S. Jager, Emily Hentz, MacKenzie Pairitz, Shae Jansen, Javier Sevilla-Martir
Lack of time dedicated to patient education is a barrier to motivational, empathetic conversations in the setting of high patient volume at the Indiana University Student Outreach Clinic (IUSOC). The Education Empowerment Team (EET) was created to: (1) empower patients through educational conversations and (2) empower a cohort of graduate and health professional students to grow in the skills of motivational interviewing (MI) and patient education. The purpose of this study is to detail the EET implementation model and evaluate the successes and barriers encountered by team members during its first three months of implementation. Fifteen EET members were selected and completed three training sessions. A survey was dispersed to members of the EET after three months of implementation. Thematic analysis of the team’s qualitative perception of their role, as well as quantitative evaluation of encountered barriers and training session utilization was completed. McNemar’s test was implemented to determine significance. EET members found the MI pre-clinical training to be most utilized (p=0.02) and requested a second, ‘refresher’ MI training later in the year, as well as role-play training scenarios. Members found the public setting of EET encounters to be the largest barrier to effective patient-volunteer relationships. The EET was successfully implemented at the IUSOC from January to March 2020 when COVID-19 restrictions forced clinic closure. The shortened duration of the EET was the largest limitation of the study; yet, the reproducible EET implementation model serves as an effective starting point for the implementation of education-focused teams at student-run free clinics. Future steps involve modifying the EET model, expanding interdisciplinary heterogeneity of the team, and evaluating the impact of EET on patient health outcomes objectively by disease progress and subjectively by patients’ assessments.
{"title":"Implementation of an Education Empowerment Team to Promote Education-Focused Conversations in a Student-Run Free Clinic: A Reproducible Model","authors":"S. Jager, Emily Hentz, MacKenzie Pairitz, Shae Jansen, Javier Sevilla-Martir","doi":"10.59586/jsrc.v7i1.301","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.301","url":null,"abstract":"Lack of time dedicated to patient education is a barrier to motivational, empathetic conversations in the setting of high patient volume at the Indiana University Student Outreach Clinic (IUSOC). The Education Empowerment Team (EET) was created to: (1) empower patients through educational conversations and (2) empower a cohort of graduate and health professional students to grow in the skills of motivational interviewing (MI) and patient education. The purpose of this study is to detail the EET implementation model and evaluate the successes and barriers encountered by team members during its first three months of implementation. Fifteen EET members were selected and completed three training sessions. A survey was dispersed to members of the EET after three months of implementation. Thematic analysis of the team’s qualitative perception of their role, as well as quantitative evaluation of encountered barriers and training session utilization was completed. McNemar’s test was implemented to determine significance. EET members found the MI pre-clinical training to be most utilized (p=0.02) and requested a second, ‘refresher’ MI training later in the year, as well as role-play training scenarios. Members found the public setting of EET encounters to be the largest barrier to effective patient-volunteer relationships. The EET was successfully implemented at the IUSOC from January to March 2020 when COVID-19 restrictions forced clinic closure. The shortened duration of the EET was the largest limitation of the study; yet, the reproducible EET implementation model serves as an effective starting point for the implementation of education-focused teams at student-run free clinics. Future steps involve modifying the EET model, expanding interdisciplinary heterogeneity of the team, and evaluating the impact of EET on patient health outcomes objectively by disease progress and subjectively by patients’ assessments.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43322052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carissa K. Harnish-Cruz, Jeremy Silver, S. Veldheer, Seong Ho Jeong, Alexis Reedy-Cooper
Background: While student-run free clinics (SRFCs) increasingly serve as part of the safety net for the uninsured and underinsured, it is unknown whether SRFCs consistently follow immunization guidelines in patients that smoke. This study characterized the preventative care in our clinic by evaluating the rate of adult immunizations and referrals of patients that smoke to cessation treatment. Methods: We conducted a retrospective chart review of patients seen in 2016 at the LionCare Free Clinic. Data extracted included tobacco smoking status, desire to quit, smoking cessation treatment referrals, influenza and pneumococcal vaccination status, and demographics. Chi-square tests and Fisher Exact analysis were used to examine differences in influenza and pneumococcal vaccination rates in smokers versus non-smokers. We assessed the rate of interested smokers who received a referral to cessation therapy. Results: In 2016, 498 patients were evaluated, of whom 67% were smokers. Among smokers, 21% reported receiving the influenza vaccination compared to 20% of non-smokers (p=0.85). Seven percent of patients who smoke received the pneumococcal vaccine compared to 5% of non-smokers. Of the total patients who were vaccinated, a small percentage received the vaccines in the clinic. Although 66% of smokers reported interest in quitting during the first clinic visit, only 3% were referred to a smoking cessation program. Conclusion: SRFCs face challenges in providing preventative health care for the underserved population. Despite guidelines recommending smokers receive the pneumococcal vaccine before age 65, few patients received it. Quality improvement interventions are needed to improve preventative health services to this vulnerable population.
