A $500K investment in employee ideas: How CHOP is helping patients in its own backyard

Five years ago, Children's Hospital of Philadelphia started a unique program to help its employees improve community members' health: the CHOP Cares Grant Program.

Through the program, hospital employees can apply for grants to help them start community projects outside the hospital setting. CHOP has awarded 155 grants since 2015, adding up to nearly $500,000.

The projects seek to address a broad range of health and wellness concerns. Recent grantees have designed a mindfulness training program for nursery school children, provided fitness classes for children with developmental disabilities, and formed an extended family support group for transgender children and their families, among other initiatives.

In June, the hospital announced the CHOP Cares Excel program, which will award an additional $35,000 to help past grant recipients expand their projects. The grants have already improved population health, and CHOP employees such as George Dalembert, MD, a two-time grant recipient, say the program sends a clear sign that the hospital is willing to invest in their ideas.

Madeline Bell, CHOP's president and CEO, said she would love for other hospitals to adopt similar programs. "There's no proprietary nature to any of this," she said. "If other hospitals could do the same thing, I would be very happy."

Here, Ms. Bell and Dr. Dalembert, an attending physician at CHOP, discuss the grant program and its impact on hospital employees and the local community. 

Editor's note: The following responses were lightly edited for length and clarity.

Question: The CHOP Cares Grant Program celebrated its five-year anniversary in early June. How did the program get started? What was the motivation behind it?

Madeline Bell: Like any great innovation, it comes from the ground up. Many people on our staff had ideas about giving back to the underserved community in our backyard, and people were seeking grant support from the hospital. We thought, why not try to organize this in a way that provides seed money for people to get their ideas started, almost like an external investor? We decided to make it a competition with criteria and an application process. Many projects have also secured external funding from other sources once we've provided the seed funding. 

Q: How have CHOP Cares programs affected local communities? Have you seen an impact on population health?

MB: Moving the dial on population health is pretty significant. One example I can share touches on food insecurity in our community, which is very high. It's probably one of the most food insecure cities in America. We started a food pharmacy, which was an idea from our staff, and we have a community garden at one of our primary care centers. Those two things together are certainly having an impact on nutrition and health. We're also in the process of rehabbing a hundred homes in Philadelphia to take away triggers for children who have asthma, and we're already seeing decreases in hospitalizations and emergency department visits.

Q: Dr. Dalembert, can you tell me about your specific CHOP Cares initiative?

Dr. George Dalembert: I am lucky enough to be the recipient of two CHOP Cares grants. My first one came in the form of support for a project that was focused on vaccination of adult caregivers against whooping cough. Babies can't get vaccinated when they're really young, so we do something called "cocooning." If you vaccinate all of the adults around them, the babies should be more safe. 

This past year, we offered free tax preparation on-site at one of our primary care clinics, the Nicholas and Athena Karabots Pediatric Care Center in West Philadelphia, as part of a pilot program through my second grant. The goal of the pilot was relatively simple: Instead of just encouraging families to add another thing to their plate and get taxes done, we brought the tax preparation to them with the help of a local community partner. The total cash that we were able to infuse back into the community, not including services and advising referrals, was just under $349,000.

Q: How has the CHOP Cares grant program affected the work culture among CHOP employees?

GD: The program sends a clear signal to CHOP employees that the institution is willing to fund important work. As someone who does a lot of physician pipeline development — from medical school to residency to fellowship to becoming an attending — I am frequently reminded of the passion and idealism that often attracts people to medicine in the first place. But the realities of practice are very complicated, and often broken health systems can really squash that idealism. Being able to help people in such a significant way with the CHOP Cares grant projects, and to do so more deeply and broadly than a 15-minute office visit might allow for, really helps to re-energize a clinician. It helps you get back to that feeling of helping people when the day-to-day grind can be really challenging.

It's also not just the clinicians who benefit. Our nurses, our front desk staff: I know they were key to making our projects successful. They were the ones doing a lot of the advertising and encouraging families to participate. They often have different connections with families that clinicians can lean on to make these projects work. 

Q: Ms. Bell, how has your background as a nurse informed your career in administration as you help develop programs like CHOP Cares?

MB: One of the most important things about being a nurse is having empathy for your patients. The community is like a patient; it's really important to have empathy for the social determinants of health in the community surrounding your hospital. Thinking of the community that way and understanding what ails the "patient community," with my nursing background, is really helpful for me. 

When I was a nurse, I used to volunteer in our Homeless Health Initiative, which provides medical and nursing support to homeless shelters in Philadelphia. I provided education, administered vaccines and helped families get access to primary care. At one point, I was also a home care nurse going into people's homes in very, very underserved communities. It gave me a real window into how resilient families are who are living in poverty. Doing small things to help them has a really big impact.

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