Page 38 - 2021 MHA Start-up Guide

From the outside, a mobile healthcare program may look like a “clinic on wheels,”— in other
words, the trappings and processes of a fixed site simply transferred to a mobile platform. While
it’s true that some programs operate in this way, mobile can and should be much more . If you
understand this going into the development of your program, you’ll not only have a much higher
likelihood of success, you’ll help disenfranchised community members regain control of their
own care .

How is a mobile clinic different from a fixed site? One key element lies in the value of working in a
community, among its members . Considering mobile healthcare is often for marginalized or un-
derserved communities, your base of clients may have already experi-
enced a loss of power or control of their care based on the perception
it’s imperative that of their social status. In a fixed-site encounter, this is exacerbated
staff adopt a collabora- by the fact that community members are the minority on site; the
tive tone with each other and dominant culture is that of the organization, and the majority of
with their clients. Shared decision the people are employees of the organization . Consider how
you felt the last time you walked into a large hospital as a cli-
making will demonstrate to the client ent . Did you experience a feeling of loss of control over your
that they are not on lowest rung of own body and care? Now imagine how someone who lacks
the ladder, but rather, can control over many areas of their life — whether due to home-
lessness, poverty or mental health issues — must feel . It could be
meaningfully participate overwhelming, disorienting and discouraging .
in their own care.

Now imagine how different it might feel if the hospital specialist were
to come to your home . In your own space, you’d have authority and
control . You’d feel empowered to participate in your own care . Similarly, in a mobile context,
power can be restored to the client. First of all, the gap between staff and client shrinks. Most
vehicles hold a maximum of four staff members. And because the vehicle is embedded in the
community, even after they’ve entered the vehicle, the client is in the majority; they’re not forced
to relinquish their power, and that helps them feel safe.

Mobile healthcare, by simply being mobile, can encourage client agency in a way that a fixed-
site organization simply cannot. But it doesn’t end with small staffs and accessibility. How you
conduct your program will also affect the clinical, educational and emotional impact you have. A
person who sees their own community as forgotten or neglected will see a mobile clinic in their
neighborhood as an effort toward inclusion. If, however, they open the door to the mobile and are
greeted by staff wearing white coats, attempting to impose institutional culture or simply speak-
ing the wrong language (literally or figuratively), that outreach effort will fizzle.

Your onboard environment should be welcoming, warm and safe for anyone who comes on . Your
staff should be mindful of the fact that how they conduct themselves will directly affect their abil-
ity to engage with those who need care the most . For example, in hospitals and other traditional
institutions, it’s not unusual to see a staff person give orders to the person “below” them in the
hierarchy; the implication to many clients is that they, too, will be on the receiving end of orders .
On a mobile, it’s imperative that staff adopt a collaborative tone with each other and with their
clients . Shared decision making will demonstrate to the client that they are not on lowest rung of
the ladder, but rather, can meaningfully participate in their own care .

36 MOBILE HEALTH CARE PROGRAM STAR T-UP GUIDE