Integrating Healthcare for Improved Outcomes

When Megan Chepkwurui was a child, she remembers visiting her grandpa’s office often.  “Grandpa” was Rex Skidmore—faculty of the University of Utah College of Social Work for 41 years and dean of the College from 1956 to 1975.  His office was full of books and papers and very important feeling.  When she went home, she and her sister would play “office”—Ms. Chepkwurui as a social worker and her sister as lawyer.

Her love for social work never left.  When she earned a bachelor’s degree through Utah State University, she majored in population and community health, with a minor in social work.   She enjoyed the work her degree funneled her toward, but she felt something was missing.  She missed the advocacy that came with social work.  So when she went back for an advanced degree, it was through the University of Utah’s College of Social Work. 

Ultimately, Ms. Chepkwurui landed somewhere in between the two worlds.  She combined both loves to work in the field of medical social work as the manager of care management at Dixie Regional Hospital.  What does that mean in practical terms?  She oversees of team of 32 nurses and social workers who care for the biological, psychological, and social health of a patient from the moment they walk in the door until discharge.  “Integrating the team is a way to address the big picture for the client,” said Ms. Chepkwurui.  “Hospital stays are usually moments of crisis for people.  Most people don’t plan to be in the hospital.  By staffing dual teams—both a social worker and a nurse—we’re able to respond to all the needs the client has.  I get to be involved in making a difference in someone’s life on one of the worst days of their lives.”

Ms. Chepkwurui doesn’t see much separation in the dual lines of the profession she’s pursued.  “Care management is part of community health and it’s part of social work.  One of the pillars of population health is working with the social determinants of health, just like in social work.  There are so many ways in which they’re related.”  Ms. Chepkwurui continued, “Being a social worker, I’m able to bring another complementary skill set to do the work better.” 

One place this is apparent in her work is with the creation of health plans.  Creating care plans is a routine part of the medical system.  Once a plan is given, patients are usually considered “compliant” or “noncompliant,” based on whether or not they fulfilled the plan to the doctor’s specifications.  Coming from a profession that centers the importance of meeting the patient where they are, Ms. Chepkwurui has a different perspective. “People aren’t noncompliant—the plan didn’t work for them.”

Ms. Chepkwurui’s influence is also reaching far beyond the walls of her office.  Serving as president of the Utah Chapter of the American Case Management Association (ACMA), Ms. Chepkwurui is involved not only in shaping the policies Intermountain Healthcare has around case management, but also the nationwide conversation on best practice.    

Decades after her visits to Grandpa’s office, as Ms. Chepkwurui sits in the college her grandfather helped build, the excitement she has for her profession is palpable.  “From my very first social work class, my first time hearing the NASW code of ethics, I knew I was home,” she says.