Connect Live @ Adventist Health

Connect Live | February 24, 2022
Story 90

In this episode, Dr. Raul Ayala joins Joyce Newmyer for an important conversation about facing healthcare inequities, we learn about an amazing young woman that went out of her way for a patient, and we find out why a cheeseburger recently brought hope to an ER.

Jessica Reynoso: What gives me strength is my faith, my kids, and making a difference in people's lives.

Cynthia Castillo: What gives me strength is all the obstacles I've overcome and being able to achieve them makes me hopeful, and that gives me the most strength.

Jasmine Sanchez: My strength working at Adventist Health is knowing that I get to guide people on their daily needs and guide them to the path that they were looking for.

Patricia Luna: My family gives me strength. The fact that I can provide a unique service to my patients and perspective gives me strength. Feeling like I belong to something gives me a lot of strength. I've been with the hospital for over 10 years. And I could say that this is one of ... This is like my second home. I feel a lot of strength, positivity. A lot of positive feelings in this place.

Maggie Navarro: I find strength in being witnessed to what goes into caring for a whole community. While I'm not a clinical staff member, working in healthcare in a hospital during a pandemic has really opened my eyes to the selflessness of so many people. This community is so connected to White Memorial and seeing everything that the nurses give each day, helps me realize that we all have strength in us that we never even knew we had.

Narrator: How do we talk to and with each other? How do we maybe do less telling, because communication, isn't just about sharing information. It's a two way street. How do we ask more questions?

Joyce Newmyer: Welcome to Connect Live at Adventist Health. I'm Joyce Newmyer, president of the Pacific Northwest Network at Adventist Health and your host for Connect Live. Live this week, compassion wins, facing healthcare inequities and A Cheeseburger Promise. Compassion wins. 26 year old Willits, California native Darian Gavazza, is one step closer to fulfilling her dream of serving as neonatal intensive care unit nurse. She joined the COPE Health Scholar program, an initiative that Adventist Health has partnered across all our networks to providing all the education and experiences for local communities to consider a career in healthcare.

Joyce Newmyer: The Adventist Health Howard Memorial team noticed Darian's hard work and deep compassion in patient care, when recently she comforted the patient and found them a new pair of pants, which she personally altered to fit their broken leg. The patient was in tears and expressed their gratitude for Darian's compassion. One of the managers was able to invite her to be a patient care technician, while she continues training to become a nurse. Darian, thank you for being a force for good. And we look forward to you becoming a NICU nurse very soon today. I'm delighted to welcome Dr. Raul Ayala, ambulatory medical officer at Adventist Health. Welcome, and I'm so glad you're with us.

Dr. Raul Ayala: Thank you, Joyce. Happy to be here.

Joyce Newmyer: You and I had a conversation recently about health disparities and inequities that exist in access to healthcare. What are we doing as an organization to address this?

Dr. Raul Ayala: Yeah, so we are actually at full 14 of our sites, are in a journey through a CA Bridge program, which identifies patients in our ERs with substance use disorders and mental health disorders, and addresses their issues and supportive pieces for their care, in our ERs and our clinics.

Joyce Newmyer: So tell me more about what that means, how, how do we support their care and bridge where they are now to where we want them to be?

Dr. Raul Ayala: Yeah. So I think that just thinking about the most important thing there is identifying these patients, the warm handoffs that are happening between the care teams of the ER physician, the ER care providers, nurses, and staff. And the pinnacle of this group of care is the substance use navigator. So each ER has a substance use navigator where we have this program and they identify the patients and look for better ways, not only to get them treatment, with medicated assistant treatment, but also the supportive care they may need in that community.

Joyce Newmyer: The mission of Adventist Health, living God's love by inspiring health, wholeness, and hope, includes a commitment to helping address the whole person. How are these navigators addressing whole person care?

Dr. Raul Ayala: That's a great question, Joyce, and one of the important things and really the backbone of this program is that substance use navigator you mentioned. It's really important because they are the liaison between the care team and that community where this patient will when they come back to, after their ER hospital visit. And the reason that they're important is because they understand not only what's happening in the ER, but also in the community. And so they know about, and they learn about resources. They know if you may or may not have a doctor. They connect you to a primary care physician, a clinic, and the ancillary services and such things as food, shelter, transportation, and other social economic factors, that may be attributing to their care.

Joyce Newmyer: So recently you and I talked about a patient who has experienced a sign life change as a result of this CA Bridge program. We'll of course protect her privacy, but please share with our viewers this example of how lives are being changed.

Dr. Raul Ayala: Yeah. Joyce. And that's really important because it's not just this example, but there are many other examples such as this, but this one really clearly comes to mind. It was shared through one of, again, our substance use navigators, where there is a patient who is in her thirties, had a small, yet big problem that came to be through a substance use disorder. She was dependent on and abused opioids. And really what it was, is she did not have a primary care physician. She did not have a medical home. And so she was being seen in the ER on and on through this substance use. And she got to befriend and really find a support within the substance use navigator and the care team. And really what started to happen is they started to build a relationship around the various happenings in her life, that really brought her to this point.

And the substance use navigator began to conversate, give resources and really be a rock of support into the community. She was going through a lot of legal matters with her two children. Fast forward, she was able to finally have a bridging point with a primary care doctor. She started attending behavioral health therapies, substance use therapies. And really that was the changing moment in her life where she wasn't seen in the revolving door of the ER, but she really got herself into care. She was able to get her children back. And the other big part was that she was able to look at other things, other than substance use with going back to school and helping other people, and really serving as a mentor type, a support for other people that may be struggling with substance use disorders.

And I really like this example of this ... I think it's just a person that's been able to overcome so much, because we may be at times where we don't know the way. And I think these programs and the substance use navigator and that care team, really helped be that support that she needed to get herself back on her feet.

Joyce Newmyer: What a great story. Sounds like health, wholeness and hope to me. How is this program funded?

Dr. Raul Ayala: This program is actually funded through federal and state monies that we apply for every year. Again, we started with three or four sites, and now we're at 14 sites. And moving on completing that to have 20 sites, to have this Bridge program in our facilities, with the transitioning into our ambulatory care.

Joyce Newmyer: That's great. So, final question. How does this program and its obvious connection to our mission square up with your personal mission as a physician?

Dr. Raul Ayala: As a physician, I always wanted to find the solutions to the medical problem, whether that's disease, et cetera. And when we talk about substance use disorders or mental health disorders, it is all encompassing of where do we begin to treat? And I think that this program really sets our mission into whole person care, because we're not just thinking about what disease you have in front of you, but also what is contributing and how do we address those social economic disparities inequities of care? And bet the forefront and be that pivoting and rock to support these patients, that are pretty much everywhere. I think it's godsend that we're given this opportunity and that's the personal mission, to care for these people in whatever setting they may be.

Joyce Newmyer: That's beautiful. So Raul, thank you for joining us to a day and introducing our viewers to this really important initiative and thanks for sharing your passion and insights for health, wholeness and hope.

Dr. Raul Ayala: Thank you.

Joyce Newmyer: Our final story today is A Cheeseburger Promise. What does a cheeseburger have to do with hope? A simple gesture can make a big impact, when there is selflessness behind it. In one recent story from Adventist Health Portland, a bag of fast food had everything to do with a patient in need, a promise and a small act of kindness, that brought hope to a hospital ER. One nurse took the time to recount this week's story and how it impacted her and her colleagues, and we're so glad she did. This is really worth a look. You can read all about it and so much more, at Friends, thanks for connecting live and we'll see you here again next week. Until then, let's be a force for good.