E. Mause, Lauren Crowther, Emmali Munger, S. Qadri
Background: One-time clinic attendance and inconsistent follow-up are common in patients experiencing homelessness and those who access care in student-run free clinics (SRFCs). While mental health concerns are prevalent in this population, the consistent follow-up and longitudinal care necessary to improve patient outcomes has many barriers. The primary objective of this study was to assess and address the patient-identified barriers to attendance at a SRFC that operates out of a homeless shelter in Omaha, Nebraska. Methods: Through a survey, patients indicated if one or more barriers in a list of examples had prevented their attendance in the past. This study also ascertained if patients had social support in place and reviewed demographic information. Between September 2020 and May 2021, 14 psychiatry clinics were held bimonthly with 35 different patients during which each patient was requested to complete a survey. Of the 35 requested, 13 patients completed the survey. Results: Of the 13 patients, 62% reported at least one barrier to care. Primary barriers patients experience are forgetting appointment time (38%), feeling so poorly they don’t feel like going (31%), and having problems with transportation (31%). Although not statistically significant, there was a trend of having a case manager (OR = 0.2143, 95% confidence interval [CI] 0.0136 - 3.3698) or having at least two social support systems (OR = 0.2143, 95% CI 0.0136 - 3.3698) decreased the odds that patients would report two or more barriers to care. Conclusions: Over half of the participants reported at least one barrier to care. Although not statistically significant, there was a trend that having a case manager and social support reduced the odds of patients reporting barriers. We suspect that creating stronger relationships with patients directly through patient liaisons and strengthening relationships with case managers will improve communication and decrease no-show rates.
{"title":"Barriers to Care: Improving Attendance at a Student-Run Free Psychiatry Clinic","authors":"E. Mause, Lauren Crowther, Emmali Munger, S. Qadri","doi":"10.59586/jsrc.v8i1.326","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.326","url":null,"abstract":"Background: One-time clinic attendance and inconsistent follow-up are common in patients experiencing homelessness and those who access care in student-run free clinics (SRFCs). While mental health concerns are prevalent in this population, the consistent follow-up and longitudinal care necessary to improve patient outcomes has many barriers. The primary objective of this study was to assess and address the patient-identified barriers to attendance at a SRFC that operates out of a homeless shelter in Omaha, Nebraska. \u0000Methods: Through a survey, patients indicated if one or more barriers in a list of examples had prevented their attendance in the past. This study also ascertained if patients had social support in place and reviewed demographic information. Between September 2020 and May 2021, 14 psychiatry clinics were held bimonthly with 35 different patients during which each patient was requested to complete a survey. Of the 35 requested, 13 patients completed the survey. \u0000Results: Of the 13 patients, 62% reported at least one barrier to care. Primary barriers patients experience are forgetting appointment time (38%), feeling so poorly they don’t feel like going (31%), and having problems with transportation (31%). Although not statistically significant, there was a trend of having a case manager (OR = 0.2143, 95% confidence interval [CI] 0.0136 - 3.3698) or having at least two social support systems (OR = 0.2143, 95% CI 0.0136 - 3.3698) decreased the odds that patients would report two or more barriers to care. \u0000Conclusions: Over half of the participants reported at least one barrier to care. Although not statistically significant, there was a trend that having a case manager and social support reduced the odds of patients reporting barriers. We suspect that creating stronger relationships with patients directly through patient liaisons and strengthening relationships with case managers will improve communication and decrease no-show rates. ","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43041631","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}
Michael Maranets, Kathryn Harmer, Sarah E. Vordenberg, Amy Thompson
Background: Student pharmacist participation in Student-Run Free Clinics (SRFCs) has not been well studied. Similarly, there is not much data for the use of pre-visit planning calls in the SRFC setting. Our SRFC is open two days a week and staffed by a multidisciplinary team of medical, nursing, pharmacy, and social work students that are supervised by physicians, nurse practitioners, pharmacists, and clinical social worker preceptors. The objective of our project is to determine the impact of pre-visit telephone calls on the accuracy of existing medication lists in the electronic health record (EHR) and the identification of medication therapy-related problems. Methods: We developed a pre-visit planning call protocol to perform medication reconciliation and identify medication therapy problems (MTPs). Trained student pharmacists called patients prior to their scheduled medical appointment to update their medication list in the EHR and conduct a preliminary assessment of MTPs. We recorded patient demographics, including age, gender, race, co-morbid conditions, medication changes documented in the EHR, and potential MTPs. Descriptive statistics were used to describe the patient population and medication changes. Results: A total of 111 patients participated in 135 patient encounters. Among prescription medications, there were 36 additions, 34 removals, and 97 adjustments to directions. There were 147 nonprescription products added, 34 removed, and 56 adjustments to directions. There were 16 situations in which a patient may have needed additional medication therapy, 14 drug-drug interactions, 12 adverse medication events, and five problems requiring additional monitoring. The median call was 5 minutes in duration. Conclusion: Student pharmacists were able to conduct pre-visit planning telephone calls to improve the accuracy of medication lists and conduct a preliminary assessment of MTPs prior to patient visits at the SRFC.
