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Building a Stronger Safety Net with Community Clinics

Dr. Lisa Abdishoo leads the Los Angeles Christian Health Centers' Joshua House Clinic near LA's Skid Row.

Outside the Los Angeles Christian Health Centers' Joshua House Clinic on downtown's Skid Row, the streets are lined with makeshift shelters pieced together from boxes, tarps, and blankets—daily reminders to clinic staff that the people they serve are among the city's most vulnerable.

Los Angeles Christian Health Centers (LACHC) President and CEO Dr. Lisa Abdishoo has worked at Joshua House since she was a medical resident at Cedars-Sinai nearly 20 years ago. Confronting this community's complex health issues as part of her training inspired her to dedicate her career to homeless medicine.

"Patients know if they walk through our doors that we will take care of them."

"Once I saw how great the needs were, I thought, 'How can I do anything else? I have to do something about this,'" says Dr. Abdishoo, who was hired as LACHC's medical director when she completed her residency.

Community Clinic Initiative

Dr. Abdishoo's passion for helping the underserved is shared by her colleagues at LACHC and the more than 30 other clinics participating in the Cedars-Sinai Community Clinic Initiative.

The Community Clinic Initiative was launched in 2015 to strengthen LA's healthcare safety net by providing support and education to community clinics so the clinics are more equipped to face challenges like meeting growing demand; providing high-quality, efficient care with limited resources; and training the next generation of clinic leaders.

The clinic's involvement will ultimately benefit the more than 10,000 patients LACHC cares for each year.

"Cedars-Sinai worked hard to understand the biggest challenges clinics face today—and designed an initiative that offers support where it is needed most," Dr. Abdishoo says.

LACHC teams participated in yearlong programs focused on financial strength, quality improvement, and leadership development.

Renewed focus on patients

Dr. Abdishoo says her clinic's involvement will ultimately benefit the more than 10,000 patients LACHC cares for each year at its flagship clinic on Skid Row and at other sites serving Boyle Heights and South LA.

As a result the Community Clinic Initiative, LACHC reevaluated floor plans by asking: "How do we want the patient to feel?" This led to the creation of more welcoming, easily navigable spaces and ways to reduce noise and stress.

"We want patients to feel dignified and respected."

Bettina Lewis, chief operations officer, says it helped shift her focus from the bottom line to the patient experience. "I put on a patient's hat to analyze each step they take from the time they enter the front door to the time they leave," she says.

Several LACHC team members participated in Cedars-Sinai's Managing to Leading program, designed for managers who are just starting their community clinic careers. Dr. Abdishoo says the combination of training, networking, and hands-on project experience helped her team develop their strengths as leaders and become more proactive as patient advocates.

Compassionate care for the underserved

Participants in the Cedars-Sinai Community Clinic Initiative share common ground in their dedication to providing compassionate care for the underserved. Here is what LACHC team members say about their commitment to the homeless:

  • Shani Welcome, clinic site manager, will never forget her first assignment at LACHC: washing the feet of the homeless. She was impressed that this was part of the clinic's care process. "I had never seen anything like this," she says. "We want patients to feel dignified and respected. I think we do a good job with that. We have earned their trust."
  • Claudia Barahona, medical assistant supervisor, grew up in Los Angeles but didn't know Skid Row existed until she started working at Joshua House. "We don't question people about living on the streets," she says. "We're here to give them a pair of socks and build a relationship and serve them. Showing them I will go the extra mile to help them fills me up."
  • Vanessa Felix, medical assistant supervisor, adds: "Patients know if they walk through our doors that we will take care of them. They feel safe here. The little things we do, even a small prayer, can be a huge factor in their lives."
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