Friday March 9, 2018 - Anchorage, AK
After arriving late on Thursday night we had a full day of tours and presentations planned for Friday at multiple areas at Southcentral Foundation (Link to website) and at the Alaska Native Heritage Center.
During the presentation we learned that Southcentral Foundation is a Healthcare Organization that provides free healthcare to Alaska Native and American Indian people who live in Anchorage and outside villages that are within the Anchorage service unit. This organization is federally based but is owned by the Native people. Also on the campus and jointly owned was the Native Medical Center which is a hospital that serves the entire Alaska Native and American Indian populations. While on tours this campus was truly incredible and filled with beauty.
First, I am going to talk about the structure of the Nuka system of care of which was described in our presentation of primary health at the Southcentral Foundation. At Southcentral Foundation they have taken the idea of patient centered care to a new level. Instead of referring to the people they serve as patients they refer to them as “client-owners” because although the healthcare workers can offer their client-owners the tools to wellness it is truly up to the client-owner to make the changes to achieve that wellness. Also within there primary care system anytime that a client-owner is coming to the clinic for any type of appointment or procedure the Registered Nurse/Case Manager takes great care to make sure that the client-owner is not due for any other screenings or tests and make sure that they will be able to talk to all the people they want to talk to. This is very important because often these people are traveling and flying into Anchorage for healthcare and it is not possible to frequently take this trip (Only 20% of Alaska is connected to a road system). To make this feasible there is also patient housing available on campus so that they are able to stay in Anchorage during this time.
After our presentation with the nursing case managers from the primary clinic we were given a tour of the Native Medical Center including their emergency center, pediatric units, obstetrics/maternity units, general units, and intensive care units. This hospital was full of beauty with windows looking out towards the mountains and had traditional artwork displays on every floor. As we learned about the hospital our tour guide explained that this is all intentional. Often Alaska Natives refer to where they are by the nature that is around them. They know that as you go East you go towards the mountain and as you go West you had to the water. Throughout the hospital every hallway ends with a large window so that the patients are able to orient themselves to the nature around them even within the city. Above is a picture taken while looking out of a window at the Native Medical Center. Every floor had a display of native art, this allows for patients coming from the villages to have a sense of home. They have pieces from all the difference regions and often patients are able to recognize a certain distant family member in their lineage who donated an item to the display. Lastly, they always try to have authentic Alaskan food for the patients to order such as seal meat or reindeer stew. By trying to incorporate history and things common to the different villages it hopefully allows patients to feel more comfortable while in the hospital or in Anchorage. This is important because for many people traveling from the villages this may be there first time in Anchorage and the cars and tall buildings may result in a culture shock and increased stress.
We also had a presentation in the Traditional Healing Center of Southcentral foundation. This is a specialty area that client-owners can be referred. Here there is a large focus on healing touch especially when focusing on chronic pain and the use of healing through stories which focuses on counseling and behavior health. I think the most interesting part of this presentation is how well the traditional healing center and the primary care clinic worked together to integrate care instead of fighting against their different viewpoints. Both departments truly recognized the role that each other played and I think this was great to see because often the differences between traditional medicine and hospital based medicine cause strong disagreements. I think that because of how traditional many of the villages are this is very important to be able to have available and this traditional medicine is strengthened by the cooperation of the primary clinics at Southcentral. Above is a picture of an art piece at the Traditional Healing Center.
In conclusion I think three main aspects specific to this population is the distance and inconvenience to receive specialized healthcare from Southcentral foundation and the medical center, the vast differences between different regions of Alaska and thus vast differences in the perspectives of patients, and the strong focus of traditional healing and practices. I think that this can easily be related to my future career because this gave very clear examples of patient centered care and the important it has on the people you are working with. I think this also has taught me how important it is to truly understand where your patient is coming from as well as what they are used to and what they expect on an every day bases. Lastly, it is important to look at your whole patient, if your only focus is a patient is coming in to get a colonoscopy done you may miss that he is in need of some vaccines or that he is a diabetic and should be assessed for proper management of that as well. Maybe your patient may need to be seen by a behavioral health specialist or a pharmacist to explain the importance of their medication schedules but you would not realize that if you are only looking at the fact that patient A is coming in for his scheduled colonoscopy.