{"title":"Assessment of Vaccination Rates among Smokers and Non-Smokers at a Student-Run Free Clinic","authors":"Carissa K. Harnish-Cruz, Jeremy Silver, S. Veldheer, Seong Ho Jeong, Alexis Reedy-Cooper","doi":"10.59586/jsrc.v7i1.206","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.206","url":null,"abstract":"Background: While student-run free clinics (SRFCs) increasingly serve as part of the safety net for the uninsured and underinsured, it is unknown whether SRFCs consistently follow immunization guidelines in patients that smoke. This study characterized the preventative care in our clinic by evaluating the rate of adult immunizations and referrals of patients that smoke to cessation treatment. \u0000Methods: We conducted a retrospective chart review of patients seen in 2016 at the LionCare Free Clinic. Data extracted included tobacco smoking status, desire to quit, smoking cessation treatment referrals, influenza and pneumococcal vaccination status, and demographics. Chi-square tests and Fisher Exact analysis were used to examine differences in influenza and pneumococcal vaccination rates in smokers versus non-smokers. We assessed the rate of interested smokers who received a referral to cessation therapy. \u0000Results: In 2016, 498 patients were evaluated, of whom 67% were smokers. Among smokers, 21% reported receiving the influenza vaccination compared to 20% of non-smokers (p=0.85). Seven percent of patients who smoke received the pneumococcal vaccine compared to 5% of non-smokers. Of the total patients who were vaccinated, a small percentage received the vaccines in the clinic. Although 66% of smokers reported interest in quitting during the first clinic visit, only 3% were referred to a smoking cessation program. \u0000Conclusion: SRFCs face challenges in providing preventative health care for the underserved population. Despite guidelines recommending smokers receive the pneumococcal vaccine before age 65, few patients received it. Quality improvement interventions are needed to improve preventative health services to this vulnerable population.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47044873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Florida continues to rank among the highest states for mental health diagnoses in the nation. Alachua County, which is home to the Gainesville community, continues to experience significant disparity in diagnoses versus access to behavioral health interventions. A significant contributor to this disparity may be the socioeconomic wellbeing of the region, where many individuals report low socioeconomic status and limited access to medical insurance. Gainesville is also home to an advanced network of primary care services and specialties to meet community needs. Among these networks is an established system of student-run medical clinics for uninsured/underinsured patients. New to this system is a psychology graduate student-run behavioral health clinic with an integrated primary care system working hand-in-hand with other medical services. The present article aims to (1) describe the development of an independent, student-run behavioral health clinic model by a graduate student team and (2) describe the implementation/integration of this new clinic model within a free clinic network to meet a need for accessible mental health services, as well as provide patients with an opportunity for integrated care. Current barriers, facilitators, and plans for the models moving forward are discussed.
