Does the Whole Impact Quality or Does the Individual Impact it First?

By Rosemarie Yetman-Arac MS, RN

In nursing school, students learn “the whole is greater than the sum of its parts,” a saying first coined by Aristotle. Every nursing theory builds on the connection between the person and how their environment affects them. It is the fundamental pillar of nursing that balances the profession as both an art and a science. The basic elements that grounds nursing philosophy all explore the point of convergence between the ever-changing biopsychosocial dynamics that impact the persons’ healthy well-being.

I am so proud that homeless health awareness is breaking into mainstream healthcare subject matters. As a Registered Nurse working in a New York City Emergency Department, first responders and emergency care providers see the effects of homelessness very closely. We see these individuals so frequently, we know their names and already know what chronic conditions are being exacerbated by homelessness before they even triage. We see them get discharged and sometimes get admitted and then discharged again back to into the homeless-hospital– cycle.

Thanks to pioneering research efforts from clinicians and supportive organizations such as the National Healthcare for the Homeless Council, we know that homelessness exacerbates the simplest of illness, prevents healing, and contributes to significant unnecessary healthcare costs that staggers in the multi-millions, if not billions. But furthermore, homelessness does not only affect a person on an individual basis, it impacts the entire community, and thus the ecosystem.

My Resolve: to dismantle traditional ways of systems thinking that silos our capacity to share viewpoints, to share responsibilities and to share solutions.

We as communities should value and work together towards the shared transdisciplinary goals of improving wellness and general health. Until we break down the concepts of yesterday that each discipline or field, each sector or industry, from business model to job description only is responsible for their own welfare, today’s real-life problems will become drastically more morbid. And to think that an individual or an organization’s output cannot produce a ripple effect that can further strain the economy, and even worse, to think that their choices does not ultimately boomerang inverse consequences is nonsensical.

Groups that disassociate from one another weakens productivity of the overall system. No one can thrive to their greatest potential, and those who are considered the most vulnerable populations will feel the grunt of the deteriorating economy, such as the homeless. Partnerships will break down political barriers, financial restraints, and will also break down the tunnel vision viewpoints of those who struggle to see the potential of a transdisciplinary future.

In healthcare, we have a saying that we all know we must never say: ‘It’s not my job’. It is too easy to become solely task or self-entity-oriented that we forget our unified vision, mission and values. Thus, we unconsciously work against the ultimate goal. This phenomenon has a name; it is called ‘The Silo Effect’ coined by Gillian Tett and it is cancerous and extremely prevalent in our society. In fact, it also has an after-effect that I call the ‘Silo Reflex’, which is a waterfall of consequences that produce feelings of unconscious resentment that is disguised as apathy and gradually minifies autonomy. Ultimately, this leads to dysfunction in groups that have been systematically oppressed by the rippling network of the dominant culture that is the ‘Silo Effect”.

Those with a tight education budget are reluctant to allocate their resources to health promotion strategies; those with restricted funds for social services initiatives don’t think they should primarily allocate their resources to promoting health education, and so on and so forth which causes estrangement and repression. This type of tribalistic thinking permeates into and determines the efficiency of the economic stability of our communities: from city agencies to the grocery and 99¢ stores, from the corner laundromats to the specialty supermarket, and from your mother’s pharmacy all the way to your favorite brunch spot down to your local hospital. Without first mindset change, quality outcomes will be departmentalized at best, mediocre at least, and likely unsustainable as it is not feasible.

Partnerships that share the synergistic vision of transcending beyond disciplinary boundaries improves the well-being of people we serve in our communities.

Utilizing a transdisciplinary framework to approach common issues our communities face will exponentially:

  • Save millions of City Budget dollars
  • Better utilization of taxpayer dollars through a sophistication of precision efficiencies in resource allocation
  • Ultimately expand discretionary funding opportunities that can support more small businesses
  • Minimize budget cuts to healthcare organizations and social services due to under-utilization of predictive analytics

Synergistic partnerships thicken the threading of an alternative trajectory that lowers the cost of providing value to health consumers and improves the quality of life for all people. Support of the concept of transdisciplinary care would allow the strategic reallocation of appropriate investments in infrastructure that aims to assist organizations in building creative solutions to aid homeless relief and most definitely more governmental involvement to aid individuals or small businesses trying to make a difference in their communities. It will benefit healthcare organizations and insurance payers by saving funds through high utilization cost avoidance. This will allow both to prioritize resource reallocation aimed to strategically reduce homelessness, improve the healthcare of the homeless, and more comprehensively impact healthy wellness. If you can impact the well-being, you can ultimately impact the world.

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Thanks !

Thanks for sharing this, you are awesome !

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