The LSU – New Orleans EM Division of Community Health Relations & Engagement seeks to bring together clinical and academic medical professionals, community service and outreach organizations, civic leaders, and public and private groups to promote and strengthen the health of our community and its residents. Recognizing that well-being is firmly rooted in social determinants of health, we believe that clinical practitioners cannot fully care for their patients without attention to and action on behalf of the non-medical barriers to health care. Collaboration and engagement with non-health care professionals working on social determinants results in more efficient, cost-effective care.
The conceptual framework of population health is policy development, research agenda, and resource allocation. This framework is centered on the intersections of clinical care, community/social services, and public health. This junction is the focus of our efforts. By “centering at the margins” – putting attention on the most vulnerable, disenfranchised, socially complex individuals – we seek to make the greatest individual health gains, thereby ameliorating profound disparities at the community level.
Community Health Relations and Engagement includes the following:
- Direct service to those in need in our community through multiple projects
- HIV/HCV “opt-out” testing for all ED patients, with on-site coordinators and real-time linkage to care
- Partnerships with local, regional, and national service providers to better coordinate and deliver multifaceted care
- Coordination with 504HealthNet to strengthen patients’ access to primary and specialty care and develop special pathways for victims of violence that reduce barriers to mental and physical health care
- Partnership with Health Guardians to identify and refer high-risk, high-utilizing ED patients who require intensive, patient-centered case management
- Collaboration with local service providers to streamline care for the most vulnerable mentally ill patients
- Collaboration with the office of the New Orleans Health Department Medical Director to integrate UMC Emergency Department within the city’s strategic public health framework
- Collaboration with public and private partners to develop and build a low-barrier homeless shelter with wraparound crisis, sobering, and other social services
- Warm handoffs for at risk patients with Healthcare for the Homeless and St. Thomas Clinics
- Education of health professions trainees
- Development of a Social Medicine elective and track for interested LSU EM residents
- Collaboration with service providers and governmental agencies to train LSU EM residents on issues of human trafficking
- Joint support with the EM Division of Diversity for an Underrepresented Minority Visiting Student Scholarship
- Research on best practices for innovative, high-quality programs within the Emergency Department and in collaboration with community partners
- Ongoing evaluation of the impact of an ED-initiated intensive case management intervention
- Research analysis on the impact of an ED-based violence intervention program using a public health model of violence as an infectious disease
- QA/QI projects around timely access to specialty care for vulnerable patients and mental health care for psychiatric patients and victims of violence
- Case studies and more rigorous evaluations of health care utilization by the most vulnerable, highest risk patients
- Evaluation of the ongoing effectiveness of Medicaid expansion with regards to health outcomes, emergency care, and access to care
- Respectful and collaborative advocacy for vulnerable populations in identifying structural or policy barriers to efficient and effective programs
The New Orleans Ceasefire program is based off of the CURE Violence model and Ceasefire in Chicago and created in order to intervene and prevent retaliation in cases of traumatic violence involving inner city youth. The Ceasefire crisis intervention team is on call 24/7, meeting victims in the hospital immediately after a violent incident; they then serve as comprehensive outreach workers to assist people with social, economic, health, and legal issues to break cycles of violence. Team members also work as conflict mediators in high-risk communities in an effort to prevent retaliatory violence, and host festivals and other events to promote healthy, peaceful neighborhoods. Emergency medicine residents support Ceasefire efforts through helping connect victims of violence with health and mental health resources, supporting community events, and studying outcomes of the project.
Ceasefire New Orleans
Covenant House Adolescent Health Teaching Program
Covenant House provides services including shelter, food, and crisis care to high risk and homeless youth in New Orleans. LSU EM residents give lectures to adolescents on topics including sexual health, trauma, and healthy lifestyles. Residents and faculty also regularly participate in the yearly Sleep Out event when they spend a night outside to raise money for homeless youth services.
Forensics and Human Trafficking
The UMC Emergency Department offers a robust forensic service for victims of sexual assault, human trafficking and domestic violence. Expertly trained forensic nurses are available 24/7 to guide survivors through the early stages of evidence collection and recovery. Patients are also offered STD treatment, HIV post-exposure prophylaxis, and follow up free of charge. UMC residents work closely with the Forensic Nursing team to coordinate patient-centered care. Residents work to promote awareness of trafficking victims through the development of physician lectures, and treatment pathways for identifying and helping these patients. Residents who are interested can also become trained and certified in Forensic exam collection themselves and become physician leaders in cultivating the Forensic Program.
University Medical Center Forensic Program
Harry Tompson Center Rebuild Clinic
The Harry Tompson Center started after Hurricane Katrina as a day shelter for the homeless and offers multiple services including social work, computer services, meals, and day activities. The center serves thousands of people yearly and includes a free clinic. LSU EM residents as well as other volunteers staff the clinic year round to provide medical care.
Harry Tompson Center
Hospital Homeless Liaison Program
Tulane medical students created an inpatient homeless liaison program at University Medical Center in 2017 to help coordinate care and discharge planning for homeless patients, especially those with complicated histories. The program is advised by LSU EM faculty and residents. Medical students work with the Street Medicine program to coordinate follow up care and with community based organizations to coordinate social services. Student leaders presented their findings at the International Street Medicine Symposium in the fall of 2017.
The NOLA Hotspotters program is based off of the Camden Hotspotting model and seeks to link multidisciplinary student teams with high utilizing patients to improve health outcomes while decreasing cost. The program includes healthcare professional students from LSU, Tulane, and Xavier. LSU EM faculty play an integral role in creating and maintaining the program, while LSU EM residents serve as advisers to the teams.
Stop the Bleed
Stop the Bleed is a national initiative from the Federal government and American College of Surgeons to empower community members to address traumatic bleeding before EMS arrival. Our emergency medicine program worked closely with trauma surgery at our hospital to implement Stop the Bleed and provide training both in-hospital and throughout the community.
UMC Stop the Bleed
Street Medicine New Orleans
SMNO began in 2014 to bring medical outreach to the unsheltered homeless and coordinate care with city social services. We work closely with police, EMS, outreach workers, healthcare for the homeless, and housing providers to locate high risk patients and coordinate care. We regularly have medical students from Tulane to educate the numerous risks of living on the street. In 2017 we became part of Luke’s House, a non-profit free clinic located in the heart of New Orleans. Directors at Luke’s House work closely with LSU EM residents and Tulane medical students to provide and coordinate medical care while also promoting initiatives for IV drug users and wound care, mental health outreach, and HIV/HCV outpatient testing.
Luke’s House Clinic
Street Medicine New Orleans
NOLA.com ‘Street medicine’ brings health care to New Orleans’ homeless
The New Orleans Advocate New Orleans medical students hit the street to care for the homeless
WDSU “Street Medicine” crew brings health care to homeless