nursing students and team members to help her clients. She was able to practice all that she was learning at Marywood in an integrated collaboration with other professionals. It was truly invaluable. As an executive committee member of the RICHY project, I have truly enjoyed the community that this collaboration has developed into and I look forward to future students having this opportunity.”
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