Episode 14 - Public Health, RN
Understanding the health of the community is essential to providing excellent patient care at Northwestern Medicine. Karin Podolski, MSN, MPH, RN, director of Community Health Services at Northwestern Medicine, talks about how she uses her nursing skills to focus on the needs of vulnerable patients.
”In the Community Health Institute within Northwestern Medicine, we're focused on making an impact and improving the health of the community. We serve very diverse areas, whether it’s the rural community of DeKalb or the city of Chicago.”
Karin Podolski, MSN, MPH, RN
Director, Community Health Services, Northwestern Medicine
Show Notes
- Podolski says she was always interested in community health, but started her career in ambulatory surgery, transitioned to finance and later found her way into community health education.
- The Community Health Institute at Northwestern Medicine strives to improve the health of the community with assessments and interventions that respond to specific community needs.
- Examples of successful interventions include expanding education and access to naloxone in response to the opioid crisis.
- Community screenings and one-on-one interactions between nurses and community members can have a deep impact on the overall health of a community, Podolski says.
- The Community Clinical Enrichment Program allows clinical staff to volunteer and work with specific areas to support cultural and language needs in local communities.
- The Healthier Communities Fund and other similar grants allow Northwestern Medicine to deploy resources and meet community needs to positively impact patients after receiving care.
- For nurses interested in working in community health, Podolski recommends learning about community health assessments and understanding what priorities exist within hospitals they may work at based on those assessments.
Episode Guests
Karin Podolski, MSN, MPH, RN
Director, Community Health Services, Northwestern Medicine
transcript
[00:00:00] Alyssa Saklak: I am Alyssa Saklak.
[00:00:06] Laurin Henderson: And I'm Laurin Henderson.
[00:00:08] Alyssa Saklak: On Better, RN, we get real about nursing,
[00:00:11] Laurin Henderson: the good and the gritty.
[00:00:12] Alyssa Saklak: We talk to real healthcare experts
[00:00:15] Laurin Henderson: with the goal of becoming better for our
[00:00:17] Alyssa Saklak: patients, our colleagues,
[00:00:18] Laurin Henderson: our family, our friends,
[00:00:20] Alyssa Saklak: our partners and ourselves.
[00:00:28] Laurin Henderson: As a new nurse, I feel like you're often so focused on the health of your patients, especially at the bedside, that it's really easy to forget they're part of a community or what will happen to them after they leave. But our patients and the communities that they come from have a really big impact on their health.
[00:00:43] Alyssa Saklak: On this episode, we're talking to a nurse who's working to improve the health of people in our communities. Karin Podolski is the director of Community Health Services at Northwestern Medicine.
[00:00:53] Laurin Henderson: You two share a connection with your master’s in public health and your public health love. This is my first time talking with Karin, so I'm really excited to get to know her a little bit.
[00:01:02] Alyssa Saklak: What does community mean to you, Laurin?
[00:01:05] Laurin Henderson: My community, I think of my family, my friends, the people that I work with, the people that I'm really closely surrounded with. I'm a Chicago transplant, so I don't know that I necessarily consider the city of Chicago my community. Does that make sense? I feel like I sort of have a mobile community.
[00:01:19] Alyssa Saklak: Yeah, but I think it's wherever you plant your roots, and it can be close by and it can also be far. It's the people and the places that kind of make you who you are, and those experiences have shaped you.
[00:01:32] Laurin Henderson: It's almost like this combination of a bunch of little micro-communities that sort of make up my larger organization and my larger sense of self. And today, when we talk to Karin, I'm really interested to hear about the Northwestern Medicine community in its entirety with all of our hospitals, downtown Chicago, all the way out to the suburbs, and how there are different needs there, and all these little communities make up our larger Northwestern Medicine community.
[00:01:59] Alyssa Saklak: Absolutely. I think it takes time to learn about your community. I remember starting here at Northwestern Medicine, being new to the city and living downtown, I had spent the majority of my time in a smaller college campus. And so I was very involved with their community health improvement centers and there was a stark difference between the two. And it took me time to feel like I was part of that and connected. And really it started with having conversations with patients and getting to know them and connecting and hearing their stories that helped me feel like I was part of that bigger picture. But it takes time and it can be hard to figure out how to feel connected.
