Accountability is undoubtedly the buzzword in health care today. It is something every health care organization in America, including ours, is striving to increase. A few years ago, as we began looking to achieve greater accountability by transforming the delivery of care in the communities we serve, we chose to concentrate on one of the most underserved neighborhoods in our area. The impact of that work soon may serve as an example to providers across the country.

The average annual income of the Frazier Courts neighborhood in South Dallas is $9,000, and more than half of its population is uninsured. Not surprisingly, this community claims one of the highest rates of diabetes in the state of Texas—currently 13 percent of the neighborhood is diagnosed with the disease. Residents there are three times more likely to die from diabetes than those living in Dallas County as a whole.

With an average of one emergency department visit per resident per month, health care in Frazier Courts for generations primarily has been delivered in the most expensive and inefficient way possible. Transforming that, we believed, could change the health and the culture of health for the entire community.

Through a joint effort with the City of Dallas and a $15 million commitment from our board of trustees, we renovated and expanded the area's existing recreation center last year, creating a Diabetes Health and Wellness Institute. The idea: To open a facility unlike any other in our 26-hospital system—one focused on education and prevention, equipped with all the tools necessary for healthy living. The goal: To change the belief by many in the community that diabetes is inevitable and a death sentence by serving the population in a completely different way.

We now deliver care to the residents of the neighborhood in their neighborhood and in a facility that not only is staffed with physicians and nurses, but also care coordinators, diabetes educators, a social worker and nutritionists. The institute provides patients affordable medications, exercise equipment, cooking classes and even a farmers' market for easy access to fresh fruits and vegetables. And if residents cannot make it to the institute, the institute goes to them via outreach programs, community ambassadors and partnerships with local churches.

This new model of care is an example of how we as providers can begin engaging patients in new ways. We can move from episodic and acute care to true health care by focusing on chronic illness, increasing the number of patient-centered medical homes and deploying logical yet out-of-the-box solutions. Only the statistics collected over the next several years will reveal the true success of the Diabetes Health and Wellness Institute. Was the initiative effective? Is it replicable? We are so optimistic that classrooms and treadmills are a part of the future of health care, we have added new models of care such as the institute to the five-year plan we call Vision 2015.

To gain trust and accountability in health care today we need to move outside the walls of our hospitals, teach prevention, emphasize wellness and provide patients the tools they need to achieve it. That is how we believe one achieves the greatest accountability—personal accountability.

Joel T. Allison is president and CEO of Baylor Health Care System in Dallas.

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