Podcast host, Emily Viverette

Viverette: This is the Faith Health Learning Forum Podcast, a podcast series designed to offer insights into the vision of FaithHealth NC, a dynamic partnership between Faith Communities, Wake Forest Baptist Medical Center, and other healthcare providers focused on improving health. I’m Emily Viverette, Director of Faith Health Education. This particular series focuses on mining the wisdom of key leaders within the division of FaithHealth Ministries at Wake Forest Baptist Health. Today, I’m talking with Jeremy Moseley, Director of FaithHealth Community Engagement in our division. His background is in public health, but I really see Jeremy as modeling the heart and soul of our work. He has been one of the key architects of our work here. Jeremy, thanks for talking with us today.

Moseley: Thank you. Glad to be here.

Viverette: I wonder if you could start by sharing a little bit of your background. What is your passion for public health?

Moseley: Well, I would have to stay it started with both of my sets of grandparents. They both, I would say, were giving people. They would give you the shirt off their back. That’s the cliché, but they would absolutely do that. My grandmother was someone who prepared meals for our farm community, anyone can come, anyone was served, and you could also take seconds home with you. She was probably the beginning of it all, beyond the professions that my parents had, but she was definitely the example that I wanted to follow throughout the rest of my life, always giving a gift until I couldn’t give anymore.

Viverette: There’s a lot of the work that we’re doing now that is about feeding people, and nursing people, and transporting people.

Moseley: Absolutely.

Viverette: That’s so wonderful. You’re from eastern North Carolina, so we both know eastern North Carolina well.

Moseley: Yes.

Viverette: We like the right kind of barbecue.

Moseley: The right kind.

Viverette: We’ve heard a little bit about your interest in public health, and I know that Gary Gunderson lured you over into FaithHealth from another part of the hospital, not long after he came on board here. How did he do that and what attracted you to what he was bringing?

Moseley: I will back up and say he did not lure me. It was a natural fit. I was asked to attend a presentation that Gary provided at Kate B. Reynolds Charitable Trust and that was the first time I learned about the Memphis Model. I had no idea that he was being recruited to Wake Forest Baptist the that time. I was just there to learn, to understand the model. I quickly saw that without the faith networks, without the social networks, the social fabric and communities of spirit aligned with the health system, we would only go so far. We had made some progress in getting our clinical teams out into the community, which was a good first step, but it was not the place where we needed to be to build long-term relationships and to look at health more holistically. Gary didn’t lure me. It was definitely something that we had to work together on to build a community that we want to see here in Winston-Salem and beyond.

Viverette: Well, tell us a little bit about your role because actually, you’re the director of the newest department in the division, Community Engagement. What is your role?

Moseley: Well, as the director, I oversee a group of supporters of health. Traditionally, they’re called community health workers. They were former environmental services staff here at the medical center, but they are our hands, eyes, and feet out in the community. They perform a lot of the home visitation that our patients often need or request, individuals who often do not have family members involved in their care, or social networks. Many of the people we serve are not members of congregations, for example. We provide sort of an extended family through our supporters. I also oversee a group of connectors both locally and regionally that provide similar support, but more so building the social networks around the patients that we try to serve. Those are my main tasks. I also have responsibilities with community benefit, our community health needs assessment processes, and many leadership capacities that Gary often involves me in.

Viverette: I’m glad you brought the work of the supporters and the connectors into the conversation because I think people will want to hear a little bit more about what is the difference between those two roles? How do you think about them? How are they funded?

Moseley: Sure. Well, supporters, they are funded through our medical center. They are part of our operations, part of our corporate services. They’re paid like employees like all of us are. Connectors are more of a contracted role. They’re paid a stipend once per month for one to two days per week of service. They are not really considered employees but they are definitely attached to our department and division. The way I see the role distinction, it’s more of an indirect-direct involvement. I see the supporters as more direct. If you think of community case management, if you think of what social work would look like in the community, they provide a similar function.

They have a certain skillset that allows them to enter into complex neighborhoods and complex communities that many other people can’t enter. Connectors can do some of the same. However, they are many times individuals who work full time, or by vocational, so they may not have the time or the ability to do some of the hands-on work that our supportive health would do, but they have relationships that extend beyond our supporters network. For instance, if you think of civic organizations, faith communities, sororities, fraternities, many of the things that we say comprise the community, they have direct relationships with those entities. They can bring a new set of partners to the table that our supporters would not be able to do.

