Ronald McDonald House New York

Family-Centered Hospitality and Care for NYC Children in Medical Crisis

Lead Organization

Ronald McDonald House New York

New York, New York, United States

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Medically fragile children suffering from serious illness living in poverty in New York City experience significant health inequity. Even if they have access to care, most lack many of the social determinants of health, including a healing environment. Evidence shows these social determinants have greater effect on outcomes than clinical treatment- 20% recovery is clinical, while 80% is influenced by social determinants. Ronald McDonald House New York has a proven model of evidence-based compassionate hospitality which delivers social determinants to pediatric cancer patients and their families. In partnership with Weill Cornell Medicine and the world-renown resources of Cornell University in healthcare, hospitality, and health equity, they will replicate the RMH-NY model, beyond pediatric cancer, to target impoverished NYC children suffering from serious illnesses. The joint solution - designing and delivering an enhanced, evidence-based, culturally competent, family-centered health intervention- will become a model of compassionate hospitality for others.

Problem Statement

While hospitals address clinical needs of seriously ill children, those from impoverished families have many unaddressed needs related to treatment and recovery. Specifically, the following adverse social determinants of health are among top health risks: poor emotional well-being; family disruption; health care illiteracy; unstable immigration status; substandard housing with issues of heating, air quality, poor municipal services; lack of transportation; and inadequate access to nutritious food.Serious illness such as cancer or heart disease, conditions requiring organ transplants or Neonatal Intensive Care (NICU) become catastrophic for families just as medical crisis demands immediate response. Low-income families risk homelessness, loss of employment, neglect of siblings, immigration violations and health-compromising stress, to focus on keeping their hospitalized child alive, all within an expensive and unfamiliar clinical setting. Further, accessing unmet needs falls to parents as desperation overrides resilience, particularly with co-existing barriers including language, legal status, cultural stigma, social isolation, financial hardship, and parental poor health.Influences existing well before a child is sick add to stress, compromising efficacy of treatment and adding to cost. Children’s ability to heal is threatened – as is family stability – during and after medical crisis, adversely affecting over 20,000 children in New York City annually. Pediatric care for critically ill children living in poverty requires a complex and costly clinical approach. The shortfall and disconnect between clinical and social determinants of health are powerful leverage points which must be addressed.

Solution Overview

RMH-NY and WCM will leverage expertise and networks to evolve and scale RMH-NY’s existing model of compassionate hospitality and care by developing a system of sites and programs focused on families and their children’s health. Houses, Family Rooms and Outreach Programs will allow families to stay close to their seriously ill children, resulting in their playing a more active role in their children’s care, ultimately leading to improved patient experience and health outcomes.This project will engage community-based organizations and convene leaders to support impoverished and immigrants NYC children to deliver tailored services addressing family needs during the critical window of care triggered by medical crisis. The network will provide 36,500 Family Nights and 60,000 Family Room Days, reaching the more than 20,000 children in hospitals and infants in neonatal intensive care with stays over five days. Addressing unmet needs of families of seriously ill children living in poverty by providing temporary housing and on-site hospitality near their child’s treatment will improve family integrity and their child’s health outcomes; length of stay and secondary costs may also be reduced.Providing wellness practices, stable home-like environments and nourishing food, social support, and transportation – integral social determinants of health – will result in outcomes of improved sleep, reduced stress and depression, increased confidence, reduced stigma and social anxiety, all improvements linked to improved health outcomes.The partners will evaluate and document the model to be shared via the Ronald McDonald House Charities global network.

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