How can a safety net be the catalyst for creating a healthier community?
Anderson, Ron J.
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The Parkland Health & Hospital System is one of the Nation's largest and most complicated safety net institutions. It provides care for over 40,000 admissions, 12,000 deliveries and 1.3 million outpatient and ED visits per year. It is a Level 1 Trauma and Burn Center, a Level 3 Neonatal Unit (one of the largest in the US), and it is part of the UTSW campus NCI designation for Cancer Care. Parkland has achieved many firsts as an innovator of the safety net, but must now rise to the challenges of "moving upstream" to invest in prevention, health promotion, earlier interventions in primary care, and care management in a fashion that is lead by a spirit of servant leadership, evidence based practice (competency) and the ethical tenets of beneficience, nonmaleficience, promotion of autonomy, distributive and social justice. The next evolutionary steps for Parkland involve collaboration with our competitors (so-called Co-optician) through a 1115 Medicaid Waiver to find and address gaps in service delivery for our most vulnerable residents. It requires the discipline to study health disparities, population health outcomes and the impact of the socioeconomic determinants of health. We have and will continue to use appreciate inquiry, dialogue and "deep listening" to guide us so as to avoid paternalism or exploitation and get the community's buy-in and participation. Enormous strength, innovation and vitality can come from the community's partnership with the safety net to effect health delivery reform at the local and regional level. We can, and must, do better by being better stewards of scarce resources, by putting quality and safety in both process and outcome at the forefront of our efforts. These efforts must be patient and community centered, not just provider centered to achieve an accountable, sustainable and affordable future.