To contribute to the health and well-being of refugee and immigrant patients, families and communities through a partnership that promotes cultural humility in the care provided.
Community House Calls (CHC) is a program within Harborview Medical Center’s Interpreter Services. Community House Calls serves limited English proficient patients, families and communities who receive health care at Harborview. Bilingual/bicultural caseworker cultural mediators provide same language services for patients facing complex medical and social circumstances and serve as liaisons to their respective communities.
Community House Calls began in 1994 when doctors Ellie Graham and Carey Jackson were jointly awarded a Robert Wood Johnson grant to help address barriers to health care for refugees and immigrants receiving care at Harborview. Caseworker cultural mediators (CCM) were hired with input from community leaders. In 1996, CHC became a Harborview program in the Interpreter Services Department, and more CCMs as well as a nurse manager were added to the staff. Currently, there is a nurse manager working with a team of nine that serve six language groups: Amharic, Cambodian, Somali, Swahili, Spanish, and Vietnamese. Of this team, two staff focus on diabetes self-management in the Somali and Spanish-speaking communities.
- Navigation: Support and teach patients to navigate health care system by overcoming barriers and identifying gaps. Facilitation of Medicaid-eligible patients to receive coverage. Help with forms and applications. Accompany patients to outside appointments as needed.
- Care Management: Monitor and coordinate on-going needs. Find resources for social issues that impact the health of patients, such as immigration concerns, job searches and enrolling in English for citizenship classes. Coordination of patient care, including arranging transportation and providing home visiting as necessary.
- Mediation & Advocacy: Observe and communicate patient and family beliefs and values as needed when in the healthcare, social service, school and agency setting.
- Health Education: Assist patients in learning about medical and health issues as well as how the healthcare system works.
- Interpretation: Provide spoken language interpretation to patients, medical providers, and staff.
- Cultural mediation & advocacy: Facilitating clinical encounters that involve cultural differences. Provide cultural consultation about issues affecting patient care. Care Coordination for complex medical and psycho-social needs.
- Education: Teach providers about cultural issues surrounding care for their patients e.g., health beliefs, traditional health practices, explaining diagnoses to patients, end-of-life issues and parenting practices. Didactic presentations providing cultural information on a variety of topics.
- Education on requests for health topics using a cultural lens.
- Consultation on issues impacting ethnic communities.
- Bridging the institution and communities viewpoints to provide positive health outcomes and optimal relationships, and equitable care.
- Facilitation of community efforts.
- Harborview Medical Center’s Community House Calls Referral
Word Document | PDF Format
- Community House Calls Brochure
- Beyond Medical Interpretation: The Role of Interpreter Cultural Mediators (ICMs)
A manual describing the work of Community House Calls in building bridges between ethnic communities and health institutions. (Revised in 1998, 41 pages).
The following videos highlight how Harborview’s patient navigator program helps LEP patients from other cultures navigate the health care system.
The following video illustrates a simulated “prehuddle” with a Cambodian interpreter/cultural mediator before a Palliative Care family meeting.
The following video shows the Physicians for a National Health Program Western Washington (PNHPWW) August 15th Monthly Meeting focused on the Community House Calls/Interpreter Services Program at Harborview Medical Center with presentations and discussion led by Lea Ann Miyagawa – Nurse Manager and three Cultural Mediator team members – Salma Musa, Kim Lundgreen and Jose Mayorga, including brief cases illustrating how they facilitate underserved patients to interact with and overcome barriers to health care.
Publications referencing the Community House Calls Program
- Faculty Spotlight: Dr. Rashmi Sharma. September 2020 article on the University of Washington Department of Medicine website.
- Interconnected: The Latino community calls for action amid high COVID-19 rates. August 2020 Seattle Times article that includes comments from Rose Cano.
- Ending Neglect: The Elimination of Tuberculosis in the U.S. describes a public health TB outreach program based on House Calls caseworker model. Pages: 197-199.
- Handbook of Immigrant Health edited by Sana Loue; Pages: 73-75; 179-180
- Speaking out as a medical interpreter and cultural mediator
April 2018 article in UW Medicine’s The Huddle publication highlighting the work of caseworker / cultural mediator Jose Mayorga.
- In Their Shoes
Spring 2018 article in UW Medicine Magazine highlighting the work of caseworker / cultural mediators Anab Abdullahi and Rose Cano.
- Diabetes Self-Management
- Stroke Awareness for Vietnamese and Cambodian Communities
- Kidney Health for Cambodian Communities
- Vietnamese Seniors
- Ethiopian Health Forum
- Cambodian Health Forum
- Daryel: Somali Women’s Wellness Project
- Homeless Diabetics from the Spanish-speaking Community
Community House Calls
Harborview Medical Center
Box 359977 Seattle, WA 98104
Contact: Lea Ann Miyagawa, MN, RN at firstname.lastname@example.org
Phone: 206 744-9256
Fax: 206 744-9981