Why should health systems address non-medical needs?

Aswita Tan-McGrory, MBA, MSPH; Deputy Director, Disparities Solutions Center at Massachusetts General Hospital

More and more, we’re seeing that hospitals need to look beyond their four walls. This is not something where the care just ends at the exit sign. We have a lot of organizations that are realizing that the care they provide doesn’t matter if you are sending the patient home to an environment that’s going to impact the outcomes.

Our chief clinical officer told us a story about an article that was written by, I think it was either a resident or medical student, who worked in the NICU. There was a baby that was born very premature. They weren’t sure if the baby was going to survive, and they basically did every intervention in the NICU world on this baby to try and save it. You know, it was a very long journey, but at the very end, the baby did make it and survived to be sent home, and it was a real success story for the NICU department. Then two or three days later, the baby came back into the emergency room because of a rat bite, and the baby died because of the rat bite. It was a very powerful story when I heard it, because it was talking about here’s where medicine fails. There are all these interventions, the team worked on this preemie for months and months, and it was a great story, but we didn’t check to see what environment we’re sending the patient home to. So that’s an example of why we can no longer ignore this. I think a lot of hospitals are doing things where they are working with community-based organizations, what happens after discharge, how can we take care of patients. There’s been some really successful models on how to collaborate with community-based organizations and work with them to make sure patients don’t get readmitted.