{"title":"Establishing Independent and Integrated Student-Run Behavioral Health Clinics to Address Mental Health Disparities in Gainesville, Florida","authors":"Gabriel Cartagena, E. Ferguson, L. Waxenberg","doi":"10.59586/jsrc.v7i1.241","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.241","url":null,"abstract":"Florida continues to rank among the highest states for mental health diagnoses in the nation. Alachua County, which is home to the Gainesville community, continues to experience significant disparity in diagnoses versus access to behavioral health interventions. A significant contributor to this disparity may be the socioeconomic wellbeing of the region, where many individuals report low socioeconomic status and limited access to medical insurance. Gainesville is also home to an advanced network of primary care services and specialties to meet community needs. Among these networks is an established system of student-run medical clinics for uninsured/underinsured patients. New to this system is a psychology graduate student-run behavioral health clinic with an integrated primary care system working hand-in-hand with other medical services. The present article aims to (1) describe the development of an independent, student-run behavioral health clinic model by a graduate student team and (2) describe the implementation/integration of this new clinic model within a free clinic network to meet a need for accessible mental health services, as well as provide patients with an opportunity for integrated care. Current barriers, facilitators, and plans for the models moving forward are discussed. \u0000 \u0000 ","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45658111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Dutta, Emmy Shearer, Luis Garcia, Helen Liu, J. Swee, Seulji Ku, Cara Lai, Steven Lin, T. Montacute, M. Charon
Background: Free clinics can serve as an important source of health information among underserved populations; however, it is difficult to track the effectiveness of health education interventions for these patients. Thus, the objective of our study was to develop and assess the impact of a health education intervention in a student-run free clinic setting. Methods: A quality improvement project was implemented in which surveys were used to assess four confidence and knowledge measures among patients who did or did not receive health education from undergraduate volunteers. Statistical significance was determined using student’s t-tests. Results: Patients who received health education from undergraduate volunteers during clinic visits reported increased confidence in their ability to manage health conditions (p<0.01), knowledge of their prescribed medications (p<0.05), and ability to manage their symptoms (p<0.05) after clinic visits compared to before their clinic visits. Discussion: Dedicated health education interventions by undergraduate volunteers during free clinic visits can lead to increased patient confidence and knowledge of their health conditions. Due to their iterative nature and ease of implementation, quality improvement frameworks may be a useful way to track the efficacy of health education programs in the free clinic setting.
{"title":"Increasing Patient Activation at a Student-Run Free Clinic: Effectiveness of a Health Education Intervention","authors":"R. Dutta, Emmy Shearer, Luis Garcia, Helen Liu, J. Swee, Seulji Ku, Cara Lai, Steven Lin, T. Montacute, M. Charon","doi":"10.59586/jsrc.v7i1.210","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.210","url":null,"abstract":"Background: Free clinics can serve as an important source of health information among underserved populations; however, it is difficult to track the effectiveness of health education interventions for these patients. Thus, the objective of our study was to develop and assess the impact of a health education intervention in a student-run free clinic setting. \u0000Methods: A quality improvement project was implemented in which surveys were used to assess four confidence and knowledge measures among patients who did or did not receive health education from undergraduate volunteers. Statistical significance was determined using student’s t-tests. \u0000Results: Patients who received health education from undergraduate volunteers during clinic visits reported increased confidence in their ability to manage health conditions (p<0.01), knowledge of their prescribed medications (p<0.05), and ability to manage their symptoms (p<0.05) after clinic visits compared to before their clinic visits. \u0000Discussion: Dedicated health education interventions by undergraduate volunteers during free clinic visits can lead to increased patient confidence and knowledge of their health conditions. Due to their iterative nature and ease of implementation, quality improvement frameworks may be a useful way to track the efficacy of health education programs in the free clinic setting.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44594973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare providers’ implicit biases negatively impact the quality of patient care. Education to promote bias awareness is the first step to mitigating this negative effect. Implicit bias education is particularly relevant to volunteers at student-run free clinics, where patients often belong to underserved populations who are most vulnerable to providers’ implicit bias. No prior studies have reported the development and evaluation of an implicit bias curriculum in this setting. We developed an evidence-based health equity curriculum for undergraduate student volunteers at a student-run free clinic and report preliminary results of a pilot study. The training program was regarded as highly informative and relevant to clinical practice by students, and their qualitative feedback was organized thematically. Our data suggest that volunteers experienced increases in empathy after participating in this implicit bias training, despite not demonstrating a significant change in implicit biases. Further study of educational interventions to modify unconscious bias and provider empathy is warranted to augment the efficacy of these interventions and their benefit to patient care.