Viverette: Well, both groups have really remarkable heroes within each of them, and the connectors as I’ve seen them, are really folks who are doing this work already, and now we’re just helping to support what they’ve been doing their whole lives. In some cases, or in all the cases, the supporters are the same way. We’ve added funding to their passion.

Moseley: Absolutely.

Viverette: I’m curious, is there a story that comes to mind? Maybe a great success story from the supporters and/or the connectors or some combination?

Moseley: I can’t think of one particular example, but I would say most of the success stories involved multiple components of our health system. I always like to tell those type of stories when our discharge planners, or our care coordinators are involved. We may make a referral to CareNet for example, for more counseling post-intervention. It’s those stories that involve the entire team, the entire health system inside that walls and also the team outside in the community. Those to me are the most rewarding stories. It takes a village, and I think when we can articulate members of that village and the different roles that they play, those are the most powerful success stories.

Viverette: Well, one of the supporters we haven’t mentioned because her role is slightly different is Angela Brown. I think for a long time, we all knew that we needed an Angela Brown, but we didn’t know how badly until we actually got her. Could you say a little bit about what her work is?

Moseley: Yes. Angela serves as our patient or client referral coordinator. Basically what that means, she handles the influx of referrals that we receive over the phone, through email, through our electronic medical records system, through our website, through walk-ins. We have individuals who walk into our office on occasion seeking assistance. She’s the one who speaks to that individual or provider, assesses the referral to see if it’s appropriate for FaithHealth to get involved. She makes sure that we get permission to get involved, and that’s really a critical point. We don’t want to presume that we know that the individual has granted us rights to access their records or go into detail about their needs, so we make sure that happens first.

Angela is that filter to get people into our system. Then, she assesses what type of network or what type of staff member should get involved. That goes beyond community engagement. Sometimes we have to seek the support of our chaplains and chaplain residents, sometimes we have to refer to Care Net as I mentioned earlier. She has become, sort of, the triager for anything involving our division that is patient or client related. I think that’s a critical piece of what we do. It also allows us to track, I would say the outcomes of those referrals that we received. She keeps databases and she keeps information on what actually happens in terms of our involvement.

Viverette: One of the stories that came to mind, I think is something that Angela was involved in, where there was a patient who was admitted and upon discharge really needed a ramp, but we couldn’t discharge her because there was no ramp. Are you able to share a little bit about that?

Moseley: Sure. I think it’s a great story in that there’s some economic factors in this story. A lot of what we do feels good. It’s the right thing to do that we believe, but it’s also the most economical in some circumstances. This individual was an in-patient, I believe had been in-patient for about three weeks to maybe a month. The care coordination team was unable to figure out how to discharge this individual because they had come in the hospital walking, but now they would be discharged with the use of a wheelchair. So that person’s total life has just changed. Who else to call, but FaithHealth? We will definitely make an effort to figure out how we can assist care coordination. Again, we work together, but we identified that there was a need for a wheelchair ramp in order for the patient to gain entry into their home. We had a Baptist connector at the time, Rev. Tony Brown, who was actually one of our first connectors. But he knew all of the ministries within the Baptist Network that were involved with building ramps.

He immediately contacted one of our local congregations. The lead member of that ministry reached out to the patient’s family. Again, we got permission first. He arrived at the patient’s house to assess the situation and they also look at different coding situations, so they get in very detailed about their methods in terms of how do they approach a job like that. That build didn’t take longer than, I would say, a week or two. Those materials were paid for in part by that congregation, but also from involvement with Care Coordination and FaithHealth. Our network definitely was a key to making sure that family was in a position to sustain their wellbeing after they got home. As soon as that ramp was built, the patient was discharged.

Again, it’s definitely an economical factor that we play in terms of how do we impact patient’s lives and the medical center. We want to make sure that we save costs for the medical center. This is one example of how we can save dollars by decreasing in-patient stays, especially when someone is ready to go home and have social barriers in order to get back home.

Viverette: That was a great story. Thanks for sharing that.

Moseley: Sure.