{"title":"Pre-Visit Planning Calls Conducted by Student Pharmacists at a Student-Run Free Clinic","authors":"Michael Maranets, Kathryn Harmer, Sarah E. Vordenberg, Amy Thompson","doi":"10.59586/jsrc.v8i1.342","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.342","url":null,"abstract":"Background: Student pharmacist participation in Student-Run Free Clinics (SRFCs) has not been well studied. Similarly, there is not much data for the use of pre-visit planning calls in the SRFC setting. Our SRFC is open two days a week and staffed by a multidisciplinary team of medical, nursing, pharmacy, and social work students that are supervised by physicians, nurse practitioners, pharmacists, and clinical social worker preceptors. The objective of our project is to determine the impact of pre-visit telephone calls on the accuracy of existing medication lists in the electronic health record (EHR) and the identification of medication therapy-related problems. \u0000Methods: We developed a pre-visit planning call protocol to perform medication reconciliation and identify medication therapy problems (MTPs). Trained student pharmacists called patients prior to their scheduled medical appointment to update their medication list in the EHR and conduct a preliminary assessment of MTPs. We recorded patient demographics, including age, gender, race, co-morbid conditions, medication changes documented in the EHR, and potential MTPs. Descriptive statistics were used to describe the patient population and medication changes. \u0000Results: A total of 111 patients participated in 135 patient encounters. Among prescription medications, there were 36 additions, 34 removals, and 97 adjustments to directions. There were 147 nonprescription products added, 34 removed, and 56 adjustments to directions. There were 16 situations in which a patient may have needed additional medication therapy, 14 drug-drug interactions, 12 adverse medication events, and five problems requiring additional monitoring. The median call was 5 minutes in duration. \u0000Conclusion: Student pharmacists were able to conduct pre-visit planning telephone calls to improve the accuracy of medication lists and conduct a preliminary assessment of MTPs prior to patient visits at the SRFC.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47851350","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}
Katherine Lilja, Teal Walters, M. Baumler, Ambria C Crusan
Background: The patients of student-run clinics, especially Hispanic/Latinx patients, are at a disproportionately high risk for chronic disease due to the negative impacts of the social determinants of health, including barriers to obtaining healthcare, ranging from lack of financial resources to fear of deportation. Nutrition services are pivotal in providing effective, holistic healthcare for this patient population seeking care at student-run clinics. The purpose of this review is to examine how nutrition assessment is conducted at student-run clinics and to determine if the nutrition assessments are culturally tailored. Methods: Three scientific databases were searched using keywords focused on the concept of nutrition assessment in student-run clinics serving the Hispanic/Latinx population. The articles generated were reviewed by 4 independent reviewers to determine key elements related to nutrition assessment and/or nutrition services provided in student-run, free, or community clinics, with attention to addressing social and cultural barriers addressed by the clinic. Results: A search of the literature related to nutrition services at student-run clinics yielded 3 results for nutrition assessment of the Hispanic/Latinx population in student-run, free, or community clinics. Several articles presented research on health behavioral counseling and food insecurity screening, but few studies were conducted specifically on nutrition assessment, especially for the Hispanic/Latinx population. Conclusions: The current assessment tools have widespread use in nutrition assessment; however, they are insufficient for the distinctive characteristics of the Hispanic or Latinx population being served in a student-run clinic. Including dietetics students into a student-run clinic, if plausible, and/or a culturally sensitive guided nutrition assessment tool for students would be of benefit to adequately address the relevant social determinants of health in the nutrition assessment of patients at student-run clinics.
