HSC rolling out transformative whole health approach to care

Dr. Sylvia Trent-Adams speaking.The elderly woman always asked for a sandwich. She arrived at the hospital by ambulance, alone every time and grateful to see familiar faces — and very hungry.

Back when Jessica Rangel, The University of North Texas Health Science Center at Fort Worth’s executive vice president of Health Systems, was a nurse on clinical rotations, she visited the elderly woman’s home. Rangel had treated this patient many times in the emergency department and knew that she suffered from a complex jumble of medical maladies that the ER couldn’t address.

Upon seeing her home, Rangel was stunned to see her living conditions: a tiny, single-room home with only one light. There was a donated, single camping burner to use for cooking and only salty crackers in the pantry. This woman in her 80s slept on a cot with one blanket and had lived that way for years.

“She told me she was very proud of her ability to take care of herself but was embarrassed that she couldn’t get her medications filled or buy food as had been the case for many years,” Rangel said. “She had painful sores on her legs that prevented her from walking to the bank, to the grocery store or to church. She was progressively losing weight and, frankly, wouldn’t survive in her current state.”

That woman, like so many other people who interact with the health care system, wanted to be well, but because of a multitude of unaddressed social determinants of health, her condition was rapidly deteriorating.

Those social determinants are the pillars of whole health, a revolutionary approach to health care assessment and delivery. HSC launched its Whole Health Initiative internally on Wednesday with a town hall event featuring Rangel, President Sylvia Trent-Adams and Dr. Janice Knebl, Chief Medical Officer for HSC Health and UNT System Regents Professor.

Whole health considers all dimensions of a person. It empowers people to discover, receive and participate in care for their body, mind, spirit and environment within and through their communities. A whole health approach allows a patient to be the driver of their health and well-being, and live healthier lives.

The whole health model will be taught and practiced on HSC’s campus and be brought into the DFW community. Students will learn how to ask patients questions that drive meaning for each person’s health care journey and collaborate with all disciplines to address health care disparities. Faculty and staff will teach whole health and continue to use a collaborative approach in clinical settings, as well as pursue research opportunities to advance whole health.

The model incorporates a person’s community, spiritual life, physical well-being, self-care, mental health, environment and financial health.

Whole health symposium speakers,
Jessica Rangel (left) and Dr. Janice Kenebl watch on as President Sylvia Trent-Adams addresses the Whole Health Town Hall Audience.

“Our patients and community are impacted by factors other than their diagnosis and demand improved social determinants of health — such as a means of transportation to be able to go to the doctor or an understanding of what their health condition is in order to make informed decisions,” Knebl said. “Potential pipelines of students, future life-changing innovations and prospective cures are all at risk of never materializing because of the lack of an opportunity to flourish.

“No other institution is better equipped to transform the landscape of health and health care than HSC. Thinking holistically about patient care is absolutely critical for future health care professionals.”

Data on the whole health approach already has shown that it’s more effective than only treating a patient using traditional means. The U.S. Department of Veterans Affairs recently published data from a three-year pilot study monitoring the effects of adding a whole health approach at 18 VA flagship sites.

Veterans with chronic pain who used whole health services had a threefold reduction in opioid use compared with those who did not. Opioid use among whole health users decreased 38% compared with an 11% decrease among those who did not use this approach. Veterans who used whole health services also reported being able to manage stress better and noted that the care they received was more patient-centered. These results indicate improvements in veterans’ overall well-being.

The demand for whole health services remains high within the VA. More than 97% of veterans responded that they were either somewhat interested, very interested or already were using at least one whole health service. The study also noted that VA employees reported lower burnout, lower voluntary turnover, greater motivation and were more likely to rate their facility as a “best place to work.”

Town Hall audience. A consistent stream of data from multiple other sources also suggests the need for a whole health approach. Studies show 80% of a person’s health is determined by factors other than access to quality care; eight in 10 doctors believe the U.S. cannot improve health outcomes or reduce costs without addressing the social drivers of health; only 8% of people above age 35 receive all of the high-priority, appropriate clinical preventive services recommended for them; one in five Americans worry about losing their housing, which leads to poorer health outcomes; and 14% of patients surveyed at HSC Health are experiencing food insecurity.

HSC’s Whole Health Committee, which will provide key input on the direction of the initiative, is broken down into six groups: research, community engagement, academic, innovation, employee and student wellness, and clinical.

“We’re embarking on a new journey with whole health,” Trent-Adams said. “It won’t happen overnight, but it’s starting now. It will alter the way we journey with people in health care.

“We will boldly and bravely pursue the path to whole health together for the betterment of our campus, our patients and our community.”

Trent-Adams thinks whole health will be transformative for HSC, the communities it serves and wherever its students go. This crucial step is the first of many to come in breaking down barriers to a healthy community and reimagining what health care delivery means.

HSC faculty, staff and students are encouraged to learn more about the university’s Whole Health Initiative at unthsc.edu/wholehealth. Included on the webpage are links to the full video from the Whole Health Town Hall and a shorter video presentation.

HSC’s external marketing campaign will launch later this spring with targeted display advertising, paid social media, streaming video and advertising with various publishing partners.

To ask a question about the initiative or make a comment, email wholehealth@unthsc.edu.

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