Hospitals and doctors offices are not the only - and sometimes not the best - places for people to receive health care.
For 15 years, a Carolinas HealthCare Systems program has focused on "outpatient settings," caring for people where they live.
"We understand the value of reaching the individual person where they are," said Pam Hurley, director of the CHS faith community health ministry. "Where do people come the most? They are coming to meet and gather in faith communities."
The faith community health ministry program started in 1997 at Carolinas Medical Center-NorthEast in Concord and was known then as the "parish nurse program." It sets up nurses and health-care promoters in faith communities. Now, more than 70 faith communities in six counties have nurses or educators in their congregations.
A hospital or doctor's office often isn't set up for nurses to build relationships with patients. A nurse working in a faith community, on the other hand, will see patients at weekly worship and events.
"Where is there a better trust relationship than to see their nurse in a church setting?" Hurley said.
Nurses and health educators offer classes for congregations. Nurses meet with members of the community, often answering questions about medications and health-care concerns.
Many people wouldn't make an appointment with the doctor to talk about those concerns, said Rebecca Barnes, faith community nurse for Kannapolis Church of God.
"There are a lot of people who will not go to the doctor or to the hospital until it is a critical need," Barnes said. "They have put things on the back burner because they are afraid to go, or they have no insurance.
"When people trust you, they will come to you, and you can help them get the health care they need."
Ministry and nursing
Barnes became a faith community nurse after working as a nursing home administrator for 30 years. She was looking for a change. She said the position at Kannapolis Church of God allowed her to "do nursing like I wanted to when I started (her nursing career)."
She likes having time to talk with people at length about their concerns and connect them with health-care information and resources. She sometimes accompanies people to doctor appointments and follows up with people who have talked with her about concerns.
"It is just a great opportunity to do ministry and nursing," she said. "I've got the best job in the world."
While most faith communities in the program are in Cabarrus County, the program is expanding into other regions and into more faith communities, including Hindu and Buddhist.
"Because the program has matured and been refined, we just continue to step it up on the structure of the program and benefits to being part of this program," Hurley said.
CHS has tracked the benefits of the program over the years. In 2011, faith community nurses made more than 200 referrals to doctors and conducted hundreds of reviews of people's medications.
They made 700 interventions, which prevented everything from emergency-room visits to duplicate medications, Hurley said.
The nurses' new Live Abundantly program encourages people to live healthier through better diet, more exercise and enough rest. More than 500 people have signed up for the program this year.
Faith communities offered 1,700 exercise classes in 2011, and participants together logged thousands of minutes walking and lost a total of 468 pounds, Hurley said.
Most nurses and health promoters in the program are volunteers, but compensated nurses are considered CHS employees, Hurley said.
CHS plans to continue extending the program, including doing more research that could help health-care leaders better understand how to address the challenging transition from inpatient to outpatient care.