5 Reasons to Cross-Train Your Healthcare Team as CHWs

Cross-training is a way to muscle up your healthcare organizations. It’s a technique often used to increase capacity among various nonclinical workers.

Using cross-training on an entire healthcare team on the core competencies of health promoters like community health workers (CHWs) and promotores can strengthen teams, improve client and patient care, and increase team efficiency.

→ Free Resource Guide: 10 Things To Fix in Women’s Health [Access Now]

What Is Cross-Training?

Cross-training is a method of spreading knowledge among a team by creating a baseline education among all team members. In casual circumstances, it might be as simple as an employee coaching others on their daily responsibilities during a lunch break or a more in-depth program to cross-train staff in primary care.

But it can also be a wider and more impactful program in healthcare agencies of all employees are cross-trained as CHWs. Most CHW training programs are accessible, easy to integrate with existing schedules, and applicable to anyone on a health staff.

The practice helps boost cohesion in the workplace because everyone understands what the CHW does and can immediately apply those skills to their day-to-day jobs. If you’re new to building an online training program for healthcare, start with learning about these benefits.

5 Benefits of Cross-Training Your Team as CHWs

  1. Excellent return on investment
  2. Promotes respect for CHWs
  3. Increases everyone’s knowledge
  4. Better team efficiency and collaboration
  5. Builds pathways for promotions and responsibilities

Excellent Return on Investment

CHWs are proven to improve health outcomes and lower costs for patients and health systems, so just imagine what could happen if you applied those skills to your entire team. Suddenly, everyone understands how to promote healthier eating for managing diabetes or navigating health insurance in simple terms or connecting patients and clients to the best specialist in your network or community.

The benefits to clients expand exponentially because they’re being supported at all touch points. Your agency is working together better and maximizing its budget.

Plus, you never have to hire a temp agency again. If your CHW needs to take time off, anyone can step in. This means that your CHWs can take off a year, a month, a vacation or even an hour for lunch. A nurse, a receptionist, an MA, a physician, a volunteer–anyone is able to answer calls, schedule appointments, connect to others. This means patients are happier and better looked after too.

Promotes Respect for CHWs

CHWs are in an awkward place in many healthcare agencies. They’re more focused on saving costs than earning money. So in a health center, for example, administrators are sometimes happier to support high earners like orthopedic surgeons than a CHW or promotora who’s trying to prevent someone coming into the hospital in the first place.

Cross-training a healthcare team can demonstrate the important and unique role of a CHW. This builds respect and understanding among the whole team. Finally, everyone else can understand what a CHW does.

 

Increases Everyone’s Knowledge

Healthcare specialists are important. All agencies need expert RNs and dietitians. But they also need expert RNs and dietitians that can motivate for change and know who to contact for Spanish interpretation in your agency.

Cross-training means your staff can support clients and patients at any stage of their wellbeing—especially if that person has complex healthcare needs. Anyone has the knowledge to help people with various diseases and conditions in different areas they might not be familiar with. Cross-trained staff are more comfortable and sensitive when supporting these clients and patients.

Better Team Efficiency and Collaboration

If a multidisciplinary team knows what the other members do, they can better communicate, coordinate job functions and patient care, and understand each other more clearly. Whenever people work together closely, they can offer suggestions for improvement and share their personal expertise.

This means that CHWs that are integrated into care teams can also understand workflows and the needs of other team members faster and intuitively. The upshot is teams get along better and need to do less explaining. This creates a more supportive environment for patients and CHWs.

Builds Pathways for Promotions and Responsibilities

CHWs who learn about others’ jobs become better at their own, and they’re also in a better position for promotion. When you cross-train healthcare employees to be CHWs, you open up the opportunity for CHWs to know more about how the rest of the care team works. They can then build other skills that can take them on to jobs with greater responsibility and breadth. This makes for happier, self-motivated employees all around.

What’s New for Navigating Health Insurance

By Monique Cuvelier

Health insurance is—if possible—even more important for Americans now than ever before. Everyone’s healthcare needs have been turned upside down, thanks to the coronavirus.