Viverette: I always think it’s pretty inspiring to hear those stories and how much of a difference FaithHealth can make in the lives of people, and how it is so many partnerships. It’s not FaithHealth, it’s all the connections and the deep relationships in the community.

Moseley: Yes.

Viverette: In our division, there are four hospitals, five hospitals actually. I wonder if you could talk a little bit about the difference between what FaithHealth looks like at the big campus which is in Forsyth County, and then how it looks a little different in Wilkes, Davie, Lexington, and now we’re bringing High Point on board.

Moseley: Yes. Well Emily, that’s a great point. FaithHealth looks different not only because of the hospital but as the community is different, we have to also make sure that we are in tuned with the community inside the hospital and outside the hospital. Each of our campuses, we have chaplain managers who serve as the FaithHealth Coordinator for chaplaincy, spiritual care, and also community engagement. These individuals take time to build relationships. They always allow leaders within our division to know what things could be standardized and what things need to be tailored based on the culture of their community.

I would say those chaplain managers are the driving force, not only to make sure that things are unique and different, but to make sure that we are culturally sensitive, but to make sure that we understand the differences in urban and rural environments, and to make sure that we understand that there are different resources that we have to tap into. There may be resource-rich urban areas, but relationship-poor urban areas, and there may be relationship-rich rural areas, but community-service poor areas. We have to look at all of those dynamics, and knowing that it all takes trusting networks to make sure that we provide the right level of service for the right people that we’re trying to engage.

Viverette: Over and over again, not only in this interview, but in other interviews from the series the importance of partnerships and relationships have been mentioned. I know that you’re really gifted in this particular area. Part of it is just because of your genuineness and your kindness, but I’m curious… how do hospitals go about building these relationships? What advice do you offer folks that are trying to get this off the ground?

Moseley: I would say be patient and allow people in relationship building capacities to go above and beyond their stated jobs. Often times what I’ve learned, is that we have people within our system who are able to be that bridge but they’re constrained by their job title. That requires visionary leadership to look at all levels of the organization from the basement to the 10th floor to really do sort of an asset mapping of who do we have in our organization that can better position us to build the level of trust that we want long term. I think that takes someone like a Gary Gunderson. That takes someone like a Dr. John McConnell or Dr. Julie Freischlag, to really understand the complexities of our communities but also the multiple assets that we have within our organization to be in right relationship with those complexities. I would say start there. Don’t look too far beyond your walls because what’s in your walls can take you outside of those walls.

Viverette: That’s well said. Can you give me an example of what that looks like in our system?

Moseley: I would say FaithHealth has become not only a service or an operational component of population health, but we have become a safe place for community dialogue. People now seek us for advice and direction on how they can become more integrated. Again, there’s no one telling them to do that, but I think over time as you have leaders in place who champion certain initiatives, and champion certain people and certain roles, people feel more comfortable going to those individuals. I think we are that bridge. We allow people to explore their passions, their innovations in a way that’s contained within a trusting relationship. I think that’s the key. We’ve built trust at a level where we don’t really have to go above and beyond what we’re comfortable doing, and we allow people to work with us hand-in-hand in the community in a way that typically doesn’t happen within other institutions.

Viverette: It is such an expansive vision. What have been some of the greatest challenges, or what is your greatest current challenge in thinking about community engagement?

Moseley: I would say the greatest challenge would be external market forces, whether it be the issues of uncompensated care, Medicaid, and the buzzword now, “social determinants,” but we look at it as “social drivers” because they are things that can be changed over time, the political environment. I would say all of those things complicate the picture, but they do not create a way for us to, I would say to give up. We definitely look around those barriers to find ways that we can go above and beyond those challenges.

Internally, I would say staffing is always a question. Do you have the right staffing model? Do you have the right level of role clarification? Do you have the right hierarchy within your department or division, and are you collaborating with other departments effectively? Those things are ongoing, but I think what we often find is that we have leaders who allow us to pause, and to reflect as we go forward, and that allows us to reposition ourselves at times. Again, I think the internal challenges are things that we can constantly work on together, but those external forces are going to be there and we have to prepare ourselves for the next level of challenges that will be coming in the near future.

Viverette: Well, some of those external challenges could cause some despair, and I’ve never seen you despairing, so I’m curious what gives you hope? How do you continue to move forward even in what feels like really hard-hearted or mean-spirited times?