{"title":"Nutrition Assessment in Student-Run Clinics Serving Hispanic/Latinx Patients","authors":"Katherine Lilja, Teal Walters, M. Baumler, Ambria C Crusan","doi":"10.59586/jsrc.v8i1.318","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.318","url":null,"abstract":"Background: The patients of student-run clinics, especially Hispanic/Latinx patients, are at a disproportionately high risk for chronic disease due to the negative impacts of the social determinants of health, including barriers to obtaining healthcare, ranging from lack of financial resources to fear of deportation. Nutrition services are pivotal in providing effective, holistic healthcare for this patient population seeking care at student-run clinics. The purpose of this review is to examine how nutrition assessment is conducted at student-run clinics and to determine if the nutrition assessments are culturally tailored. \u0000Methods: Three scientific databases were searched using keywords focused on the concept of nutrition assessment in student-run clinics serving the Hispanic/Latinx population. The articles generated were reviewed by 4 independent reviewers to determine key elements related to nutrition assessment and/or nutrition services provided in student-run, free, or community clinics, with attention to addressing social and cultural barriers addressed by the clinic. \u0000Results: A search of the literature related to nutrition services at student-run clinics yielded 3 results for nutrition assessment of the Hispanic/Latinx population in student-run, free, or community clinics. Several articles presented research on health behavioral counseling and food insecurity screening, but few studies were conducted specifically on nutrition assessment, especially for the Hispanic/Latinx population. \u0000Conclusions: The current assessment tools have widespread use in nutrition assessment; however, they are insufficient for the distinctive characteristics of the Hispanic or Latinx population being served in a student-run clinic. Including dietetics students into a student-run clinic, if plausible, and/or a culturally sensitive guided nutrition assessment tool for students would be of benefit to adequately address the relevant social determinants of health in the nutrition assessment of patients at student-run clinics.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41578840","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}
Benjamin Liu, Miranda Brown, Alexandra Bennett, Samira Samant, Rebecca Lundh, Catherine Ferguson
Improving patient satisfaction in a student-run free clinic setting presents unique challenges as free clinics often receive very high patient satisfaction scores. It may seem odd to label this “a problem”; however, this phenomenon may mask patient concerns and impede a clinic’s abilities to measure the effect of interventions on patient satisfaction. In this article we detail our experience with addressing patient satisfaction in a student-run free clinic, the approach we took, key lessons learned, and recommendations for future clinics creating project goals aimed at improving patient satisfaction.