{"title":"Implementation of an Evidence-Based Health Equity Curriculum for Reducing Implicit Bias at a Student-Run Free Clinic","authors":"K. Gururangan, Charisma Hooda, L. Osterberg","doi":"10.59586/jsrc.v7i1.256","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.256","url":null,"abstract":"Healthcare providers’ implicit biases negatively impact the quality of patient care. Education to promote bias awareness is the first step to mitigating this negative effect. Implicit bias education is particularly relevant to volunteers at student-run free clinics, where patients often belong to underserved populations who are most vulnerable to providers’ implicit bias. No prior studies have reported the development and evaluation of an implicit bias curriculum in this setting. We developed an evidence-based health equity curriculum for undergraduate student volunteers at a student-run free clinic and report preliminary results of a pilot study. The training program was regarded as highly informative and relevant to clinical practice by students, and their qualitative feedback was organized thematically. Our data suggest that volunteers experienced increases in empathy after participating in this implicit bias training, despite not demonstrating a significant change in implicit biases. Further study of educational interventions to modify unconscious bias and provider empathy is warranted to augment the efficacy of these interventions and their benefit to patient care.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47667699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madhavi Murali, Alaya Bodepudi, Imaima Casubhoy, E. Kraemer
Background: The hemoglobin A1c is critical for monitoring and managing type II diabetes and providing clinicians with a framework for a treatment plan. Our study analyzes compliance to the American Diabetes Association (ADA) standards of appropriate A1c monitoring and encourages other clinics to monitor the same information within their own clinics. Methods: A retrospective chart review was conducted on all patients who visited the Sojourner Health Clinic between January 2017 and November 2019. All patients who had met the criteria for A1c screening based on recommendations from the ADA were included in the study, as well as patients who were charted as diabetic or pre-diabetic. A total of 88 patients met the criteria for this study. Data collected included patient documentation as diabetic or pre-diabetic and patients’ three most recent A1c values with corresponding dates. Based on this data, these patients were categorized as diabetic, pre-diabetic, or non-diabetic, and were evaluated on whether their A1c was monitored at appropriate intervals. Results: A total of 21.6% of patients were monitored appropriately for their diabetic status determined by their A1c values. Only 18.2% of diabetic patients were accurately monitored. Patients with an unknown diabetic status had the lowest rate of appropriate monitoring. Conclusions: Most patients at the Sojourner Health Clinic are not properly monitored for diabetes using the clinic's modified A1c monitoring guidelines. The clinic can make several improvements to strengthen adherence to these guidelines with the implementation of new protocols for better A1c monitoring. Further studies should be made to assess the efficacy of these changes.