After arriving late on Thursday night we had a full day of tours and presentations planned for Friday at multiple areas at Southcentral Foundation (Link to website) and at the Alaska Native Heritage Center.
During the presentation we learned that Southcentral Foundation is a Healthcare Organization that provides free healthcare to Alaska Native and American Indian people who live in Anchorage and outside villages that are within the Anchorage service unit. This organization is federally based but is owned by the Native people. Also on the campus and jointly owned was the Native Medical Center which is a hospital that serves the entire Alaska Native and American Indian populations. While on tours this campus was truly incredible and filled with beauty.
First, I am going to talk about the structure of the Nuka system of care of which was described in our presentation of primary health at the Southcentral Foundation. At Southcentral Foundation they have taken the idea of patient centered care to a new level. Instead of referring to the people they serve as patients they refer to them as “client-owners” because although the healthcare workers can offer their client-owners the tools to wellness it is truly up to the client-owner to make the changes to achieve that wellness. Also within there primary care system anytime that a client-owner is coming to the clinic for any type of appointment or procedure the Registered Nurse/Case Manager takes great care to make sure that the client-owner is not due for any other screenings or tests and make sure that they will be able to talk to all the people they want to talk to. This is very important because often these people are traveling and flying into Anchorage for healthcare and it is not possible to frequently take this trip (Only 20% of Alaska is connected to a road system). To make this feasible there is also patient housing available on campus so that they are able to stay in Anchorage during this time.
After our presentation with the nursing case managers from the primary clinic we were given a tour of the Native Medical Center including their emergency center, pediatric units, obstetrics/maternity units, general units, and intensive care units. This hospital was full of beauty with windows looking out towards the mountains and had traditional artwork displays on every floor. As we learned about the hospital our tour guide explained that this is all intentional. Often Alaska Natives refer to where they are by the nature that is around them. They know that as you go East you go towards the mountain and as you go West you had to the water. Throughout the hospital every hallway ends with a large window so that the patients are able to orient themselves to the nature around them even within the city. Above is a picture taken while looking out of a window at the Native Medical Center. Every floor had a display of native art, this allows for patients coming from the villages to have a sense of home. They have pieces from all the difference regions and often patients are able to recognize a certain distant family member in their lineage who donated an item to the display. Lastly, they always try to have authentic Alaskan food for the patients to order such as seal meat or reindeer stew. By trying to incorporate history and things common to the different villages it hopefully allows patients to feel more comfortable while in the hospital or in Anchorage. This is important because for many people traveling from the villages this may be there first time in Anchorage and the cars and tall buildings may result in a culture shock and increased stress.
We also had a presentation in the Traditional Healing Center of Southcentral foundation. This is a specialty area that client-owners can be referred. Here there is a large focus on healing touch especially when focusing on chronic pain and the use of healing through stories which focuses on counseling and behavior health. I think the most interesting part of this presentation is how well the traditional healing center and the primary care clinic worked together to integrate care instead of fighting against their different viewpoints. Both departments truly recognized the role that each other played and I think this was great to see because often the differences between traditional medicine and hospital based medicine cause strong disagreements. I think that because of how traditional many of the villages are this is very important to be able to have available and this traditional medicine is strengthened by the cooperation of the primary clinics at Southcentral. Above is a picture of an art piece at the Traditional Healing Center.
In conclusion I think three main aspects specific to this population is the distance and inconvenience to receive specialized healthcare from Southcentral foundation and the medical center, the vast differences between different regions of Alaska and thus vast differences in the perspectives of patients, and the strong focus of traditional healing and practices. I think that this can easily be related to my future career because this gave very clear examples of patient centered care and the important it has on the people you are working with. I think this also has taught me how important it is to truly understand where your patient is coming from as well as what they are used to and what they expect on an every day bases. Lastly, it is important to look at your whole patient, if your only focus is a patient is coming in to get a colonoscopy done you may miss that he is in need of some vaccines or that he is a diabetic and should be assessed for proper management of that as well. Maybe your patient may need to be seen by a behavioral health specialist or a pharmacist to explain the importance of their medication schedules but you would not realize that if you are only looking at the fact that patient A is coming in for his scheduled colonoscopy.