Providing Culturally Competent Care Through Cleveland Clinic’s Community Lung Clinic

Minority and underserved populations are disproportionately impacted by respiratory diseases. In Northeast Ohio, there is a higher death rate due to chronic lower respiratory diseases when compared to the national average. This region also has a higher percentage of individuals and families who live below the poverty level.

With this in mind, Cleveland Clinic opened the Community Lung Clinic — a program that aims to provide “culturally competent care and address health disparities related to lung health through education, research, quality improvement and community outreach.”

A project initiated by Raed Dweik, MD, Chairman of the Respiratory Institute at Cleveland Clinic, the program is now led by Andre Smith, MD, with the support of a passionate team, including Curry Cates and Rhonda Jenkins, program managers in the Respiratory Institute.

“We recognized a need within our community and set out to better support underserved patient populations in Northeast Ohio,” notes Jenkins. “The Community Lung Clinic is designed to meet the needs of patients with diverse backgrounds, and this includes facilitating access to care and community resources.”

Collaboration and community

Through the Community Lung Clinic, patients are connected to dedicated physicians providing culturally sensitive care, and that includes helping individuals access both medical services as well as community support.

Conditions diagnosed and treated through the program include allergies, asthma, COPD, infectious disease, interstitial lung disease, obstructive sleep apnea, pulmonary hypertension, sarcoidosis and sickle cell lung disease. The Community Lung Clinic also offers pulmonary rehabilitation, lung cancer screening, smoking cessation, community education and outreach, referrals for e-coaching, and screening for social determinants of health.

Depending on a patient’s specific needs they may also receive referrals to other medical providers within the Cleveland Clinic system who manage diabetes, heart disease, hypertension and vascular disease or, who can support weight loss, physical fitness and smoking cessation.

To better serve patients, the Community Lung Clinic team collaborates with social workers in primary care to connect patients with various community resources, such as housing and food assistance.

Lack of transportation can be a major barrier to care for many patients, and now, with the support of a Caregiver Catalyst Grant, the program has partnered with Uber Health to provide transportation assistance.

Since initiating this service, Jenkins has witnessed its impact firsthand. “I was with a physician whose patient had cancelled their appointment for that day due to transportation and childcare issues. She has had to cancel multiple appointments; however, she was dealing with new symptoms and needed to see the doctor,” she recalls. “At that point, it was about 15 minutes past her appointment time, but I called and helped her coordinate a ride with Uber Health, and the physician was able to see her right away.”

“When I spoke with the patient after her appointment, she expressed her gratitude. She really felt as though her health was on the line. This patient wants to be healthy and be there for her children, and she was very thankful to be able to use this service and get the care she needs. Moments like this is why we do what we do.”

Growth and future directions

Since its inception, the program continues to evolve and grow. The team is currently shifting to a “hub model” based on a zip code analysis that examined different health contributors, such as smoking rates, health literacy rates, food deserts, etc. “Through this analysis we identified five ‘hubs’ that represented the most opportunity for our program and appointed a champion for each location,” explains Cates.

The champions are tasked with understanding the unique needs of their community. “We will then visit each ‘hub’ to discuss what we can do to best serve the patients there,” says Cates. “Each population is unique, and not every community needs the same support. While there are tenants of our offerings that will be the same everywhere, our goal is to tailor our program as much as possible to the different communities we hope to impact.”

Every member of the Community Lung Clinic has a vested interest in caring for underserved patients, and they recently came together for the first team retreat. This was a chance to have open and honest discussions around culturally competent care and how to facilitate this in clinical practice. This is the first of many opportunities for team collaboration and learning.

“The mantra of our program is, ‘Building Trust with Every Breath,’” says Cates. “And everything we do comes back to that. We understand that a person’s health is intimate and fragile, and it takes trust to be open and vulnerable with your provider. We want to continue to build that trust and impact our patients’ lives for the better.”