{"title":"Implementing Non-Value-Added Time as an Indicator of Patient Satisfaction in a Student Run Free Clinic","authors":"Benjamin Liu, Miranda Brown, Alexandra Bennett, Samira Samant, Rebecca Lundh, Catherine Ferguson","doi":"10.59586/jsrc.v8i1.322","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.322","url":null,"abstract":"Improving patient satisfaction in a student-run free clinic setting presents unique challenges as free clinics often receive very high patient satisfaction scores. It may seem odd to label this “a problem”; however, this phenomenon may mask patient concerns and impede a clinic’s abilities to measure the effect of interventions on patient satisfaction. In this article we detail our experience with addressing patient satisfaction in a student-run free clinic, the approach we took, key lessons learned, and recommendations for future clinics creating project goals aimed at improving patient satisfaction.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45328252","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}
Jody He, J. Goté, Haley S D'Souza, Daniel Barmas-Alamdari, G. DiSandro
Background: Diabetic retinopathy is one of the leading causes of blindness in the world, and its development and progression can be prevented with appropriate glycemic control. The Health Outreach Partnership of EVMS Students (HOPES) Student-Run Free Clinic at Eastern Virginia Medical School (Norfolk, VA) provides both primary care and ophthalmology care to patients from underserved backgrounds. The purpose of this retrospective chart review is to assess whether a student-run free clinic’s primary care and ophthalmology services are effective in preventing the development and progression of diabetic retinopathy. Methods: Inclusion criteria were a diagnosis of Type 2 Diabetes Mellitus (T2DM), two or more HOPES Ophthalmology Clinic appointments separated by at least 4 months between January 2015 and July 2019, and medical management of T2DM by the HOPES Primary Care Clinic. Objective patient data collected were HbA1c, visual acuity, and documented dilated fundus examination findings. Results: There were 174 HOPES Ophthalmology visits and 66 diabetic eye exam appointments in this five-year time period. The average HbA1c for patients at the initial appointment with the Ophthalmology Clinic was 7.77% ± 1.65% and the average HbA1c at the most recent appointment was 7.4% ± 2.28%. Among all patients, there was no statistically significant change in visual acuity in either eye from baseline to the most recent visit. There was no change in fundus examination findings in any of the patients from their initial visit to their most recent visit. Conclusions: The HOPES Clinic has been effective in preventing the development and progression of diabetic retinopathy in its patients who regularly follow up with both the primary care and ophthalmology clinics. This study highlights that a student-run free clinic is capable of making an impact in the community by preventing the development of a potentially blinding disease, but that further strategies to enable consistent patient follow-up are needed.
{"title":"Efficacy of a Student-Run Ophthalmology Service in Managing Diabetic Retinopathy: A Five-Year Retrospective Review","authors":"Jody He, J. Goté, Haley S D'Souza, Daniel Barmas-Alamdari, G. DiSandro","doi":"10.59586/jsrc.v8i1.292","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.292","url":null,"abstract":"Background: \u0000Diabetic retinopathy is one of the leading causes of blindness in the world, and its development and progression can be prevented with appropriate glycemic control. The Health Outreach Partnership of EVMS Students (HOPES) Student-Run Free Clinic at Eastern Virginia Medical School (Norfolk, VA) provides both primary care and ophthalmology care to patients from underserved backgrounds. The purpose of this retrospective chart review is to assess whether a student-run free clinic’s primary care and ophthalmology services are effective in preventing the development and progression of diabetic retinopathy. \u0000Methods: \u0000Inclusion criteria were a diagnosis of Type 2 Diabetes Mellitus (T2DM), two or more HOPES Ophthalmology Clinic appointments separated by at least 4 months between January 2015 and July 2019, and medical management of T2DM by the HOPES Primary Care Clinic. Objective patient data collected were HbA1c, visual acuity, and documented dilated fundus examination findings. \u0000Results: \u0000There were 174 HOPES Ophthalmology visits and 66 diabetic eye exam appointments in this five-year time period. The average HbA1c for patients at the initial appointment with the Ophthalmology Clinic was 7.77% ± 1.65% and the average HbA1c at the most recent appointment was 7.4% ± 2.28%. Among all patients, there was no statistically significant change in visual acuity in either eye from baseline to the most recent visit. There was no change in fundus examination findings in any of the patients from their initial visit to their most recent visit. \u0000Conclusions: \u0000The HOPES Clinic has been effective in preventing the development and progression of diabetic retinopathy in its patients who regularly follow up with both the primary care and ophthalmology clinics. This study highlights that a student-run free clinic is capable of making an impact in the community by preventing the development of a potentially blinding disease, but that further strategies to enable consistent patient follow-up are needed.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42982840","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}
