9 Tips to integrate Promotoras into Health Center Care Teams
Changes in health care policy have shifted delivery systems towards more patient-centered models of care. To adapt, Health Centers have sought new strategies, such as Promotora de Salud programs, to reform the way their care teams function. As members of the communities they serve, Promotoras (or Community Health Workers) are in a unique position to contribute to Health Center care teams. Their expertise in the culture of the community can help a care team better understand the context behind a patient’s condition, leading to the development of more effective care plans. Although Promotoras can be an asset to any care team, to flourish in this role they need Health Center support. These tips will help your Health Center integrate Promotoras into a care team.
1. PREP THE TEAM
Clearly explain to the care team what the Promotora’s role will be and what services they will provide. As a member of the team with their own distinct expertise, the Promotora should be treated as a peer. Explain that although they will be contributing as a peer, they will play a supportive role, as they do not have the same clinical training.
2. HIRE FULL-TIME PROMOTORAS
This will reinforce that they are a peer and that they are bound to the same ethical and confidentiality codes as other employees.
3. RECRUIT THE RIGHT CANDIDATE
Look for the essential traits recommended for a Promotora and for experience, even in a different role, in the health field. Be sure the candidate will be comfortable speaking up at team meetings. If the applicant has not completed all of the required training, provide it for them.
4. PROVIDE AN INTENSIVE ORIENTATION
For many Promotoras, it can be intimidating to work alongside clinical staff. Providing the appropriate training will not only ensure that they have all the necessary skills and knowledge to work in a clinical setting, but it will also help the Promotoras build confidence in their abilities.
5. REGULAR SUPERVISION MEETINGS ARE KEY
They allow the supervisor and Promotora to problem-solve difficult cases, track accomplishments, and identify and discuss areas for further training. As non-traditional health workers, this one-on-one time is very important in making the Promotora feel supported.
6. INCLUDE PROMOTORAS IN FREQUENT TEAM MEETINGS
Team meetings build a cohesive team and are the optimal time for the Promotora to provide input into a care plan as it evolves. This will also allow the team to stay up-to-date on the Promotoras’ work, and vice-versa.3
7. ALLOW PROMOTORAS TO DOCUMENT THEIR WORK ON EHRs
This allows clinical staff to directly see and benefit from the impact of these services. Also, Promotoras are often in a much better position to collect accurate and honest patient data, particularly for social and environmental factors.
8. SUPPORT PROFESSIONAL DEVELOPMENT
Ongoing training will help Promotoras fill gaps in their knowledge or skillset. They will also benefit from networking opportunities by participating in local professional groups and attending conferences.4 In addition, periodically offer their direct supervisors relevant training opportunities.1,6
9. SHARE RESULTS WITH LEADERSHIP
If the Promotoras’ work has been carefully documented, conducting an evaluation and getting results will be much easier. The results obtained from a meaningful evaluation are critical to the sustainability of a program. Share them with leadership often to gain continued support for the program.
- Brownstein, J. N., Hirsch, G. R., Rosenthal, E. L., & Rush, C. H. (2011). Community health workers 101 for primary care providers and other stakeholders in health care systems. Journal of Ambulatory Care Management, 34(3), 210-220.
- Shah, M., Kaselitz, E., & Heisler, M. (2013). The role of community health workers in diabetes: update on current literature. Current diabetes reports,13(2), 163-171.
- Findley, S., Matos, S., Hicks, A., Chang, J. & Reich, D. (2014) Community Health Worker integration into the health care team accomplishes the triple aim in
a patient-centered medical home: A Bronx Tale. Journal of Ambulatory Care Management, 31(1), 82-91.
- Allen, C., Escoffery, C., Satsangi, A., Brownstein J. (2014). Strategies to improve the integration of Community Health Workers into health care teams: “A little fish in a big pond”. Preventing Chronic Diseases, 12. 5. Pittman, M., Sunderland, A., Broderick, A. & Barnett, K. (2015) Bringing Community Health Workers into the Mainstream of U.S. Health Care. Institute of Medicine. 6. National Association of Community Health Centers (2015). Community Health Worker integration into primary care settings. Available from http:// blogs.nachc.com/hcnews/wp-content/uploads/2015/01/Issue-Brief_CHWs-atCCI-FINAL-010515.pdf (Accessed April 8, 2015).
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This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under cooperative agreement number U30CS09744, Technical Assistance to Community and Migrant Health Centers and Homeless for $617,235.00 with 0% of the total NCA project financed with non-federal sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.