Putting vision into practice to meet the needs of the poor

In 1986 the Sisters of Charity of the Incarnate Word, a multi-institutional system based in Houston, established specific mission objectives for all its healthcare facilities to meet the challenge of caring for the medically indigent in their communities. In response, St. Michael's Hospital, Texarkana, AR, established the Medical Indigent Committee to develop project proposals. To gain approval, proposals had to meet criteria established by the Sisters of Charity corporate office. These were consistency with mission, evidence of need, operational feasibility, and financial feasibility. The committee's first task was to collect information on the health status of the poor in its service area. Based on their findings, the committee decided to target the elderly and the very young for programs. After some brainstorming sessions, the committee developed three proposals: 1. Home Care Skills. 2. Pulmonary Rehabilitation Program. 3. Sick Child Clinic. By the end of 1986 the first two proposals were approved and funded; the Sick Child Clinic was not, because of operational concerns. The hospital offered the first Home Care Skills course in June 1987 and repeated it later that year. The 16-hour program proved so successful that the hospital is now considering having the class videotaped. The Pulmonary Rehabilitation Program began in May 1987. Although the hospital has not yet determined whether it has achieved its goal of reducing readmissions for poor patients with chronic obstructive pulmonary disease, program attendance exceeds that of other classes by more than 50 percent.