Julia Krumholz, H. Mumber, E. Tunstall, Amanda Okaka, Minh-Thuy Nguyen, Rebecca Webb, Larissa Wenren, E. Cournoyer, Sarah Rodriguez, Celine Toder, Natalie Pierre-Joseph
Background: Student Run Teen and Tot Service (SRTTS) is a student-run, interdisciplinary service-learning program at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC). In this paper, we describe the program, which aims to increase medical students’ exposure to pediatrics while providing education and support to teenage mothers and their babies. Methods: Medical students at BUSM learned developmental milestones and trained in communication, patient-centered education, and the pediatric interview and physical exam. SRTTS leaders recruited patients to free monthly service evenings held at BMC. The babies received medical exams and the teenage mothers received health and parenting education. Students filled out pre- and post-participation surveys rating their comfort with pediatric medicine and education, and patients completed demographic and satisfaction surveys. Both the patient and student surveys were analyzed using a descriptive approach. Results: Analysis of pre-and post-participation student surveys demonstrated that the mean confidence level (reported on a 5-point scale, with 1=Not at all confident and 5=Extremely confident) increased for all measured domains, including interacting with children and adolescent mothers (from 2.46 to 4.08 and 2.08 to 3.92, respectively), giving anticipatory guidance (from 1.62 to 3.63), and performing a pediatric physical exam (1.08 to 2.85). Patients rated their experience with the program and the care they received highly, indicating that they would use the health education that they received in the future. Conclusions: The supplemental care provided by SRTTS was well received by patients. Additionally, medical students improved their skills in a variety of pediatric medicine and education topics. SRTTS is limited by the number of patients and students who participated. Expanding SRTTS will further integrate adolescent mothers and children into the healthcare system and allow medical students to further increase their proficiency in pediatric medicine.
{"title":"Student-Run Teen and Tot Service: Increasing Medical Trainee Exposure to Pediatric Education while Providing Educational and Health Services to Teenage Mothers and their Children","authors":"Julia Krumholz, H. Mumber, E. Tunstall, Amanda Okaka, Minh-Thuy Nguyen, Rebecca Webb, Larissa Wenren, E. Cournoyer, Sarah Rodriguez, Celine Toder, Natalie Pierre-Joseph","doi":"10.59586/jsrc.v8i1.315","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.315","url":null,"abstract":"Background: Student Run Teen and Tot Service (SRTTS) is a student-run, interdisciplinary service-learning program at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC). In this paper, we describe the program, which aims to increase medical students’ exposure to pediatrics while providing education and support to teenage mothers and their babies. \u0000Methods: Medical students at BUSM learned developmental milestones and trained in communication, patient-centered education, and the pediatric interview and physical exam. SRTTS leaders recruited patients to free monthly service evenings held at BMC. The babies received medical exams and the teenage mothers received health and parenting education. Students filled out pre- and post-participation surveys rating their comfort with pediatric medicine and education, and patients completed demographic and satisfaction surveys. Both the patient and student surveys were analyzed using a descriptive approach. \u0000Results: Analysis of pre-and post-participation student surveys demonstrated that the mean confidence level (reported on a 5-point scale, with 1=Not at all confident and 5=Extremely confident) increased for all measured domains, including interacting with children and adolescent mothers (from 2.46 to 4.08 and 2.08 to 3.92, respectively), giving anticipatory guidance (from 1.62 to 3.63), and performing a pediatric physical exam (1.08 to 2.85). Patients rated their experience with the program and the care they received highly, indicating that they would use the health education that they received in the future. \u0000Conclusions: The supplemental care provided by SRTTS was well received by patients. Additionally, medical students improved their skills in a variety of pediatric medicine and education topics. SRTTS is limited by the number of patients and students who participated. Expanding SRTTS will further integrate adolescent mothers and children into the healthcare system and allow medical students to further increase their proficiency in pediatric medicine.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41785693","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}