Some people are sicker, some are withholding their preventative care checkups, such as breast cancer screenings, until they feel comfortable visiting doctors, and others still have shifts—or gaps—in their coverage as their jobs change and as President Trump limits and threatens to overturn the Affordable Care Act (ACA).

→ Free Resource Guide: 10 Things To Fix in Women’s Health [Access Now]

It’s been more than 10 years since the ACA passed—and seven years after CHWTraining released the Navigating Health Insurance course–more Americans are insured. However, more people are under-insured. Plus, government funded education about the ACA has been either reduced or eliminated, which leaves many more people confused about coverage.

Avoiding Chronic Conditions

The simplest first step for anyone in navigating health insurance is to avoid the need for care. Preventive care, such as immunizations and cervical cancer screenings, can help individuals and their families stay healthy and reduce the risk of developing a chronic disease.

Lifestyle choices—exercising and eating healthfully—also contribute hugely to a person’s health and finances.

“1 in 3 US adults has pre-diabetes,” says Eric Hannah, the Chief Catalyst at Mode Health in East Lansing, MI. “That is an impending tsunami on the healthcare and insurance system.

“One point I preach is that health literacy needs to include how the insurance plan works, but also how [people can] care for themselves, for example avoid lifestyle-related chronic conditions, and navigate the healthcare system–when to go to the ER.”

Hannah refers to “food as medicine,” a technique of choosing the right foods to reduce or even avoid medication for conditions such as diabetes.

The impact of making smart lifestyle choices can save a great deal of money. Diabetes, for one, is expensive. The journal Diabetes Care revealed the cost for one single person with diabetes to be more than $13,000.

The average economic cost per person was projected to be $13,240 for diagnosed diabetes, $4,250 for undiagnosed diabetes, $500 for prediabetes, and $5,800 for gestational diabetes mellitus (GDM). –Diabetes Care, September 2019.

“When we empower people to be good health citizens and healthcare consumers, it can transform how and how much we pay for healthcare,” Hannah says.

CHWs and Health Insurance

Without the proper education about health insurance, patient populations will only decline if trends in insurance cover continue on the path they’re on.

This is why community health workers, promotores and other health promoters are so important in helping people become insured and also understand the basics of health insurance. CHWs can connect clients to professionals who can help them sign up for insurance, make payments and file claims.

That’s why we created Navigating Health Insurance and included it as part of our core competencies for CHWs learning track. As part of our latest updates to the course, we took a careful look at how things have changed in the last six years. The data reveal that confusion about health coverage in the U.S. has a strong impact on people’s overall health and well-being.

Trends in Navigating Health Insurance

According to the Commonwealth Fund, which conducts surveys of health insurance, today compared to 2010:

  • More people have insurance
  • More people are underinsured
  • People who are underinsured or uninsured have trouble getting care because of cost and paying medical bills

Here are some important highlights about health insurance we learned during our recent updates:

Low Health Insurance Literacy Stops People from Seeking Care

People who don’t understand how health insurance works are more likely to avoid care. People will skip treatment due to cost. This is a powerful case for health insurance literacy as well as general health literacy.

Noncitizens Are More Likely Than Citizens To Be Uninsured

Nearly a quarter of lawfully present immigrants and more than four in ten (45%) undocumented immigrants are uninsured compared to less than one in ten (9%) citizens.

 

The U.S. Spends More on Health Than Anywhere Else

On average, the U.S. spends twice as much as other wealthy countries per person on health., according to a KFF analysis of OECD and National Health Expenditure (NHE).

 

Many People Think They Don’t Need Travel Health Insurance

Serious problems when traveling in other countries are rare, many people do get hurt. People with chronic illnesses can also be at risk of a medical emergency. This decision can be an expensive mistake if they become sick or hurt while in other countries, and their main insurance doesn’t work. Request a copy of the Travel Health Insurance Toolkit to use with clients.   

 

Millions of People are Uninsured and Even More Are Underinsured

Around 25 million people don’t have health insurance at all, and for those who do, premiums on family policies have increased 54% in the last decade.

 

Not understanding health insurance is bad for people in the U.S. Government debates about ACA and Medicaid aren’t helping people know how their health is affected by coverage. Community health workers are more important than ever when it comes to navigating health insurance.

