Transportation Is Healthcare. TCLA 28 Explored What It Takes to Make Care Reachable.
An appointment is on the calendar. A provider is ready. But can the patient get there and get get back home?
The 28th Transit Citizen Leadership Academy cohort met for nine weeks between August and October. Over those class sessions, they met for nearly 24 hours that included learning, field experiences, and conversations about access to healthcare in Middle Tennessee.
With support from sponsor, Ascension Saint Thomas Foundation, 21 participants representing 17 organizations examined how transportation decisions shape people’s ability to reach care. They brought perspectives from transit operations, technology, government, planning, engineering, business, and community services. Together, they developed recommendations that put the patient’s entire journey at the center of the conversation.
Their capstone’s title makes the point plainly: Transportation Is Healthcare.
Participants arrived with different experiences and reasons for joining. Some already worked directly with transportation systems. Others wanted to become stronger advocates, understand regional growth, or bring new ideas into their organizations. Their applications identified access to jobs, housing affordability, and daily living costs as leading transportation concerns.
Healthcare gave the class a shared lens for exploring how those issues connect. Where someone can afford to live affects how far they must travel. Work schedules affect when they can seek care. Transportation costs compete with other household needs. A trip that looks possible on a map may be difficult to complete in daily life.
One participant captured an early realization in session feedback:
“Transportation significantly impacts health outcomes - I knew the link was there but not just how severely.”
That deeper understanding required looking closely at how the system works. Participants explored funding, government responsibilities, transit operations, and the relationships needed to move an idea toward implementation. They asked challenging questions about regional coordination and how to build public support for better mobility.
Some of the most concrete learning happened outside the classroom.
After riding the WeGo Star to Donelson Station, participants evaluated the walk to Donelson Library. They looked at the experience through the eyes of someone arriving by transit: Is the destination easy to find? Is the walk comfortable? Can people of different ages and abilities make the connection?
They saw strengths: nearby restaurants, sidewalks in good condition, and space with potential for growth. They also identified opportunities for clearer directions, more shade, improved accessibility, and public spaces that feel more welcoming and connected.
Those observations helped make a larger lesson visible. A transit stop is one part of a journey. The walk beyond it matters, too.
As one participant wrote in session feedback:
“There's a lot more that goes into transit than service. The experience at the stop is paramount, as well as the journey to and from the stop.”
For healthcare access, those connections can carry particular weight. A patient may need to navigate a transfer, find a clinic entrance, travel with a mobility device, or coordinate help from a caregiver. Getting to the appointment is only half the task. The return trip must work as well.
The class brought those lessons into its capstone, Transportation Is Healthcare: Making Care Reachable in Middle Tennessee. Drawing on course material and a patient and his caregiver’s experience, participants examined gaps in accessing care from their perspective.
Their recommendations focused on data, coverage, and collaboration: make transportation needs visible, make the whole trip usable, and clarify who can help.
One recommendation offers a straightforward starting point: ask about transportation when scheduling care, while there is still time to address a barrier.
The capstone pairs that early question with assistance proportionate to the need. Some patients may need clear information about available services. Others may need help with coordination across transportation providers, benefits, and caregivers. More complex circumstances may call for additional navigation support.
The written report proposes a six-month pilot at one hospital campus to test that approach and track whether identified transportation needs are resolved before appointments. It is a proposal for further discussion, with a practical purpose: help patients make the next trip while gathering information that can guide longer-term improvements.
The post-program surveys suggest participants left ready to carry the conversation forward.
Among the Post- CLA respondents:
100% reported better understanding of transportation decision-making and funding.
92% reported better understanding of how transportation affects access to healthcare.
100% said they were likely to discuss mobility with colleagues, elected officials, or community leaders.
92% said they were likely to apply something they learned to their work, organization, or community.
These findings reflect respondents’ own assessments and intentions. The next opportunity is turning that readiness into action.
One participant described the shift this way:
“Yes - TCLA helped me zoom out and realize the impact transportation has on the individual and recommit to remembering that in my work.”
That is a meaningful outcome for a leadership academy: people returning to their organizations and communities with a clearer understanding of the system and greater attention to the people who depend on it.
Thank you to the Ascension Saint Thomas Foundation, our speakers and partners, and the members of TCLA 28 for investing in this work.
The class has given us recommendations worth discussing and a question worth carrying into every conversation about healthcare access: What will it take for this person to reach care and return home?
Percentages are rounded. The proposed capstone pilot has not been implemented.