[00:02:35] Laurin Henderson: And your love for public health didn't end in college because you're in a master's program right now to get your master's in public health. So this is gonna hit really close to home for you. I feel you are gonna nerd out with Karin. Welcome, Karin.
[00:02:48] Karin Podolski: Thank you.
[00:02:49] Laurin Henderson: Can you tell us a little bit about your nursing career and how did it lead you into community health?
[00:02:54] Karin Podolski: This is actually one of my favorite questions to answer when I work with students and kind of thinking about my journey because it is a circuitous journey that brought me to community health. I mean, I knew I was always interested in the community from a broader standpoint when I was in nursing school. My first job when I graduated was actually in ambulatory surgery. So I worked in a pre-op, post-op GI lab, and you know, worked for the population that was very ambulatory and, you know, short-term relationship with folks. That got me interested in kind of thinking about a broader standpoint, like looking at more of a population. And so applying the concepts of nursing, and it really comes down to it. It's always this back to the basics of nursing, right? The assessment, diagnosis, intervention, evaluation. So that is what we do on a population level, and I always thought of making a broader impact than an individual patient while still having the opportunities. Community does offer that relationship-building with members of the community, but the work that you're doing and the interventions are more of a broader standpoint. So I knew that I wanted to do something related to that, and I also knew I wanted to go back to school. I started back in the day at Northwestern Medicine. I think I'm in my 27th year. So back in the day I started working and going back to school through tuition reimbursement. And I went for my master's in community health nursing as well as my master's in public health. So I knew I wanted to go and learn about the concepts related to public health. And then just kind of took a little journey for a while. I worked in finance for patient access, so focusing on individuals that perhaps don't have the ability to pay or don't have insurance for their medical care. So working to help facilitate that process and then an opportunity came along in community education at the time and it evolved from providing education in the community to a more of a broader model. The opening came up and I've never looked back. It's just been a great opportunity.
[00:04:39] Alyssa Saklak: It's part of the nursing curriculum to learn about community and public health. And then you graduate and to your point, you get pushed into wanting to learn the skills, learn about acute inpatient care, and then you kind of get pulled back and parts of nursing that you're really passionate about. And that, to me, was always community health, public health. And kind of similar to your story. I think what's so hard, and I'm curious, your perspective is like we all kind of serve a role in the healthcare system and it's easy to lose sight of what other intricate pieces are happening. So within the community health, public health at Northwestern Medicine, what does that look like? What are you doing, what is the impact? We're seeing a lot of patients who are in acute needs and we're caring for them, but what happens after they leave? What does that branch look like and why is that so important?
[00:05:25] Karin Podolski: Right. In the Community Health Institute within Northwestern Medicine, we're focused on making an impact and improving the health of the community, and that is part of our mission as Northwestern Medicine. We have a very structured process around that because we have a large footprint, right? We serve very diverse areas, whether that be the rural community of DeKalb and Sandwich, Illinois, versus the city of Chicago. So, there are just a wide variety, but focusing on alignment of our mission as well as the requirements of being a health system. We assess the needs of our community service area, and we do the same process we learned back in nursing school, goes back to the process assessment of the community. You know, identifying priorities and then identifying interventions to address those priorities. So that is done at every local level. So there's a lot of common themes, like access to care is a priority at all of our hospitals as well as behavioral health is a priority at many of our organizations. And then we go and identify community-based interventions to address those needs, and then we balance that with what we're seeing in the inpatient side. We have some great opportunities for nurses on our team that go out and provide community-based interventions like blood pressure screenings and A1C screenings, community health education, vaccinations out in the community. So there's a way to utilize nursing skills while going out and making an impact in the community.
[00:06:43] Laurin Henderson: When I think about community health, especially in the Chicagoland area, it can sort of seem like we're trying to boil the ocean. There is so much work to be done in the area. Is there a specific program or something specific that Northwestern Medicine does that you're especially proud of or that you feel is especially impactful for our local community?
