Communities Come Together For Patient Care

Community Healthcare Heroes

Neighbors care for neighbors during a pandemic

Staff members at COVID-19 testing siteThe Community Care Alliance (CCA) is a network of six BIDMC-affiliated community health centers located throughout Greater Boston. “Our work is all about empowerment,” says Lucy Chie, MD, a physician at South Cove Community Health Center. With roots in the civil rights movement, health centers provide critical medical services that are firmly grounded in community. “Cultural competency is not just a buzzword, it’s at the core of everything we do,” says Alberte Altine-Gibson, Community Health Manager at Bowdoin Street Health Center in Dorchester.

Another central component of care at community health centers is recognizing how environmental factors, or social determinants, influence health. By seeking to understand each patient’s complete health story, clinicians ensure patients feel seen and heard, ultimately improving outcomes. “When we provide holistic care, we build trust, which is necessary to advance healthcare equity,” says Kelly Orlando, Executive Director of Ambulatory Services at Beth Israel Deaconess HealthCare–Chelsea.

These values—trust, cultural competency, and community-mindedness—are essential both day to day and in times of crisis. Throughout the COVID-19 pandemic, leaders from BIDMC and the CCA came together to support their diverse patient populations.

Coming together is typical for us. But this was on a whole new level.
Marcelle Denis, MHA
Manager of Practice Operations
Bowdoin Street Health Center

Beth Israel Deaconess HealthCare–Chelsea

For practitioners at BID Chelsea, hypothetical COVID-management plans turned into actions very quickly. As the virus began to spread, BIDMC scientists mobilized to develop large-scale, in-house COVID-19 testing. “When people started coming in with serious symptoms, we soon realized we couldn’t limit our testing site to just BIDMC patients,” says Jose Abrego, MD, a primary care physician at BID Chelsea. The testing site at BID Chelsea became available to all residents, regardless of where they typically received care or their insurance and immigration status. The site was selected as a partner with the State of Massachusetts’ Stop the Spread campaign, and at its peak, tested nearly 450 individuals per day. “This is how we do it in Chelsea,” says Lourdes Cruz, a testing tent swabber. “We look out for our families and neighbors here.”

The popularity of the testing site was due, in large part, to the cultural competencies of its staff. “Chelsea is the second most densely populated city in the state, with a significant Latinx community,” says Nancy Littlehale, NP, nurse practitioner at BID Chelsea. “It was important to have native Spanish speakers, like Lourdes, at the tent so patients felt comfortable and could ask questions.” To support this effort, Littlehale developed talking points for staff conducting calls to deliver test results, ensuring patients received up-to-date information on the virus. For patients who tested positive, BID Chelsea partnered with a local hotel to provide accommodations for those who were unable to quarantine at home.

Additionally, BID Chelsea actively recruited patients to participate in research conducted by BIDMC to evaluate potential therapeutics. “We are committed to ensuring that diverse populations are involved in research. Only then can we develop treatments and solutions that effectively address the disease,” says Orlando. “People want to take care of themselves and of their families. Through our work, we empower them to do so.”

Bowdoin Street Health Center

Across town, Bowdoin Street Health Center also became a place where patients and community members could get tested for COVID-19. “After we found out we would become a testing site, we came together and developed a plan where everybody had a role,” says Marcelle Denis, MHA, Manager of Practice Operations. “It was a true team effort.” Bowdoin Street providers were intentional about creating an environment where patients and residents alike felt safe. Based on community feedback, the testing tent was set up in the parking lot, away from the clinic.

Bowdoin Street staff also worked hard to create accessible, informational resources. With guidance from the Massachusetts Department of Public Health, Altine-Gibson led Bowdoin Street’s contact tracing efforts and the creation of educational packets for community residents, available in multiple languages. “Most of our patients are people of color, and primarily identify as Afro Latino and Afro Caribbean,” says Altine-Gibson. “In a time that was filled with anxiety, we wanted to make information as accessible as possible.” Adds Denis: “We have built trusting relationships with our patients. They know they can always come to us.”

In addition to information, the packets—which were eventually distributed across the Beth Israel Lahey Health system—included masks, gloves, and hand sanitizer. “Many of our patients live in multigenerational housing and cannot work remotely or quarantine,” says Altine-Gibson, explaining that staying at home is a privilege. From the start, Bowdoin Street staff knew their patient population would experience COVID-19 at disproportionate rates—long before it was confirmed by CDC data—because of the well-established link between social determinants and health outcomes. “It was a tough time, but our community members actively showed up and cared for one another,” says Altine-Gibson. “That’s at the heart of who we are.”

South Cove Community Health Center

Many patients at South Cove were feeling nervous about the virus before their physicians were. “Before the pandemic hit Boston, nearly all of our patients were already wearing masks,” says Chie, an obstetrician at the center, which serves mostly low-income, Chinese immigrant individuals and families. “They were concerned about COVID-19 very early on, even before we were.”

As director of the more than two decades-old doula program at South Cove, Chie leads a group of physicians and labor coaches in providing invaluable support, comfort, and care during a special but complicated life experience, made more challenging during a pandemic. “It is certainly scary to receive a COVID-19 diagnosis, and even more so during pregnancy,” explains Chie. The South Cove team stayed abreast of changing restrictions and guidelines, providing care to patients in labor 24 hours a day, seven days a week. With support from generous donors, the team was able to supply patients with blood pressure cuffs, which were difficult to secure due to supply chain shortages.

Throughout the pandemic, practitioners at South Cove served as vital conduits of information. They continually translated updated materials and hosted regular Zoom information sessions, where patients could ask questions and learn more. “Our patients are strong and resilient, even when faced with unknown circumstances,” says Chie.

Looking to the Future

Over a year and a half after the pandemic began, CCA faculty and staff are proud of their respective communities’ ability to unite. “Coming together is typical for us. But this was on a whole new level,” says Denis. This time also reinforced the importance of patient-centered care. “COVID-19 was an important reminder that patients understand their own healthcare needs best,” says Chie. “As physicians, one of our primary roles is to listen.”

Now, community health center staff are focused on vaccination efforts. “Our efforts are centered on reaching patients who are hesitant and working through any questions they might have,” says Abrego. With vaccinations ongoing, there is a sense of hope in the air, made possible by the truly heroic work of community center staff members. “I have never seen us this strong,” says Altine-Gibson. “When there’s a fire, the firemen come. This was our time to show up and boy did our team show up.”

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