challenges, including unstable housing or homelessness, food insecurity, complex behavioral health issues, and lack of insurance. Cooper is amazed at the staff, the impact they have made, and the unyielding commitment to making a difference. One such trailblazing staff member, Megan E. Williams, Director of Complex Care at Regional One Health, began her career in Memphis in 2018. She earned her master’s degree as a clinical nurse leader and worked in various roles, focusing on complex patient situations for more than a decade. Her role has been instrumental in expanding services and improving patient outcomes by integrating community resources and addressing critical social determinants of health. “I started intervening on about 30 to 50 patients myself, seeing trends in why they were coming into the hospital all the time,” Williams explained. This hands-on approach allowed her to identify and address recurring issues effectively. ONE Health’s internal complex care model uses a comprehensive set of 13 categories to more precisely assess, identify, and address patient needs. “Our highest domains are food insecurity and transportation needs,” Williams said. Through whole-person care and accelerated access to services, ONE Health aims to improve the health, selfsufficiency, and wellbeing of uninsured men and women with complex social and medical needs. By connecting patients with appropriate levels of care, the program strives to reduce unnecessary emergency department visits and inpatient hospitalizations, thus bending down the financial cost curve. Williams specifically emphasizes the challenges of coordinating care across systems within the hospital with the community. The importance of breaking down “silos” among various service agencies refers to the isolation and boundaries between units in a health system. When departments and agencies operate independently, it can lead to fragmentation of care, medical errors, high costs, and poor patient outcomes. In a silo-type environment, information sharing is limited and collaboration across agencies is minimal. Megan explains how the ONE Health program at Regional One Health collaborates with various community and institutional partners to avoid working in “silos.” They coordinate with entities such as the Community Alliance for the Homeless and MIFA, which provide critical support services. 18 2024 Gratitude Report
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