Shayann Ramedani, V. Khristov, M. Palisoc, Megan H Mendez Miller
Student-run free clinics play an essential role in meeting the needs of underserved populations while providing service-learning opportunities to health professions students. While these clinics have been an asset for many institutions, the success hinges on the successful selection of clinic locations, studying resource utilization, the receptiveness of the local population, and effective strategic planning. The Student-led and Collaborative Outreach Program for Health Equity (SCOPE) Free Mobile Clinic at the Pennsylvania State University College of Medicine was established in 2017 to address the needs of underserved populations in Central Pennsylvania. Starting from one clinic, SCOPE has grown to twelve different sites across the county and has addressed different needs in diverse populations from rural to urban. The clinic has reached 435 individuals, provided 95 consultations with attending physicians, and distributed more than 120 vaccinations in the three years it has been fully active. During its evolution, the organization has developed a guidance algorithm that is critical to its operations and expansion initiatives. This algorithm has enabled strategic community resource deployment, garnered interest from private nonprofit collaboration and local government investment. Based on objective data, we identified new patient populations and clinic sites. Here we describe our experience developing and utilizing our deployment algorithm and the challenges and lessons we learned in growing a novel clinic model in a rural landscape.
{"title":"An Algorithm for Free Clinic Deployment: Bridging the Gap in Healthcare Access in Rural Pennsylvania","authors":"Shayann Ramedani, V. Khristov, M. Palisoc, Megan H Mendez Miller","doi":"10.59586/jsrc.v8i1.305","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.305","url":null,"abstract":"Student-run free clinics play an essential role in meeting the needs of underserved populations while providing service-learning opportunities to health professions students. While these clinics have been an asset for many institutions, the success hinges on the successful selection of clinic locations, studying resource utilization, the receptiveness of the local population, and effective strategic planning. The Student-led and Collaborative Outreach Program for Health Equity (SCOPE) Free Mobile Clinic at the Pennsylvania State University College of Medicine was established in 2017 to address the needs of underserved populations in Central Pennsylvania. Starting from one clinic, SCOPE has grown to twelve different sites across the county and has addressed different needs in diverse populations from rural to urban. The clinic has reached 435 individuals, provided 95 consultations with attending physicians, and distributed more than 120 vaccinations in the three years it has been fully active. During its evolution, the organization has developed a guidance algorithm that is critical to its operations and expansion initiatives. This algorithm has enabled strategic community resource deployment, garnered interest from private nonprofit collaboration and local government investment. Based on objective data, we identified new patient populations and clinic sites. Here we describe our experience developing and utilizing our deployment algorithm and the challenges and lessons we learned in growing a novel clinic model in a rural landscape.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43717561","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}
Amanda Pitre, Yamini Mulla, Bianca L Arboleda, Eliza Nguyen, Heather Stewart, Emma Hale, Elizabeth Cook, Alexander Shahin, Lucy Guerra, Deborah Trehy, Karim Hanna, Eduardo Gonzalez
Background: In the United States, about half of all pregnancies are unplanned. Unplanned pregnancy carries increased risks to patient and fetus and is increased independently by both poverty and being a racial or ethnic minority. The purpose of this study was to examine the percentage and types of contraceptives used by patients at the student-run Building Relationships and Initiatives Dedicated to Gaining Equality (BRIDGE) Healthcare Clinic and determine if clinic staff provided appropriate annual contraceptive counseling. Methods: A retrospective chart review was performed for all active BRIDGE patients that were female and aged 18-60 between 2015 and 2020. Information collected included demographics, obstetric history, tobacco use, medical history of deep vein thrombosis (DVT) or hypertension, and contraception use. Results: Of 145 patients reviewed, 77.2% used contraception at some point during the study period. Surgical contraception was the most common form used. No patients with a documented history of DVT or tobacco use used estrogen-containing contraception during the study period. One patient out of the twenty with documented hypertension used an estrogen-containing form of contraception for one year. Conclusions: Overall, our clinic counseled the majority of patients of child-bearing age on contraception use. Contraception use in our population is above the national average and is appropriately prescribed.