Moseley: I have to go back to my grandmother. It all starts with love, when you love what you do, when you love the people you’re serving, when you love the people you work with, you don’t become burdened. You don’t become downtrodden. I think you become rejuvenated. It gives you a sense of accomplishment when you go home every night and you know that the people you work with have given all they can give. They’ve shown every example of love that you could imagine during the course of a day, and that’s the only way you can fight fear. That’s the only way you can fight evil, is that you show that you love beyond measure and I would say that you are one of the examples of what you want to see the community to be.

I think every day, you have to show that example of what you hope from others. People see that. People will see that when you give your all, you give your love, you give your trust. They reciprocate that. It takes time and everybody doesn’t do it the same way, but I do pride myself on really studying people, examining them to understand how they express their love because every person doesn’t express it in the same way. Sometimes you have to pay attention to numbers. Sometimes you have to pay attention to facial expression. Sometimes you have to pay attention to how a person is walking. It can become real detailed, but I don’t want to go too far, but just be cognizant of everybody around you, and try to listen more than talk. That will be my final piece.

Viverette: I those listening know now why I might have said you’re one of the key architects of our work. I do love that spirit. One of these days we’re going to get you to preach, I hope.

Moseley: It might be possible.

Viverette: It is such a loving, faithful, perspective, and I do think there’s a way in which that perspective draws people to you and is encouraging to others around you, what makes you a good leader.

Moseley: Thank you.

Viverette: That almost would be a perfect place to end except that we have a little bit more time. I have one or two more questions.

Moseley: Okay. Sure.

Viverette: What advice do you have for folks who might be trying to get in the community engagement world? Whether they’re at the medical center or an agency, where did they start? Who are the natural partners? Where might folks look?

Moseley: That’s a great question. I don’t think there’s a one size fits all way to do that. Think about what you’re trying to accomplish. I think that’s the first step, because it’s going to take different partners to accomplish different things. If your goal is to be present in the community long term, think about whose been there for the long run. Think about the institutions that have been there for hundreds of years. Think about the people who attend functions at those institutions, and what do they bring to the table. You have to go about, again, an asset mapping process, and that can take a formal process that many of us have been involved in, and have developed here and in Africa, and different places, or it could just take an informal set of asset mapping tools and resources.

You have to take your time to look at the broader context of the community, who’s there, maybe again in an informal role. No one that has a position or charge to take care of the health of the community, but it could be someone who goes about their daily life caring for others. But it’s hard to find those individuals if you don’t step outside of the walls of where you work. You have to take time to go out into the community, meet with different individuals, meet with individuals inside your organization who live in those communities, pay attention to the news. You have to also read newspapers and read internet articles because there are some things that are written that you wouldn’t find in other places, show up to community meetings. That could be local governmental meetings. That could be neighborhood association meetings. It could be meetings at church or a congregation. Just be present. That’s the main thing that I’m trying to say. You have to be present in all forms to find the people who can help you integrate into that community.

Viverette: One last question, what’s been your greatest learning over the past six years since you’ve been with FaithHealth?

Moseley: The job is never done. You have to look at FaithHealth as a journey. I don’t know what the end point is, and I think that’s a good thing. When you’re working towards a certain goal, you become very much relaxed, you become less innovative, you often times become more constrained in terms of the types of things that you can do, and the types of relationships and partnerships you can build. I think having that journey mindset that this is a marathon, this is not a sprint, because often times we get caught up in short term goals. We have to achieve this by X. We have to reach this by Y. But I don’t think that’s what FaithHealth is about. I think FaithHealth is about creating a beloved community. You can’t put a timeframe on that. Not putting that time frame has allowed us to move at the speed of trust, and that’s something that we’ve always said, and that’s something that we all believe in. That requires us to not only meet short-term metrics, but plan for long term goals and solutions that extend beyond what our clinical apparatus sometimes places on us. While we’re a good partner with the clinical team, we also look a lot further down the road I believe, sometimes which allows us to proceed at a different pace, and allows us to build the relationships that are long lasting to overcome many of the mistrust and the detrimental acts and deeds that many of these institutions have done in certain communities over time. I think having that long term focus helps us.

Viverette: Great. Well Jeremy, thank you so much for your time and letting me interview you today.

Moseley: Thank you. Glad to be here.