Chicago Community Health System Thrives Under Leadership of Executive Nurse Fellows Program Alum

In many ways, Chicago's Access Community Health Network (ACCESS) represents the kind of nurse-led health care envisioned in the Institute of Medicine's report on the future of nursing.

    • December 15, 2010

Last fall, Donna Thompson, R.N., M.S., got a call from an Illinois lawmaker on behalf of a recently unemployed and newly uninsured constituent who was the victim of a violent neighborhood crime. He had been beaten in the head with a baseball bat. The man had been treated in a local hospital, but the care didn’t cover his two front teeth; he had to keep his tongue pressed up against them to keep them from falling out. And he was discharged with no plan for follow-up care and no means to afford it.

Thompson understands the importance of proper dental care (her uncle died from an untreated tooth infection) and stepped in to help the man keep his teeth. She connected him to a dentist at Access Community Health Network, where she serves as chief executive officer.

Still in possession of both pearly whites, the man is one of millions of people in underserved areas of greater Chicagoland who have benefited from the integrated approach to comprehensive health care services offered at ACCESS, which has flourished under Thompson’s steady hand.

An alumnus of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2003–2006), Thompson took the reins of ACCESS in 2004, after having worked there for nearly a decade. The network is now the largest federally qualified health care (FQHC) organization in the country, serving more than 215,000 patients every year and giving patients access to more than 20 specialty care services.

It is the kind of care envisioned in the groundbreaking report on the future of nursing released in October by the Institute of Medicine (IOM). Indeed, at ACCESS, nurses hold positions of leadership above and alongside other professionals; physicians, nurses and others work together to provide a seamless array of primary and specialty care for all patients, regardless of their backgrounds or ability to pay; nurses carry out the kind of primary and preventive care services they were trained to do; and nurse research is a priority.

In many ways, it represents the future of the nursing profession as outlined in the IOM report, The Initiative on the Future of Nursing: Leading Change, Advancing Health.

Community observers are taking note. In 2008, the United Way of Metropolitan Chicago gave ACCESS its Outstanding Agency Partner Award and in 2009 it gave the network its Outstanding Leadership in Continued Quality Improvement Award.

Thompson has also drawn kudos as a nurse leader. In 2007, she received the Athena Award for her leadership in developing community health and was recognized as one of Chicago United’s Business Leaders of Color. In 2008, Thompson received the Chicago National Organization for Women’s 2008 Outstanding Community Leader Award.

The road to success hasn’t always been easy, especially in recent years, Thompson says.

The Illinois state government can be slow in paying for services, she notes. And that has led to hiring freezes and spending caps. “‘This too shall pass’ is my stance during difficult times,” she wrote in a recent blog post.

Indeed, if past is precedent, ACCESS will come out ahead.

In 1995, Thompson was asked to help turn around ACCESS, then a dilapidated health system in danger of financial collapse. Buoyed by the deep commitment of the network’s providers to their patients and the network’s identity as a shelter from some of the most devastating effects of poverty, Thompson threw her energy behind rebuilding ACCESS—and she did so with remarkable success.

“I got to understand that the network is more than just a collection of doctors’ offices,” she says. “It is a place that provides jobs to the community. It is a cooling station for those who don’t have air conditioning and who don’t feel comfortable opening windows in the unsafe neighborhoods where they live. It’s a place where health providers get together to make sure people have turkey at Thanksgiving, and toys and coats at Christmas. It is a safe haven.”

Nearly a decade later, in 2004, she was named chief executive officer. Since then, the network has added 15 new health centers, grown its budget to $136 million, and earned accreditation from the Joint Commission, a distinction that places it among the top 10 percent of ambulatory care providers in the nation.

Thompson has also taken several groundbreaking steps in community health care practices that have won national recognition. ACCESS now ties physician compensation to quality measures; provides neighborhood-based specialty care; co-locates services to reach isolated populations; works with hospitals to address emergency room overcrowding; and cultivates research partnerships to generate evidence-based insights about patients and practices.

In 2002, she organized Stand Against Cancer, bringing together a diverse group of more than 1,400 women to advocate for increased breast and cervical cancer funding, a project she focused on during the three years she spent as an Executive Nurse Fellow. Thanks to her work, the state government has set aside $4 million a year to combat breast and cervical cancer ever since 2004, and 4 million women have been reached through awareness campaigns.

The daughter of a nurse’s aide who grew up in rural Illinois, Thompson raced up the ladder of nurse leadership and has no plans to slow down—even in the current economic climate. Rather, she sees an explosion of growth in the coming years as millions more people enter the health care system due to the health reform law. Indeed, she expects the patient population at ACCESS to grow fivefold—to 1 million a year—in the years ahead.

“We are positioning ourselves to be one of the major portals in our area to absorb the many people who for the first time will have a primary health care home,” she says. “We are really excited about that.”

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