Former hospital environmental workers support health in the neighborhoods of Winston-Salem

By Les Gura

In the small but neatly appointed living room of Shirley Gray’s home in east Winston-Salem, Annika Archie and Vernita Frasier gently ask Gray questions and offer reminders.

“How’s your blood sugar?”

“Are you eating well at home?”

“Do you feel like you’re healing?”

“Do you have any family members to help you?”

“You look so pretty in that.’’

The last comment was Archie’s compliment for the deep red dress Gray was wearing on the afternoon that Archie and Frasier visited. The two women, both longtime employees at Wake Forest Baptist Medical Center, used to clean rooms as part of the hospital’s Environmental Services team.

Today, Archie and Frasier work full time for FaithHealthNC, reaching into the community to help dozens of patients with assistance after a hospital stay — everything from making sure their medicines are taken in the right dosages and at the right time to connecting them with resources that might help them pay utility bills or rent.

How Archie and Frasier became a key part of the FaithHealthNC team is indicative of the transformative nature of health care in the 21st century and a testament to — in Archie’s words — faith.

“FaithHealth is about the Lord God coming to me from a different direction,’’ Archie says. “When I look back, I could tell I was already doing this type of work before. Sometimes, when I was cleaning a patient’s room, they’d tell me they were in need of a prayer or some type of assistance. And I’d be in the phone book looking and telling them about resources. This just gives me a better chance to advance what I know.’’

A program takes shape

In late 2012, Wake Forest Baptist Medical Center, like many other hospitals, was facing unprecedented financial challenges, yet looking for every way to preserve its triple mission of care, research and education.

Gary Gunderson had just arrived as vice president of faith and health ministries from Memphis, where he had seen hundreds of congregations help the hospital control the cost of its care to the most vulnerable neighborhoods. “Who could do such work on the streets in Winston-Salem?” he wondered.

The answer fell on the table when Gunderson found himself in a meeting discussing the Medical Center’s environmental services workers, some of whom lived in the very neighborhoods where need was concentrated.

Gunderson proposed a partnership between his division and environmental services, promising to save the hospital money in charity care by making use of the environmental services workers in new ways.

“Everyone knew that proactive is better — and cheaper — than reactive,’’ Gunderson says. “This is how to be proactive.”

With the support of Karen Huey, the Medical Center’s vice president for facilities, it was decided to train the employees to assist FaithHealthNC. Over the next few months, Archie and Frasier became full-time members of FaithHealthNC, while two other Environmental Services employees — Pecola Blackburn and Mary Dendy — began working part time for FaithHealthNC.

Close to 200 patients and families have been served by the initiative already, says Jeremy Moseley, project administrator of community engagement for FaithHealthNC.

“It’s all about building trust and showing people we are part of the mission as well,’’ he says.

Perhaps most important, all Environmental Services employees are encouraged to talk with patients and share their needs with appropriate people in the Medical Center, most often chaplains or nurses. Today, helping patients get on track with follow-up care and avoiding readmittance is critical for both patients and hospitals.

Milander Smallwood, education manager for Environmental Services, says his team’s members had long spoken with patients, but didn’t always know what to do with the information they gained.

“Now they know they can help,’’ Smallwood says.

Keeping people comfortable

Shirley Gray was admitted to the Medical Center last winter with severe pain and a terrible cough.

It turned out she had pancreatitis, with an inoperable stone in her pancreas. She would be in and out of the hospital several times, and during one of those visits, she was diagnosed with diabetes.

By the spring, when she was again released, she was assigned to Archie. People have a natural affinity to Archie, whose outfits alone — she wears a large colorful hair clip every day to match her bright clothing — are enough to cheer patients and draw compliments.

“I appreciate it,’’ Gray says of the concern Archie and Frasier show for her well-being. “They’re very nice and keep me comfortable. I’ll call and tell her I have a problem and she’ll tell me to call the doctors and they’ll come and see about me. If I need some food, they get it for me.”

During a typical visit to Gray’s home — they see her once every two weeks and speak with her by telephone at least weekly — Archie will run through a list of reminders.

Amid talk of family, fashions and television, she’ll make sure Gray is taking her medications, inquire about any new pains Gray might be experiencing and ask about her financial situation.

When she realizes Gray might not be properly checking her blood sugar level, Archie promises Gray she’ll get her the help she needs with a care team to ensure her diabetes doesn’t land her back in the hospital or, worse, the emergency room.

A natural connection

Many of the Environmental Services employees grew up in the area and are familiar with the neighborhoods of the patients they encounter. So it is building on a strength to take advantage of the employees’ knowledge in the community to assist patients.

Frasier, for example, grew up down the block from Gray. When Frasier told Gray to “keep on hanging in there, baby,’’ it held an even greater significance. Gray smiled as she recalled the Vernita Frasier she remembered.

“You were little, about like that,’’ Gray says, holding her hand to her hip.

Archie says she appreciates the fact that patients such as Gray care as much for her as she does for them.

“Some people just want to hear you or see you,’’ Archie says. “It can be healing for their situation.”

Between the jobs saved and the work being done by Archie, Frasier, Dendy and Blackburn, everyone wins, Gunderson says.

“It feels great to help people and my hospital at the same time by doing the right thing at the right time.”

UPDATE: Read the article by the Institute for Healthcare Improvement here.