{"title":"Contraception Use and Counseling at a Student-Run Free Clinic","authors":"Amanda Pitre, Yamini Mulla, Bianca L Arboleda, Eliza Nguyen, Heather Stewart, Emma Hale, Elizabeth Cook, Alexander Shahin, Lucy Guerra, Deborah Trehy, Karim Hanna, Eduardo Gonzalez","doi":"10.59586/jsrc.v8i1.280","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.280","url":null,"abstract":"Background: In the United States, about half of all pregnancies are unplanned. Unplanned pregnancy carries increased risks to patient and fetus and is increased independently by both poverty and being a racial or ethnic minority. The purpose of this study was to examine the percentage and types of contraceptives used by patients at the student-run Building Relationships and Initiatives Dedicated to Gaining Equality (BRIDGE) Healthcare Clinic and determine if clinic staff provided appropriate annual contraceptive counseling. \u0000Methods: A retrospective chart review was performed for all active BRIDGE patients that were female and aged 18-60 between 2015 and 2020. Information collected included demographics, obstetric history, tobacco use, medical history of deep vein thrombosis (DVT) or hypertension, and contraception use. \u0000Results: Of 145 patients reviewed, 77.2% used contraception at some point during the study period. Surgical contraception was the most common form used. No patients with a documented history of DVT or tobacco use used estrogen-containing contraception during the study period. One patient out of the twenty with documented hypertension used an estrogen-containing form of contraception for one year. \u0000Conclusions: Overall, our clinic counseled the majority of patients of child-bearing age on contraception use. Contraception use in our population is above the national average and is appropriately prescribed.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44873850","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}
Coronavirus Disease 2019 (COVID-19) is a highly contagious infectious disease associated with significant rates of morbidity and mortality. With limited treatments for COVID-19, the most effective strategy developed to mitigate the effects of this disease is vaccination. Unity Clinic, an interdisciplinary, student-run free clinic (SRFC) at the University of Oklahoma Health Sciences Center (OUHSC), created a COVID-19 vaccine clinic that started in January 2021 to participate in the mass vaccination campaign in Oklahoma. Health profession students from seven different colleges present at OUHSC served in either non-clinical or clinical volunteer roles at the vaccine clinics. Between January 6 and July 16, 2021, Unity Clinic hosted 119 vaccine clinics, administered 39,665 vaccines, and had 16,830 student volunteer hours logged. The vaccines administered through Unity Clinic composed 1.2% of all vaccines administered in the state and 11.1% of all vaccines administered in Oklahoma County. This descriptive report demonstrates the effective use of an SRFC for large-scale COVID-19 vaccination events. Unity Clinic’s COVID-19 vaccine clinic has the potential to serve as a model for other SRFCs around the country to use for the current COVID-19 pandemic and adapt for other public health issues in the future.