[00:07:03] Karin Podolski: Wow. You're right on that level about boiling the ocean. That's one of those things, you know, you drive home at night, you're like, am I even making an impact? There's just so many needs and so many stories that you hear and then they change, right? We come up with a plan and then, oh, there's a different population that needs something immediately so that we kind of redivert our efforts. But I think we've been good at trying to identify top priorities where we can really make an impact as a healthcare organization, so leveraging our talents is what it really is. So what are we best at solving? Two that come to mind is we've done a lot of work around harm reduction for opioid fatal overdoses. And we've done this through work, having nurses go out and provide education about utilization of Narcan as well as free Narcan. So going out to a variety of locations, whether it be food pantries, or at local events, working with colleges, there's so many different populations to address with, you know, across the whole age spectrum. There's an opportunity to provide Narcan and also change the stigma at the same time. Having Narcan is almost like a CPR method, right? It's something anybody can carry, ‘cause anybody might come across someone that's dealing with an opioid overdose. And then that shifted into working with the Drug Take Back Days, so attending those twice a year. And then that shifted to kiosks at facilities where you can go and provide, there's a box on the wall, like a dropdown box, and you can obtain the free Narcan. That was a nurse-led initiative that we were able to help provide to the community.
[00:08:27] Laurin Henderson: Yeah, we're seeing that change in stigma around Narcan a lot on the inpatient side too. We have a, I wouldn't say they're new anymore, but an addiction medicine consult team that are huge advocates for Narcan in hand on discharge, which I think is so great. It's one, changing the stigma. And two, when I started nine or 10 years ago, I don't ever remember us talking about discharging a patient with Narcan.
[00:08:50] Alyssa Saklak: I always say whenever we're onboarding new nurses into the hospital, that the hospital mirrors what's happening out in the community and the world. So, as Laurin mentions, that we see different waves of needs. I think what people don't always understand is the impact of community health in the assessments that we do. Something that's really important that I learned in school was community health needs assessments. And those happen typically what I hear, like three to four years. When was Northwestern Medicine's last one, and I guess, you know, clearly that's a huge part of your role and your team of seeing like what did the data show and then what are those interventions?
[00:09:26] Karin Podolski: Community Health Needs Assessment is a standardization for identifying the needs of a population. So, looking at public health data as well as key stakeholder information. So, we'll go through a very formal process. There's a whole team that does this, and it has to be done. It's part of the Affordable Care Act, that we have to do that for each hospital. We have three hospitals in our health system that do theirs together. But other than that, it's at every hospital and it's done every three years. Just the way it works within our organization, they're all kind of at different levels. So one year three hospitals might be doing theirs and in another year, five hospitals might be completing theirs. It kind of rotates. Northwestern Memorial Hospital in Chicago is currently going through the process of identifying priorities and a methodology to address those priorities. So it follows a formal process just like you would do with the patient at the bedside where you're just assessing the situation, the landscape, and that's looking at, again, public health data. We also do surveys on information on, you know, self-reported behaviors and self-reported barriers, that type of thing. We ask individuals about, you know, what are you seeing in your community and what types of things are you experiencing? And even from, do you typically consume five more fruits or vegetables a day? So typical health behaviors that promote health as well as challenges. Do you have difficulty in transportation to get to your appointments? Can you afford your medications? The same types of questions we ask, you know, on admission for a patient coming to the hospital. And then we do that for a community and then take that information and gather as a team, both internally as well as those key difference makers in a community gather together and look at the data and then narrow down some priorities. So, each hospital will pick three or so priorities to focus on for the next three years. And then we identify, you know, evidence-based interventions to address those priorities. I think access to care would be a priority in the community. So, we hear that a lot, right? So, we hear information like, I don't have a primary care physician or medication, transportation, location. There's so many things that affect access to care. So then we'll narrow down to that particular community to identify interventions. And that could be, you know, working with a local, federally qualified health center that could help promote access, or looking at Northwestern Medicine could perhaps put a location in this community because there is no primary care in the community. Or we look at helping bolster community-based transportation options so people could get to their appointments and that type of thing. So, we look at particular evidence-based interventions and the challenges that you have to kind of stick with them long enough to make an impact. And that's where it varies from the hospital side or the ambulatory side of nursing, where, you know, you'll see a patient have intervention for a shorter period of time where working with a community, you won't see a shift in the needle for almost sometimes years. Narcan's a great example where it's finally maybe turning the tide of fatal overdose deaths. And we look at that from a public health standpoint and the coroner data that's shifting but that's been years of intervention.