{"title":"An Evaluation of Hemoglobin A1c Monitoring at a Student-Run Free Clinic in Kansas City, Missouri","authors":"Madhavi Murali, Alaya Bodepudi, Imaima Casubhoy, E. Kraemer","doi":"10.59586/jsrc.v7i1.232","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.232","url":null,"abstract":"Background: The hemoglobin A1c is critical for monitoring and managing type II diabetes and providing clinicians with a framework for a treatment plan. Our study analyzes compliance to the American Diabetes Association (ADA) standards of appropriate A1c monitoring and encourages other clinics to monitor the same information within their own clinics. \u0000Methods: A retrospective chart review was conducted on all patients who visited the Sojourner Health Clinic between January 2017 and November 2019. All patients who had met the criteria for A1c screening based on recommendations from the ADA were included in the study, as well as patients who were charted as diabetic or pre-diabetic. A total of 88 patients met the criteria for this study. Data collected included patient documentation as diabetic or pre-diabetic and patients’ three most recent A1c values with corresponding dates. Based on this data, these patients were categorized as diabetic, pre-diabetic, or non-diabetic, and were evaluated on whether their A1c was monitored at appropriate intervals. \u0000Results: A total of 21.6% of patients were monitored appropriately for their diabetic status determined by their A1c values. Only 18.2% of diabetic patients were accurately monitored. Patients with an unknown diabetic status had the lowest rate of appropriate monitoring. \u0000Conclusions: Most patients at the Sojourner Health Clinic are not properly monitored for diabetes using the clinic's modified A1c monitoring guidelines. The clinic can make several improvements to strengthen adherence to these guidelines with the implementation of new protocols for better A1c monitoring. Further studies should be made to assess the efficacy of these changes.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47011366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Barriers to accessing dermatologic care are important to address for individuals without health insurance. This report aims to highlight dermatologic health disparities facing the uninsured population, to demonstrate the invaluable impact a monthly student-run free clinic can have on this population, and to encourage the implementation of dermatologic free clinics at other institutions. Methods: Data was collected using the electronic medical record “Chart Reports†tool to create a query for total dermatology visits from 2012-2019. Records were reviewed and descriptive data was collected on diagnoses, medications, procedures, and follow-up rates of a student-run dermatology free clinic from 2012-2019. Results: Over this period, dermatologic care was provided to 215 patients and a total of 321 diagnoses were made. The most common diagnoses included atopic dermatitis (26), seborrheic keratosis (21), and acne (17). Twenty-three skin cancer diagnoses were made, including 13 basal cell carcinomas, 8 squamous cell carcinomas, one case of melanoma, and one case of nonmelanoma skin cancer, unspecified. Conclusion: A higher prevalence of atopic dermatitis, melanoma, and non-melanoma skin cancer has been reported in ethnic minorities and people of low socioeconomic status. This aligns with our results and these findings highlight the significant need for improved access to dermatologic screening and follow-up for individuals without health insurance. This report also shows the unique opportunity free clinics have to address dermatologic health disparities in the local community.
{"title":"Addressing Dermatologic Health Disparities: Characterization of a Free Dermatology Clinic for an Uninsured Population","authors":"K. O’Connell, E. Bartholomew, A. Villanueva","doi":"10.59586/jsrc.v7i1.215","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.215","url":null,"abstract":"Background: Barriers to accessing dermatologic care are important to address for individuals without health insurance. This report aims to highlight dermatologic health disparities facing the uninsured population, to demonstrate the invaluable impact a monthly student-run free clinic can have on this population, and to encourage the implementation of dermatologic free clinics at other institutions. \u0000Methods: Data was collected using the electronic medical record “Chart Reports†tool to create a query for total dermatology visits from 2012-2019. Records were reviewed and descriptive data was collected on diagnoses, medications, procedures, and follow-up rates of a student-run dermatology free clinic from 2012-2019. \u0000Results: Over this period, dermatologic care was provided to 215 patients and a total of 321 diagnoses