{"title":"Establishing a COVID-19 Vaccine Clinic at a Student-Run Free Clinic","authors":"Brandon W. Moritz, Tram Le, D. Bratzler","doi":"10.59586/jsrc.v8i1.319","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.319","url":null,"abstract":"Coronavirus Disease 2019 (COVID-19) is a highly contagious infectious disease associated with significant rates of morbidity and mortality. With limited treatments for COVID-19, the most effective strategy developed to mitigate the effects of this disease is vaccination. Unity Clinic, an interdisciplinary, student-run free clinic (SRFC) at the University of Oklahoma Health Sciences Center (OUHSC), created a COVID-19 vaccine clinic that started in January 2021 to participate in the mass vaccination campaign in Oklahoma. Health profession students from seven different colleges present at OUHSC served in either non-clinical or clinical volunteer roles at the vaccine clinics. Between January 6 and July 16, 2021, Unity Clinic hosted 119 vaccine clinics, administered 39,665 vaccines, and had 16,830 student volunteer hours logged. The vaccines administered through Unity Clinic composed 1.2% of all vaccines administered in the state and 11.1% of all vaccines administered in Oklahoma County. This descriptive report demonstrates the effective use of an SRFC for large-scale COVID-19 vaccination events. Unity Clinic’s COVID-19 vaccine clinic has the potential to serve as a model for other SRFCs around the country to use for the current COVID-19 pandemic and adapt for other public health issues in the future.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44708675","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}
Evan Chen, Peter Hoang, Katherine Garcia, Nicholas Richwagen, M. Pasarica
Introduction: Keeping Neighbors in Good Health Through Service Clinic is a student-run, multidisciplinary free clinic dedicated to providing healthcare to uninsured, low-income patients in Central Florida. A quality improvement project was performed to decrease the rate of patient no-shows via altering the patient appointment communication method. Methods: A needs assessment was performed from June 2017 to March 2018 (n=104 patients). The intervention was implemented over an 18-month period, from April 2018 to September 2019 (n=243 patients). The intervention changed the communication method with patients such that they received appointment reminder texts two days before their appointments and responded to confirm or cancel their appointments. Phone calls were used for rescheduling, confirming cancellations, or contacting patients who had not responded to the CareMessage text. The Mann-Whitney U test was utilized for comparison of appointment no-shows, number of phone calls made, and number of patients scheduled per clinic between pre- and post-intervention groups. Results: The needs assessment showed that the average number of no-shows was 0.80 per clinic, while the average number of no-shows post-intervention was 0.26 per clinic (p=0.040). The average number of patients scheduled per clinic pre- and post-intervention was 6.90 and 7.84 (p=0.370), respectively. The average number of patients seen per clinic pre- and post-intervention was 5.93 and 6.74 (p=0.640), respectively. The average number of phone calls made weekly was 9.13 per clinic pre-intervention and 3.23 post-intervention (p<0.001). Conclusion: CareMessage is effective in reducing appointment no-shows and the number of follow-up phone calls made for appointment reminders. This intervention is important for increasing patient continuity of care, access to care, and clinic efficiency.
{"title":"CareMessage Text Usage Increases Appointment Adherence in a Student-Run Free Clinic","authors":"Evan Chen, Peter Hoang, Katherine Garcia, Nicholas Richwagen, M. Pasarica","doi":"10.59586/jsrc.v8i1.295","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.295","url":null,"abstract":"Introduction: Keeping Neighbors in Good Health Through Service Clinic is a student-run, multidisciplinary free clinic dedicated to providing healthcare to uninsured, low-income patients in Central Florida. A quality improvement project was performed to decrease the rate of patient no-shows via altering the patient appointment communication method. \u0000Methods: A needs assessment was performed from June 2017 to March 2018 (n=104 patients). The intervention was implemented over an 18-month period, from April 2018 to September 2019 (n=243 patients). The intervention changed the communication method with patients such that they received appointment reminder texts two days before their appointments and responded to confirm or cancel their appointments. Phone calls were used for rescheduling, confirming cancellations, or contacting patients who had not responded to the CareMessage text. The Mann-Whitney U test was utilized for comparison of appointment no-shows, number of phone calls made, and number of patients scheduled per clinic between pre- and post-intervention groups. \u0000Results: The needs assessment showed that the average number of no-shows was 0.80 per clinic, while the average number of no-shows post-intervention was 0.26 per clinic (p=0.040). The average number of patients scheduled per clinic pre- and post-intervention was 6.90 and 7.84 (p=0.370), respectively. The average number of patients seen per clinic pre- and post-intervention was 5.93 and 6.74 (p=0.640), respectively. The average number of phone calls made weekly was 9.13 per clinic pre-intervention and 3.23 post-intervention (p<0.001). \u0000Conclusion: CareMessage is effective in reducing appointment no-shows and the number of follow-up phone calls made for appointment reminders. This intervention is important for increasing patient continuity of care, access to care, and clinic efficiency.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48561439","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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