[00:12:12] Alyssa Saklak: It's so fascinating because I think about how large our healthcare system is and how different the populations are. It's so important that we do these assessments so that we can really make a difference from prevention care all the way to acute and patient in the population we serve that are coming to seek health care in hospitals. Because one of the capstones I was trying to do for my master's in public health was partnering with the Emergency Department to say, what can we do to help? What are things that we're seeing in the public? And downtown, one of the managers said they saw an increase of scooter-related injuries in Chicago. It's something I wouldn't even think of. But again, those assessments and kind of seeing like what are the trends? And to your point, it almost feels like as soon as you kind of put together an intervention and our plan, you won't always see that direct impact, which can be really hard to say like, are we doing the right thing? Are we making a difference? And I guess my question to you is how do you keep pushing and keep, with these interventions that we develop to see that long-term effect and see that long-term difference, especially in a world where we want instant gratification? We wanna solve something, we want one medication, it fixes, it's changed, but this is a long game. So what are some of those motivational tactics or kind of ideas that kind of help your team?
[00:13:24] Karin Podolski: Well, you know, the scooter example is a perfect example of looking at data, almost like lab results on a patient, right? So you're looking at the information and helping drive those interventions, and then thinking about what's in evidence-based best practice out there. Then also looking at the community. What would work? Is it helmets? Is it education? What education? What's the right intervention to kind of help make an impact? And I think as a nurse, what goes back to is just that one-on-one interaction that we do have. When you ask about what keeps us going? It's that family. We do a lot of work with folks that need car seats and, you know, having those interventions about providing car seats to families and having that and making the impact. Or, you know, a blood pressure screening that we had, at one location, elevated, I mean really serious, elevated blood pressure screening, and then you try to get the patient to go to the Emergency Room. He didn't wanna go. He had a dog, he was worried about his dog. So it's those interactions that really keeps you going.
[00:14:20] Laurin Henderson: Yeah, it's those things that make us feel like we actually are having an impact. We've talked so much about how I know that what I'm doing is right, but it's those things that we can cling to, to know we are doing something for the community and we are doing right by these people. Something that you had just mentioned, Karin, was the education piece. We see such a diverse patient population, and I imagine that is only amplified out in the community. Can you speak a little bit to some of the strategies that you all use while you're out in the community to educate people who maybe have different levels of health literacy or there's maybe some cultural things at play? How do you handle that out in the community and how do you think that translates to the inpatient side?
[00:14:59] Karin Podolski: We've worked with a patient education group within our organization as well as looking at national organizations. You know, the American Heart Association has done a lot of work. Rather than duplicate efforts, how can we leverage existing best practice that is already out there? When it comes to the cultural piece, that has been a challenge as well, and we looked to identify an opportunity to bolster our workforce within the Community Affairs department. And with Northwestern Medicine, being a large organization, we have a lot of individuals that live and work in different communities. So we have engaged a program called Community Clinical Enrichment, where we have folks that can sign up that are bedside clinical staff that want to get involved in the community and can shift their schedules and it can work with some of the stuff we do is on evenings, weekends, different days that may align with someone's schedule who's interested and available. That helps bolster from a language standpoint. We had an event that was in a predominantly Asian community in Chinatown recently, where we had individuals that spoke languages that we were able to connect with members of that community, where in the past it was just only English-speaking nurses that we had that were doing blood pressure screening. It is definitely been an opportunity to grow and learn on that and try to crack that nut because it is hard.
[00:16:19] Laurin Henderson: Yeah, I hear you say something that we think about a lot on the inpatient side is that we want a workforce that's representative of the community that we're serving, because it's only gonna benefit the people that we're caring for. We have to have the representation for the people that we're caring for. One, so that people trust us, and two, so that they feel like we know what we're talking about and we're relatable to what they're going through.