If you’re not including training about navigating health insurance in your CHW workforce, start now. If you’re interested in building a diabetes education program for your team with these or other courses, contact us to learn how to add certified training to your program. Our team will be in touch ASAP to schedule a time to chat.

Originally published Dec 15, 2019, updated July 24, 2020.

10 Things That Will Make You Care About Women’s Health [Resource Guide]

By Eliana Ifill

Healthcare has a gender bias problem. Women are less likely than men to get the right kind of treatment, to have their illnesses correctly diagnosed, and to be included in important clinical research.

Men and women are biologically different and have unique healthcare needs, including in obvious areas like reproductive care or breast cancer screening, and also extending beyond.

→ Free Resource Guide: 10 Things To Fix in Women’s Health [Access Now]

Healthcare should be all about keeping people alive and healthy, right? It needs to conform to people no matter what their gender is and if they’re in the LGBTQ+ community. (For the record, men get ignored in areas of healthcare too, especially with mental health.)

If it doesn’t, healthcare leaves wide gaps that lead to worse health outcomes for women. Those gaps grow even wider among minority women and those in underserved and rural communities.

Some troubling facts:

  • On average, black women in the US are 2 to 6 times more likely to die during childbirth than white women,
  • 17% of women of color in the US have no health insurance, compared to white women’s 8%, according to this study,
  • And an estimated 44% of transgender women suffer from clinical depression, compared to 5.5% in the overall population of women.

Women’s Health and COVID-19

Now, with a global pandemic, reproductive health has receded even further into the background.

“As state governors responded to the COVID-19 pandemic, they affected reproductive care in a myriad of ways. Governors issued orders to protect access to health care, preserve supplies of protective equipment, and reduce exposure to and transmission of the coronavirus. In some states, these orders protected reproductive health care, while in others, governors used the pandemic as an excuse to restrict this care,” according to the Guttmacher Institute.

10 Ways Community Health Workers Can Help Women

Community health workers have the unique opportunity to educate, inform, and provide support to the women in the communities they serve, effectively knocking down and helping the population access the preventive and health care services that can often be life-saving.

CHWTraining has launched a comprehensive women’s health resource for community health managers, providers, and others working on the front lines of women’s health and preventive care to help navigate the intricacies of women’s health.

Top 10 Women’s Health Issues

  • Breast Cancer
  • Gynecological Cancer
  • Reproductive Health
  • Maternal Health
  • Heart Disease
  • Mental Health
  • STDs, STIs, and HIV
  • Violence Against Women
  • Transgender
  • Age

Check out the Improving Women’s Health resource guide for an understanding of why and how to close the health gaps.

7-Step Plan to Strong Core Competencies

Frontline health workers are the core of your organization and bringing new hires up to speed should be as steady as a healthy heart.

That process of training health workers, including community health workers or promotores (CHWs/Ps), in core competencies should be repeatable and worry-free, but it’s not always.

Download Now: Guides, Webinars and Articles for CHW Programs [Free Resources]

The problem is that some CHWs/Ps are brand new to the job and responsibilities, and others have decades of experience. Others still transfer to the position from a clinical background, such as nursing, and have different skillsets or must learn new job boundaries.

Not providing consistent training to these team members, their supervisors–and potentially the whole multidisciplinary care team—is trouble. Work doesn’t get done or done incorrectly, people step on each other’s toes, and it sparks friction among employees.

Why CHW Training Doesn’t Happen

CHWs/Ps have detailed jobs, they’re uniquely positioned in an agency, and they need to know how to do them. Most supervisors and program managers agree on that. But not all CHWs do. Why? Because some people are …

  • Confused about their job and don’t know how to ask for training
  • Nervous or embarrassed about asking supervisors for job training
  • Resistant to training support, especially if they feel they already know all there is to know
  • Overwhelmed supervisors who are juggling multiple job duties without adding training on top of it.

To add to the problem, CHWs/Ps are often considered to be at the bottom of the agency hierarchy, and decisionmakers decide to skip training.

In healthcare, the consequences of neglecting a core training plan are costly. At worst, clients and patients might not get the care they need. Or maybe it’s just that internal staff are confused, and that heaps onto your heap of management duties. The upshot is you’re pulled away from your regular work to address training gaps or its consequences.

