Donors willing to fund “out of the box” solutions to our community’s health problems can make a big impact and help improve the way VMC provides care to its patients. With grant funding from El Camino Healthcare District, Valley Health Center Sunnyvale now has a Public Health Nurse, Joy Almquist, who visits the homes of high-risk chronic disease patients to assess environmental and home conditions that influence health behavior, and assists with the coordination of community resources. Though only in its first year, the program is already having a significant impact on people’s lives.
One of the most common patient needs is assistance with medication management. Joy works with a patient named Pamela who has a complex medication regimen that includes more than 20 prescriptions plus oxygen therapy for treatment of emphysema.
Once home from a doctor’s visit, patients like Pamela can have a hard time managing all of their medications, so Joy makes home visits to provide one-on-one help with strategies for medication compliance. Joy’s work with Pamela has also helped avoid readmission to the hospital – whenever Pamela is having a hard time breathing she communicates with Joy who determines if the issue is urgent and can quickly arrange for a clinic visit. Pamela recently shared with Joy, “I don’t know what I’d do without you. This program is very important especially for people who can’t get around. You come to my home and it makes it so much easier and more personal.”
Joy also works with Melvin, another patient referred for assistance with medication management and compliance. Joy helped Melvin establish a routine for taking medications and checking his blood sugar, which has improved his health. With Joy’s help, Melvin also keeps and attends his dental and medical appointments on time, enabling him to remain home and stay independent.
Assessing environmental factors is something Joy is also trained to do. In her work with April, a patient with cirrhosis who is dealing with related symptoms, Joy focused on the importance of good nutrition and abstaining from alcohol. Together they discussed how April could adopt a liver-friendly diet, and Joy shared resources for alcohol counseling and treatment. Joy has actively helped April address barriers to attending her regular follow-up appointments with her primary care provider. April shared, “Joy has absolutely changed the way I think about my body and myself. I had the worst eating habits and, until I got sick, I never understood how it was all related. She makes me want to do all the right things to stay healthy and get my body and mind focused on long-term goals.”
Indeed, Joy says that her patients’ goals become her goals. She works to help patients maintain good health with her guidance and encouragement, which can make all the difference for those with complex medical conditions and challenging environmental factors. Having a dedicated Public Health Nurse working directly with VHC Sunnyvale’s primary care team means that every patient who needs individual support in a home setting can receive it, ideally improving the health of patients and reducing trips to the emergency room. Shari Hurst, VHC Sunnyvale Clinic Manager, shares, “I am confident that the collaboration between Public Health and Adult Primary Care at VHC Sunnyvale has helped patients in the North County area get access to key services that improve their health and well-being. The collaboration is an example of creative, patient-focused teamwork.”
With the support of El Camino Healthcare District, we hope to continue implementation of this innovative program at VHC Sunnyvale and establish a model of care that can be replicated to help patients throughout Santa Clara County. You can learn more about El Camino Healthcare District’s investment in the health of our community in their 2013 Community Benefit Report.