The HealthPartners Como Clinic offers a wide range of medical and dental services, including Family Practice, Internal Medicine and Pediatrics. Additional specialty services include: Primary Care Orthopedics, Breastfeeding Support Services, Physical Therapy, Adolescent and Adult Health Psychology, Surgery, Audiology, Diabetes Education and Support, Nutrition, Chiropractic, Acupuncture, Geriatric Care and Travel Medicine. The Clinic serves about 25,000 patients in St. Paul and the surrounding area.

Patients Taking the Lead

Who would expect poetry discussions in a health clinic?  Well, for two dozen regular attendees of the Lifelines poetry group, it’s a highlight on the monthly activities calendar of the HealthPartners Como Clinic Health Club. 

The foundation of the HealthPartners Como Clinic Health Club (Health Club) is rooted in patient leadership and engagement in a health-promoting community.  The Health Club operates using a democratic model of planning and decision making that is based on the Citizen Health Care model created by William Doherty, Ph.D. of the University of Minnesota.  The central premise is that the greatest untapped resource for improving health care is the knowledge, wisdom and energy of individuals, families and communities who face challenging health issues in their everyday lives.   

The Health Club is led by a group of approximately ten citizen patients and three health care professionals. Dr. Doherty is the Process Leader for the group, which meets monthly to discuss opportunities and projects. The mission of the Health Club is to engage patients of all ages as active agents of their own health and well-being, and as citizens of the Como Clinic community.  And, it’s really working!  During 2016, membership more than doubled and is now at 750 members. Programs are expected to involve individual participation and to be free.  The measuring stick is whether an activity is geared toward supporting people in their health goals, and if it taps the leadership of Como Clinic’s community members

Jennette Turner, MPH, is a health coach and has served as the Health Club’s Project Manager since 2014.  She is quick to point to the leadership of patients as one key for the success and longevity of the Health Club.  She said, “Patients both drive the agenda and lead individual events.” 

Her second shout out is for Dr. Steve Radosevich, the Clinic medical director.  When Dr. Doherty approached HealthPartners’ executive leadership with the idea of developing a health club in a clinic, Dr. Radosevich was the first person they thought of to take on the project.  He is recognized as being extremely progressive and willing to try new things.  Jennette said, “Dr. Radosevich is a true visionary.  He sees that lifestyle choices are the root cause of the majority of disease, death, and health care costs in the US today, and believes engaging patients to take an active role in their own health is the way to improve healthcare outcomes.”  One of our patients remarked that “we are doing healthcare together”, and Dr. Radosevich really works to make that possible at the clinic.  It’s also fun for Health Club members that he likes to cook and even teaches cooking classes. 

Jennette identifies other keys to success for the Health Club:

  • Senior management support is critical. Senior leaders supported the original creation and are also supporting expansion to other clinics.
  • Having some designated staff time (approximately one to one and a half days per week) for coordination and promotion has enabled the Health Club to function well and expand activities.
  • It’s important to keep inviting patients to participate.Patients often learn about the Health Club through their providers during medical visits.It is also promoted in the clinic lobby and on-line.Patients can subscribe to a monthly electronic newsletter detailing the upcoming events. Each four-page newsletter is chock full of information about what’s new for the month, ongoing activities, notable news and a spotlight on a special topic featuring a Health Club member.
  • The Health Club operates on the core principles of the Citizen Health Care model that expects professionals to see themselves as citizens and partners, not just providers.

Something for Everyone

Activities are planned to support healthy eating, physical activity, emotional resilience and overall well-being.  Among the diverse activities in 2016 and 2017:

  • Hands-on cooking classes at the Clinic and through an affiliation with the nearby Good Acre’s teaching kitchen
  • Onsite clinic gardens and gardening workshops
  • Yoga classes designed for patients of all ages and ability levels
  • Group bike rides and biking workshops
  • Weekly walking group
  • Lifelines Poetry Discussion Group
  • Email-based sleep hygiene program
  • Community discussions on health-related topics such as post-election stress, gun violence, racism and health.
  • TED Talk movie nights and book groups on emotional well-being topics
  • Email-based Attitude of Gratitude program.

Benefits

Patients and staff have commented on the value the Club brings to them.

  • Patients are empowered to promote their health in different ways.
  • The club activities encourage social interaction that can reduce isolation people may be experiencing.
  • Staff and patients attend events and work together developing relationships and getting out of the traditional hierarchical structure.
  • The message for patients is that ‘my clinic cares about my health in different ways’.Jennette believes this may contribute to the consistently high patient and staff satisfaction ratings the clinic has.

What’s next?  What’s challenging?

  • The Club is still considered a pilot project.Attendance at events and activities is tracked.However, new ways to measure the impact and results would be useful and are being developed.
  • Identifying new patient leaders for the Health Club is an ongoing process.A good source is noticing and inviting patients who have participated in a number of events.More age and ethnic diversity in leaders would be welcome.
  • Paying attention to what people are talking about, or issues identified by staff and patients helps the leadership group think about new activities.
  • While most activities have been successful, a few have not.It’s OK to try new things even if they don’t attract many participants.
  • The HealthPartners White Bear Lake Clinic is the next site starting a program.While some things may be similar, the Club is developing based on the interests of the patient leaders at that site.

More about the Citizen Health Care Model

Citizen Health Care is a community organizing approach to engaging ordinary people as co-producers of health and health care.  It goes beyond the activated patient to the activated community, with health professionals gaining public skills for working with local groups of people who see themselves as builders of health care initiatives—rather than simply being consumers of professional services.  It requires some new attitudes and skills from health professionals who work with patients in a truly democratic fashion with a flattened hierarchy.  A core principle is to let citizens drive programs, rather than having programs service citizens.

For more information about the Citizen Health Care Model, view the website:  www.CitizenProfessional.org, or read this article:  http://www.cehd.umn.edu/fsos/projects/cpc/pdf/citizenhealth2006.pdf