How Turning a QI Project Into "Research" Almost Sank a Great Program‪.‬

Two years ago I had a great idea. I was able to put two disparate thoughts together in the same sector of my brain. One thought was that the low-income patients of my health center needed a place to exercise at no cost. The other was that the local YWCA, where I had been exercising for twenty years, offered institutional memberships to local agencies, like day care centers, which used these memberships as a staff benefit or incentive. My idea was to purchase institutional memberships for our patients as a new intervention that we could offer in the management of chronic disease. Institutional memberships cost the same as a membership for a family of four, but they allow any four members of an agency to use the cards whenever the facility is open. When a staff member comes from an agency to exercise, she swaps some form of identification for one of the assigned magnetic cards and then has use of all the exercise areas-pool, gym, strength room, aerobics classes, and so on. I checked with the membership coordinator about whether she would be open to offering YWCA institutional memberships to our patients, and she was happy to say, "Yes, why not?" The local community mental health center had recently made a similar arrangement for their patients. I immediately sent out a flurry of emails to every doctor and nurse practitioner at the health center. I also contacted residents who had graduated from our program and former faculty, asking them to send me money or checks written to the YWCA to buy these memberships. Each would cost $875, or only $850 if we paid the total up front. Within two weeks I had raised $1,700. I also wanted to be sure that health center employees would benefit from the project, so I decided to raise money for a staff membership as well. One former graduate called me and asked, "How much money do you need, Luce?" I told him I needed $850 for a staff membership, and he said, "Hey, I blow that much at the track every week! No problem." The check was in the mail.