C4P at Ingalls Memorial Hospital
The Comprehensive Care, Community, and Culture Program (C4P) at the University of Chicago Medicine (UCM) has demonstrated promising impacts on improving health outcomes and decreasing hospital utilization. While UCM is an academic medical center, there is also significant opportunity for the program to be effective in community hospital settings. Improving the quality of care patients receive in community hospital settings is especially important given that they account for a majority of hospitals nationwide and provide inpatient and ambulatory care to a wide range of communities.
To see if the program may be effective in community hospital settings, we expanded the C4P study in December 2019 to Ingalls Memorial Hospital, an affiliate community hospital of UCM, which is located just south of Chicago in Harvey, Illinois. Similar to the C4P program at UCM, patients in the C4P Program at Ingalls receive care from a Comprehensive Care Physician (CCP) in the hospital and in the clinic. Patients are also asked regularly about a range of unmet social needs and receive resources to help address those needs that are identified.
The Ingalls C4P team includes four Ingalls CCPs, a team of UCM researchers, and several C4P AmeriCorps members. Ingalls patients are eligible for C4P if they have been hospitalized at least once in the past 2 years and have an in-network insurance plan.
Comprehensive Care Physicians at Ingalls
At the time of the expansion, several Ingalls physicians were already providing inpatient and outpatient care to their panels of patients, similar to Comprehensive Care Physicians (CCPs) in C4P, but without the focus on patients who are frequently hospitalized. The integration of the C4P model allows for these physicians at Ingalls to focus their practice on patients who are at risk of hospitalization, which in turn helps increase the stability of inpatient volumes.
The Ingalls CCPs are Drs. Cressa Perish, William Crevier, Kaveh Rahmani, and Solmaz Rahmani.
Identifying and Addressing Unmet Social Needs
C4P AmeriCorps members at Ingalls call patients every three months to ask about their unmet social needs and communicate any needs that are identified with the patient’s CCP. The C4P team then works together to identify local resources to help address these unmet needs. For example, a patient experiencing food insecurity is referred to the Ingalls dietary team, where the patient receives referrals to local food pantries and administrative support in applying for food assistance programs.
Ongoing Initiatives at Ingalls
The C4P Ingalls team is also working on several ongoing initiatives to improve patient care and health outcomes. These initiatives include increasing participation in the C4P program and research study among patients with disabilities, collaborating with community organizations to identify local resources to address unmet social needs, and improving the identification of a patient’s primary care physician from within the patient’s hospital record.