Applying the Chronic Care Model (Part 1)

Community Resources ranging from educational institutions and government agencies to nonprofits and faith-based organizations play a vital role in bolstering health systems efforts, support and engage chronically ill patients actively. It is important to:

• Encourage patient involvement in effective community programs.
• Foster partnerships with community organizations to support and develop interventions addressing service gaps.
• Advocate for policies that enhance patient care.

Numerous valuable resources and services, such as peer support groups, exercise programs, and various aging services programs, exist outside typical medical systems. It's crucial for care teams, including physicians, to educate and motivate their patients to engage in beneficial community programs. Additionally, care teams should explore partnerships with community organizations to bridge gaps in much-needed services. Examples of community resources in Jamaica include the National Health Fund, Jamaica Moves Program, the PATH program for relief and the Caribbean Community of Retired Persons.

Take a moment to think about the following self-reflective questions:

• How might you use community resources in your role of providing patient care?
• What might hold a team back from using these resources?
• What has worked well for you in the past?
• Are there any recommendations to improve the support provided?