were made. The most common diagnoses included atopic dermatitis (26), seborrheic keratosis (21), and acne (17). Twenty-three skin cancer diagnoses were made, including 13 basal cell carcinomas, 8 squamous cell carcinomas, one case of melanoma, and one case of nonmelanoma skin cancer, unspecified. \u0000Conclusion: A higher prevalence of atopic dermatitis, melanoma, and non-melanoma skin cancer has been reported in ethnic minorities and people of low socioeconomic status. This aligns with our results and these findings highlight the significant need for improved access to dermatologic screening and follow-up for individuals without health insurance. This report also shows the unique opportunity free clinics have to address dermatologic health disparities in the local community.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42913166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Scott, Dolly Patel, Alexa Hughes, Alexis Reedy-Cooper
Background: While student-run free clinics are a valuable resource to the community, there are limitations leading to challenges with clinic flow. Previous research has identified checklists as a useful intervention in medicine. This project sought to evaluate the efficacy of a checklist on student volunteer accuracy and adherence to clinic flow, and patient visit times. Methods: From June 2019 to February 2020, volunteers at select clinics received a checklist listing important steps of a patient encounter. The authors sent surveys to volunteers following all clinics and recorded patient visit times. The outcomes measured were: volunteer accuracy (number of steps completed); volunteer adherence (order of steps); perceived helpfulness of the checklist; and patient visit times. The first three outcomes were assessed via self-reported survey data and the last outcome was assessed via collection of time data. Fisher’s exact tests to assess statistical significance (p<0.05). Results: Thirty-eight student volunteers completed surveys, for a response rate of 67.9%. Eighteen (47%) of those who completed surveys were part of the experimental group (received checklist), while the remaining 53% were part of the control group (did not receive checklist). Nine (50%) of 18 volunteers with a checklist spoke to patient navigation and/or lifestyle educators before presenting to an attending, compared to 1 (5%) of 20 volunteers without checklist (p=0.0025). Of the 18 volunteers who received a checklist, 16 (89%) found the checklist helpful. There was no significant difference between mean visit time pre-checklist (74 minutes, SD= 29.6) and post-checklist (79 minutes; SD=28.3; p=0.46, n=134). Conclusion: The checklist improved clinic flow by increasing volunteer accuracy and adherence. The checklist was also perceived to be helpful, and did not increase patient visit times.
背景:虽然学生开办的免费诊所是社区的宝贵资源，但也存在局限性，导致诊所流动面临挑战。先前的研究已经确定检查清单是一种有用的医学干预手段。本项目旨在评估核对表对学生志愿者的准确性和对诊所流程的依从性以及患者就诊时间的有效性。方法:从2019年6月到2020年2月，在选定的诊所，志愿者收到了一份清单，其中列出了与患者会面的重要步骤。作者向志愿者发送调查问卷，跟踪所有诊所并记录患者就诊时间。测量的结果是:志愿者的准确性(完成的步数);志愿者依从性(步骤顺序);感知清单的有用性;病人就诊次数。前三个结果通过自我报告的调查数据进行评估，最后一个结果通过收集时间数据进行评估。fisher®精确检验评估统计学意义(p<0.05)。结果:38名学生志愿者完成了调查，回复率为67.9%。完成调查的18人(47%)为实验组(收到清单)，其余53%为对照组(未收到清单)。18名有检查表的志愿者中有9名(50%)在就诊前与患者导航和/或生活方式教育者进行了交谈，而20名没有检查表的志愿者中只有1名(5%)进行了交谈(p=0.0025)。在收到清单的18名志愿者中，16名(89%)认为清单很有帮助。检查前平均就诊时间(74分钟，SD= 29.6)与检查后平均就诊时间(79分钟;SD = 28.3;p = 0.46, n = 134)。结论:检查表通过提高志愿者的准确性和依从性改善了临床流程。检查表也被认为是有帮助的，并没有增加病人的就诊次数。
{"title":"Impact of a Checklist on Clinic Flow and Patient Visit Times at a Student-Run Free Clinic","authors":"A. Scott, Dolly Patel, Alexa Hughes, Alexis Reedy-Cooper","doi":"10.59586/jsrc.v7i1.213","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.213","url":null,"abstract":"Background: While student-run free clinics are a valuable resource to the community, there are limitations leading to challenges with clinic flow. Previous research has identified checklists as a useful intervention in medicine. This project sought to evaluate the efficacy of a checklist on student volunteer accuracy and adherence to clinic flow, and patient visit times. \u0000Methods: From June 2019 to February 2020, volunteers at select clinics received a checklist listing important steps of a patient encounter. The authors sent surveys to volunteers following all clinics and recorded patient visit times. The outcomes measured were: volunteer accuracy (number of steps completed); volunteer adherence (order of steps); perceived helpfulness of the checklist; and patient visit times. The first three outcomes were assessed via self-reported survey data and the last outcome was assessed via collection of time data. Fisher’s exact tests to assess statistical significance (p<0.05). \u0000Results: Thirty-eight student volunteers completed surveys, for a response rate of 67.9%. Eighteen (47%) of those who completed