So what do you do if you have a team that needs core competency training but aren’t sure where to start? Lucky for you, this problem has already been solved. Read on.

7-Step Plan to Strong Core Competencies

  1. Give CHWs a detailed job description.
  2. Find gaps.
  3. Document obsessively.
  4. Set time on the calendar for training and check-ins.
  5. Set up ongoing training.
  6. Don’t skimp on the training budget.
  7. Ask an expert to help you with your training plan.

Give CHWs a detailed job description.

Some agencies fail immediately because they don’t have a set job description for the CHW/P. But no one can do a good job if they don’t know what the job is. Create an overview of the job in writing, and a bulleted list of what each duty is. It can be helpful to create a job workflow to think of all possible tasks and how they’re implemented. If you’re at a loss, you could always start with something like Integrating Community Health Workers into Primary Care Practice from the National Health Care for the Homeless Council.

Many employers fail at effective onboarding right off the bat. Your new recruits won’t get off to a good start without absolute clarity about their responsibilities. Give them an overview in writing, as well as a bullet-pointed list of their primary duties. I find it helpful to rank the importance of these tasks to assist them in their prioritization process.

Find gaps.

Most agencies have at least some kind of internal training, and many have strengths in core competency areas like service coordination or ethics. Document what those training strengths are and then look for the weaknesses. Those gaps will tell you where you need to build out a comprehensive core competency training program.

If you’re looking for a list of competencies, read Most Important Job Skills To Build a CHW Career Path.

 

Document obsessively.

People leave their jobs for any number of reasons and programs evolve. Whatever you figure out now, document it so you can repeat it for the next time. Having a training process in place will help it go more smoothly.

You don’t have to do it yourself, by the way. Ask your current employees to write out what processes they use to complete their tasks. This might even be you if you’re just starting a CHW program, so write whatever you can when you can.

Set time on the calendar for training and check-ins.

Many unsuccessful training programs fail because there’s no urgency to complete or allotted time. You can solve both problems by setting a training framework, including:

  • Set up one-on-one times with you or a job peer to ask questions
  • Allow staff one day or afternoon a week just for training
  • Expand weekly training allowances include what CHWs/Ps should be learning all year.

Set up ongoing training.

Training isn’t a one-and-done event. It’s iterative and goes on to address the needs of clients, patients, and health trends. Implement a continuous learning strategy so you can help your staff always be aware of changes in guidelines and new skills.

Don’t skimp on the training budget.

When you’re figuring out how much to budget for your annual training plan, think about all the staff that should and can be trained under the same umbrella. CHWs/Ps need set courses for core competencies, but those courses can also be helpful for other staff or that might support other programs. That will help define where funding comes from and how much you can get from your investment.

Deciphering the true costs of online training is a complicated task that can easily reach beyond the boundaries of any grant or budget line item. Broaden your search to dig up all the costs you and your colleagues might be feeding into training–and identify ways to trim.

Your agency will set the training budget that fits, but make sure you have enough resources so you can do it right.

Ask an expert to help you with your training plan.

Successful CHW/P training covers core competencies and also many other nuances of client and patient care you might not have thought of. For example, a breast cancer screening course is better implemented with an outreach skills course.

An expert can take into consideration all your agency’s needs and strengths and make recommendations. The expert might be a partner agency, someone who set up a CHW training program at a different agency, or one of CHWTraining’s education consultants.

When a CHW/P core competency plan is set and your team is successfully completing it, everyone profits. Give your staff a chance to succeed, and your agency and community will benefit from a strong core.

Why Teaching About Health Disparities Transforms Communities

By Kellie Woodson

As an instructional designer, I use my expertise in teaching and learning to create learning experiences on a wide variety of health topics. Whether I’m developing a course on breast cancer genetics or oral health , a significant part of the process is partnering with experts in the field to develop courses that are informative, engaging and effective.  Since many of these courses are written for frontline health workers such as community health workers or promotores (CHWs/Ps), they must also motivate participants to make positive changes in their communities.

[RELATED: Improve the mental wellness of your team]

Overcoming Barriers to Healthy Choices

A typical course not only provides information on health conditions; it also teaches strategies to effectively guide others in making healthier choices. To do this, it is important to acknowledge the barriers to healthy living that many people face.