[00:16:43] Alyssa Saklak: It's something I'm very passionate about. This is the community that we live in and it's the patients and it's why we went into nursing to care for people. I think that's why my passion is how do we connect with people? When I go into a patient's room and I hear about their life and where they live, the people and support that they have around 'em, because it truly takes a community to help support and uplift and make sure that everyone is cared for. There's so many challenges to it. It can be overwhelming, but it takes every single person to really put their hands in and do their part and connect and make that difference. One thing that comes to mind is the Northwestern Medicine Healthier Communities grant. You mentioned about the car seats. And that was, I believe, one of the initiatives through the grant that they helped with, but my hope is that a nurse can listen to this and feel inspired to say, wait, I wanna apply to that. I've connected with several of my patients, and here's a common thing that I've heard. You know, an assessment can only go so far. I really think the work and the conversations can really help you identify, where are we suffering or where are we challenged as a community? What’s your thoughts on that?
[00:17:46] Karin Podolski: Northwestern Medicine receives funding for different initiatives and one of the opportunities that's promoted both in the community as well as within the organization from the employee giving standpoint is impact to the communities. So there's a Healthier Communities Fund and it's like that grassroots effort. Like I really wanna make a difference. I'm seeing something. And so the applications that we receive are just so creative, first of all, very creative. And they are from staff level clinical folks that are saying, “Hey, you know what, we're seeing patients that are struggling with food and they would really benefit from some food vouchers.” So it's not like they would say, we need car seats and then car seats magically appear. No, there's more work beyond that. So once they receive the funding, then you actually have to go out and, you know, procure these gift cards or vouchers for groceries or, Uber vouchers, or you know, education on low sodium for heart failure patients. So they actually have to do the work and make the impact and then report back on what the impact was. And then we are able to understand, well this worked for this team, maybe this would work for another team. Food is a very common thing that clinical staff identify. And I think it's that concern that I'm sending this individual home. They've already been very ill and they're gonna have to recover and recuperate. And one of the best ways to do that is nutrition. So can they access some nutritious food tonight? And I think they're really concerned about that. I bet people are going home and thinking about what that patient is eating tonight. Because I know they just don't have the ability to afford healthy food. So the different opportunities and projects that people have that are so creative and that's the way we were able to get those funds out to those that could really make an impact with the patients.
[00:19:18] Alyssa Saklak: I think that these are very vulnerable conversations too, when people need help in our community. It's something that I love about our Northwestern Medicine team is our ability to listen and be vulnerable with our patient population to hear those because it's not easy to ask for help all the time. And then to be able to connect on this level and really partner with one another to help. I get goosebumps whenever I think about it, 'cause I just think that's what our world needs. And that's the hope and the light that keeps us going as a healthcare profession.
[00:19:49] Laurin Henderson: It really is, like, the care that we're providing on the inpatient side doesn't stop at discharge. Like you said, Karin, I think a lot of our nurses are probably thinking about these folks when they go home and wondering if they're gonna come back or where are they gonna sleep tonight? And that can weigh really heavily.
[00:20:04] Alyssa Saklak: If I'm a new nurse and I'm new to a hospital system, what would you suggest? You know, I wanna learn more in my community, I wanna be able to understand more. What would be those first steps, or what would be your words of wisdom or advice to them?
[00:20:18] Karin Podolski: I would say when getting that first job it's all networking, right? Going out there and kind of connecting with folks. I mentioned before about the community health needs assessment. So, finding out who's responsible for that, and kind of starting there. If you go and you just type in a community on any health organization's website, you'll see what it is that the health system is doing for the community. And that would be, you know, I'm biased 'cause I love the community component, but I would be doing that as part of my research and where I'm applying to work. So go and find out if they are committed to the community and kind of see that. And also within that document you'll see, what are the priorities for their health system or their hospital? And then how are they addressing those priorities? And then within there, there's always contact information and reaching out and finding out who owns this document, and then kind of seeing what opportunities are available within that organization for staff to be involved.
[00:21:06] Alyssa Saklak: I think it's a great place to start and hopefully help with your understanding of health care and nursing and the communities you serve, regardless if that's Northwestern Medicine or different corners of the world. Karin, thank you so much for being on the podcast. Every time I talk to you, I feel re-inspired.
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[00:21:23] Laurin Henderson: Thanks so much, Karin.
[00:21:24] Karin Podolski: Thank you. It's been a great experience.
[00:21:32] Laurin Henderson: Thank you for listening. Please follow us wherever you get your podcasts and rate and review the show.
[00:21:36] Alyssa Saklak: We'd love to hear your comments and any topics you might want us to explore.