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The AIMS Model: An Approach to Addressing the Social Determinants of Health in Primary Care

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Although a growing body of research suggests that social determinants of health—social, functional, environmental, cultural and psychological factors—are intricately linked to health and wellness, our fragmented medical and social services are underequipped to address these needs. The Ambulatory Integration of the Medical and Social (AIMS) model—developed by the Center for Health and Social Care Integration (CHaSCI) at Rush University Medical Center—integrates masters-prepared social workers into primary care teams to identify, address and monitor social needs that influence health. Preliminary evidence indicates that AIMS reduces clients’ emergency department visits, hospitalizations and readmission rates. Also AIMS creates opportunities for community-based organizations (CBO) to develop partnerships with local health clinics to integrate care and promote better health outcomes—building on the expertise of CBOs and opening the door for new sustainability mechanisms.

This web seminar will highlight training and implementation support for CBOs interested in replicating AIMS.



Robyn Golden, LCSW, Associate Vice President of Population Health and Aging, Rush University Medical Center, Chicago, IL

Matthew Vail, LCSWClinical Social Worker in the Department of Social Work and Community Health at Rush University Medical Center & Coordinator for the Center for Health and Social Care Integration.

Sharlyn Pech, LCSW, AIMS Social Worker, Aging Care Connections, LaGrange, IL