Community Health Worker Outreach to Assess Confounders of Health

Background and ObjectivesIn July 2020, recognizing the potential conflict between COVID-19 quarantine guidelines and other medical and social needs, a university-affiliated family medicine clinic developed a workflow to support patients who test positive for COVID-19. The workflow relies on Community Health Workers (CHWs) to call patients, identify needs, and connect them to community resources, with the goal of reducing barriers to maintaining COVID-19 isolation. The objective of this study was to understand the design, implementation, and maintenance of the workflow to provide guidance for other primary care practices interested in developing similar workflows. MethodsThis qualitative study was conducted in a federally qualified health center. Key informant interviews were conducted with six personnel involved in the workflow. Using a semi-structured interview guide, interviewers asked participants about the design, implementation, maintenance of the workflow, and benefits and harms. Interviews were analyzed using an immersion-crystallization approach. ResultsAcross all workflow phases, adaptability and content expertise were reported as essential for workflow success. The main barrier was the lack of coordinated COVID-19-related workflows across the system. Delivery of whole-person care was identified as the primary benefit to both patients and the healthcare system. ConclusionsInterview participants felt that integrating CHWs into the workflow benefitted patients and the clinic. For other practices interested in implementing a similar workflow, themes for success include a workflow framework built on patient-centeredness, adaptability, and the unique content expertise of CHWs.