For example, we know that regular health checks and healthy eating are important to overall health. But the truth is, getting to the doctor or grocery store can be very difficult for individuals who are disabled, elderly, or who live in rural areas.

The courses I write challenge participants to acknowledge and reflect on the realities of others that they might otherwise take for granted.

  • How does a person who struggles to get around their own home travel to regular doctor’s visits?
  • How can a person make healthier food choices if they only have access to neighborhood convenience stores? 
  • Does the disproportionate number of tobacco advertisements in low-income communities affect smoking rates in these areas?
  • How does one’s education level affect their ability to complete an application for financial healthcare assistance?

The truth is that for many individuals, factors such as age, disability, geographical location and education level pose significant barriers to staying healthy. These barriers in turn give rise to health disparities, or preventable differences in the rate of disease and access to health services among specific groups of people.  While health disparities can and do affect all people, they are more common among minorities and the socio-economically disadvantaged.

The coronavirus has been a wake-up for many as they see how the pandemic is affecting races differently in this country. Hospitalization and death rates from COVID-19 are highest among American Indian or Alaska Native and non-Hispanic blacks—five times higher than for whites, according to the CDC.

When writing a tobacco cessation course for the state of Washington’s Community Health Worker Training program, I learned that African Americans, Asian Americans, members of the LGBT community and American Indians use tobacco products in disproportionate numbers when compared to other groups in Washington.

Across the nation, individuals with lower income and education levels are also more likely to use tobacco.  These disparities then give rise to tobacco-related illness and disease. Due to the lack of quality health care, individuals living in rural areas, those who are living at or below the poverty line and those who have lower education levels are more likely to die as a result of tobacco-related disease.  

 

Health Disparities Reach Farther Than You Think

It’s important to understand that health disparities aren’t simply the result of groups of people making bad choices. Disparities are systemic, complex and cyclical in nature. For example, groups of people who migrated to the U.S. have been found to have high rates of mental disorder and trauma due to the hardships they experienced during migration.  Racism and oppression often result in trauma-related mental illness. To make matters worse, marginalized groups of people often avoid diagnosis and treatment which further perpetuates these disparities.

Consider these statistics:

  • Asian-American women over age 65 have the highest suicide rate of all similarly-aged women in the United States.
  • LGBT youth are about 2 1/2 times more likely to attempt suicide than their peers.
  • Only about ten percent of physicians practice in rural America.
  • People who live and work in low socioeconomic circumstances have an increased risk for mortality, unhealthy behaviors, reduced access to health care and low quality of care.
  • Due to trauma experienced before and after immigration to the United States, Southeast Asian refugees have an increased risk for posttraumatic stress disorder.
  • Native Hawaiians and Pacific Islanders are 30 percent more likely to be diagnosed with cancer than whites.
  • Close to a third of Hispanics get regular health care, including those with chronic health conditions.
  • African-American adults with cancer are significantly less likely to survive prostate cancer, breast cancer and lung cancer than their white counterparts.

These alarming statistics only represent a small fraction of the disparities that exist in our country. Remember that health disparities are found in every group in the U.S. and in every part of the body.

Frontline Health Workers and Communities

Being a frontline health worker is not just about giving guidance and advice– it’s a call to action and advocacy. These people and their employers their community members better than anyone else, and they understand the communities’ challenges, weaknesses and strengths.  As they educate and guide clients to achieving better health, they have the responsibility to acknowledge barriers to care and why they exist. This understanding will help them to better anticipate their client’s needs and respond appropriately and effectively.

Frontline health workers take different paths to solving problems. Many take it upon themselves to create much needed resources and programs in their communities. Others see themselves as organizers who unite members of the community to create solutions where none exist. Whatever the response, you are in the position to make a tremendous impact.

At the end of the day, the goal is to build communities where race, sex, sexual identity, age, disability or socioeconomic status never, ever affect one’s ability to be healthy.

Kellie Woodson is an expert in teaching, learning, and instructional design with content area specialization in health, science, and mathematics. She has extensive experience developing curriculum and learning programs for schools, organizations, and national and international publishers.