surveys were part of the experimental group (received checklist), while the remaining 53% were part of the control group (did not receive checklist). Nine (50%) of 18 volunteers with a checklist spoke to patient navigation and/or lifestyle educators before presenting to an attending, compared to 1 (5%) of 20 volunteers without checklist (p=0.0025). Of the 18 volunteers who received a checklist, 16 (89%) found the checklist helpful. There was no significant difference between mean visit time pre-checklist (74 minutes, SD= 29.6) and post-checklist (79 minutes; SD=28.3; p=0.46, n=134). \u0000Conclusion: The checklist improved clinic flow by increasing volunteer accuracy and adherence. The checklist was also perceived to be helpful, and did not increase patient visit times.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48151582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Mason, Nayanika Challa, J. Baek, Arthur J Pollauf, Emily Veach, Luis Regalado, Jacy Leon
PODEMOS, Spanish for “We Canâ€, is an interdisciplinary healthcare organization based in Columbus, Ohio, that is designed to meet the healthcare needs of communities around the city of El Progreso, Honduras. Honduras is a developing country in Central America that scores low in most indicators of healthcare quality and access. Most notably, there is a tremendous need for expanded access in rural communities. Established in 2008 by students from the Ohio State University College of Medicine, PODEMOS conducts biannual medical brigades that run primary care clinics in three rural communities around El Progreso through the volunteer service of United States (US)-based medical, pharmacy, and dental professionals. Additionally, the organization works with local leaders to provide healthcare services for patients with chronic conditions, fill gaps in US-based provider coverage, and recruit patients. PODEMOS bases its care on two models, the acute care model for common adult complaints and all children under the age of 18, and the chronic care model for a subset of adult patients who need more complex care for chronic conditions such as diabetes mellitus and hypertension. Providers then have access to select laboratory and pharmacy services for their patient’s needs. PODEMOS has had a large impact on local communities since its inception, as evidenced by the numerous acute patient visits in its 11 years of existence and the 136 patients currently enrolled in chronic care program. Nevertheless, the organization continues to face challenges in areas such as interprofessional collaboration, security, and maintaining patient turnout. This piece is a descriptive report on PODEMOS, a student-run international medical organization based out of the Ohio State University Wexner Medical Center, that seeks to inform other student-run organizations about the organization’s structure and operation.
{"title":"PODEMOS: A Student-Led International Medical Brigade","authors":"T. Mason, Nayanika Challa, J. Baek, Arthur J Pollauf, Emily Veach, Luis Regalado, Jacy Leon","doi":"10.59586/jsrc.v7i1.184","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.184","url":null,"abstract":"PODEMOS, Spanish for “We Canâ€, is an interdisciplinary healthcare organization based in Columbus, Ohio, that is designed to meet the healthcare needs of communities around the city of El Progreso, Honduras. Honduras is a developing country in Central America that scores low in most indicators of healthcare quality and access. Most notably, there is a tremendous need for expanded access in rural communities. Established in 2008 by students from the Ohio State University College of Medicine, PODEMOS conducts biannual medical brigades that run primary care clinics in three rural communities around El Progreso through the volunteer service of United States (US)-based medical, pharmacy, and dental professionals. Additionally, the organization works with local leaders to provide healthcare services for patients with chronic conditions, fill gaps in US-based provider coverage, and recruit patients. PODEMOS bases its care on two models, the acute care model for common adult complaints and all children under the age of 18, and the chronic care model for a subset of adult patients who need more complex care for chronic conditions such as diabetes mellitus and hypertension. Providers then have access to select laboratory and pharmacy services for their patient’s needs. PODEMOS has had a large impact on local communities since its inception, as evidenced by the numerous acute patient visits in its 11 years of existence and the 136 patients currently enrolled in chronic care program. Nevertheless, the organization continues to face challenges in areas such as interprofessional collaboration, security, and maintaining patient turnout. This piece is a descriptive report on PODEMOS, a student-run international medical organization based out of the Ohio State University Wexner Medical Center, that seeks to inform other student-run organizations about the organization’s structure and operation.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43513989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heather Farthing, Sarah Simko, Francelia J. Eckembrecher, Daphne G. Eckembrecher, Isabel C. Penabad, Yanelys Fernandez, Veronica Nunez, Sophia Pines, Nicole Cruz, Rebecca Tanenbaum, Berta Cabrera, Luz Gallardo, Erin Kobetz
Background: Social determinants of health (SDOH) put some groups who access care at student-run free clinics (SRFCs) at higher risk for adverse medical outcomes. Free or low-cost community services supplement clinic-based interventions, but access is limited by knowledge, transportation, language, and/or trust. Social needs assessments may be electronically paired with resource connection tools to connect patients to local, validated resources. The objective of this pilot study was to evaluate the SDOH screen and resource connection tool developed at a SRFC. Methods: The tool was piloted with a convenience sample of 40 patients with scheduled outpatient appointments at a SRFC in Miami, Florida. Participants were given information about a variety of services and screened for high-risk situations such as human trafficking. Follow-up survey via telephone at 2-4 weeks identified survey acceptability, successful connections, and barriers to access. Results: Forty participants completed the assessment. All participants were counseled regarding exercise and nutrition and requested information about more than one resource. Sixty percent (n=24) were successfully contacted for follow-up. Of these, 29% (n=7) were able to connect with one or more recommended resources. Reasons given for failure to access resources included lack of time or transportation, health issues, and lack of response from contacted organizations. Conclusions: Social needs assessments may be implemented in SRFCs to identify high-risk needs, facilitate linkage to local organizations that meet these needs, gather data to guide future programming, and provide education and counseling. Stronger connections with local organizations and closed loop referrals may be needed to facilitate connection to community resources.
{"title":"Development and Evaluation of Electronic Social Needs Assessment and Resource Connection Tool in Facilitating Utilization of Community Services That Address Upstream Health","authors":"Heather Farthing, Sarah Simko, Francelia J. Eckembrecher, Daphne G. Eckembrecher, Isabel C. Penabad, Yanelys Fernandez, Veronica Nunez, Sophia Pines, Nicole Cruz, Rebecca Tanenbaum, Berta Cabrera, Luz Gallardo, Erin Kobetz","doi":"10.59586/jsrc.v7i1.181","DOIUrl":"https://doi.org/10.59586/jsrc.v7i1.181","url":null,"abstract":"Background: Social determinants of health (SDOH) put some groups who access care at student-run free clinics (SRFCs) at higher risk for adverse medical outcomes. Free or low-cost community services supplement clinic-based interventions, but access is limited by knowledge, transportation, language, and/or trust. Social needs assessments may be electronically paired with resource connection tools to connect patients to local, validated resources. The objective of this pilot study was to evaluate the SDOH screen and resource connection tool developed at a SRFC. \u0000Methods: The tool was piloted with a convenience sample of 40 patients with scheduled outpatient appointments at a SRFC in Miami, Florida. Participants were given information about a variety of services and screened for high-risk situations such as human trafficking. Follow-up survey via telephone at 2-4 weeks identified survey acceptability, successful connections, and barriers to access. \u0000Results: Forty participants completed the assessment. All participants were counseled regarding exercise and nutrition and requested information about more than one resource. Sixty percent (n=24) were successfully contacted for follow-up. Of these, 29% (n=7) were able to connect with one or more recommended resources. Reasons given for failure to access resources included lack of time or transportation, health issues, and lack of response from contacted organizations. \u0000Conclusions: Social needs assessments may be implemented in SRFCs to identify high-risk needs, facilitate linkage to local organizations that meet these needs, gather data to guide future programming, and provide education and counseling. Stronger connections with local organizations and closed loop referrals may be needed to facilitate connection to community resources.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49669122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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