Mini Docs: A Novel Online Course Delivery to Empower Student Advocates for SARS-CoV-2 Safety on Oahu
CP11 - Mini Docs: A Novel Online Course Delivery to Empower Student Advocates for SARS-CoV-2 Safety on Oahu
CP11 - Mini Docs: A Novel Online Course Delivery to Empower Student Advocates for SARS-CoV-2 Safety on Oahu
Poster Type: Research
Track/Topic: A. T. Still University
Research Objectives: The Leeward coast population recorded a higher SARS-Cov-2 positivity rate compared to other Oahu regions. Health literacy education has been shown to prevent community-acquired infections. This program used short videos and Zoom to increase understanding of SARS-Cov-2 among middle school students and aid in disease prevention.
Research Study Design/Methods: 200 6th and 7th grade students were emailed the SARS-Cov-2 video project by their school and encouraged to participate voluntarily. They watched a 5-minute video regarding SARS-Cov-2, disease prevention guidelines, and healthy coping practices. Students completed identical, anonymous surveys before and after the video, to assess baseline knowledge and improved understanding on SARS-Cov-2 along with preventative practice measures. 100 students participated in a Zoom discussion session in break out rooms of 10-20 students after completing the surveys. Two weeks later, students completed an anonymous qualitative short answer reflection survey to assess if they continued these practices after the activities.
Research Principal Findings and Quantitative/Qualitative Results: Participants responded positively to small group discussions and taught coping strategies they learned. 58.5% responded to the pre-survey, 34% to the post survey, and 7% to the reflection survey. Before watching the videos, 68.4% of respondents rated their understanding of SARS-Cov-2 as high, 66.7% believed SARS-Cov-2 vaccines would protect them and their families, and 76.9% social distanced frequently. After watching the videos, 95.5% of respondents rated their understanding as high, 84.1% of students believed that SARS-Cov-2 vaccines would be protective, and 91.3% of students expressed intentions to practice social distancing more frequently.
Research Conclusions on Impact on Health Centers: This program, part of an on-going partnership between WCCHC and local schools, provided a unique perspective with the change to online learning. It was successful in increasing middle school students’ understanding of SARS-Cov-2, how to protect themselves, their families, and community. Students reported positive behavioral and attitude changes, shared healthy coping strategies, and utilized what they had learned into their daily lives. Based on the positive results of this program, implementing a similar program at schools can assess generalizability across various underserved areas of Hawai’i. It is worth considering online learning as an additional effective teaching modality during pandemic restrictions.
Authors:
William Phillips, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Joy H. Lewis, DO, PhD, FACP, Professor, Medicine and Public Health Chair, SOMA Dept. of Public Health, A T Still University School of Osteopathic Medicine
Christina Adams, MD, A.T. Still University -School of Osteopathic Medicine Arizona
Kate Whelihan, MPH, CPH, COPC and Public Health Research Specialist, Department of Public Health, A T Still University School of Osteopathic Medicine
Maria Salas Balajadia, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Charlene Mae L. Rocimo, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Therese Nicole A. Diñoso, OMS-III, , AT Still University School of Osteopathic Medicine in Arizona
Austin J. Wang, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Patrick Rim, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Kim Lim, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Jennifer Nordbye, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Eun Ah Cho, Hawaii, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Poster Type: Research
Track/Topic: A. T. Still University
Research Objectives: The Leeward coast population recorded a higher SARS-Cov-2 positivity rate compared to other Oahu regions. Health literacy education has been shown to prevent community-acquired infections. This program used short videos and Zoom to increase understanding of SARS-Cov-2 among middle school students and aid in disease prevention.
Research Study Design/Methods: 200 6th and 7th grade students were emailed the SARS-Cov-2 video project by their school and encouraged to participate voluntarily. They watched a 5-minute video regarding SARS-Cov-2, disease prevention guidelines, and healthy coping practices. Students completed identical, anonymous surveys before and after the video, to assess baseline knowledge and improved understanding on SARS-Cov-2 along with preventative practice measures. 100 students participated in a Zoom discussion session in break out rooms of 10-20 students after completing the surveys. Two weeks later, students completed an anonymous qualitative short answer reflection survey to assess if they continued these practices after the activities.
Research Principal Findings and Quantitative/Qualitative Results: Participants responded positively to small group discussions and taught coping strategies they learned. 58.5% responded to the pre-survey, 34% to the post survey, and 7% to the reflection survey. Before watching the videos, 68.4% of respondents rated their understanding of SARS-Cov-2 as high, 66.7% believed SARS-Cov-2 vaccines would protect them and their families, and 76.9% social distanced frequently. After watching the videos, 95.5% of respondents rated their understanding as high, 84.1% of students believed that SARS-Cov-2 vaccines would be protective, and 91.3% of students expressed intentions to practice social distancing more frequently.
Research Conclusions on Impact on Health Centers: This program, part of an on-going partnership between WCCHC and local schools, provided a unique perspective with the change to online learning. It was successful in increasing middle school students’ understanding of SARS-Cov-2, how to protect themselves, their families, and community. Students reported positive behavioral and attitude changes, shared healthy coping strategies, and utilized what they had learned into their daily lives. Based on the positive results of this program, implementing a similar program at schools can assess generalizability across various underserved areas of Hawai’i. It is worth considering online learning as an additional effective teaching modality during pandemic restrictions.
Authors:
William Phillips, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Joy H. Lewis, DO, PhD, FACP, Professor, Medicine and Public Health Chair, SOMA Dept. of Public Health, A T Still University School of Osteopathic Medicine
Christina Adams, MD, A.T. Still University -School of Osteopathic Medicine Arizona
Kate Whelihan, MPH, CPH, COPC and Public Health Research Specialist, Department of Public Health, A T Still University School of Osteopathic Medicine
Maria Salas Balajadia, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Charlene Mae L. Rocimo, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Therese Nicole A. Diñoso, OMS-III, , AT Still University School of Osteopathic Medicine in Arizona
Austin J. Wang, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Patrick Rim, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Kim Lim, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Jennifer Nordbye, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Eun Ah Cho, Hawaii, OMS-III, AT Still University School of Osteopathic Medicine in Arizona
Speaker(s): Author(s):
Why Patients Do Not Follow Through With Behavioral Health Referrals: Patient-Perceived Barriers in a Community Health Care Setting
CP13 - Why Patients Do Not Follow Through With Behavioral Health Referrals: Patient-Perceived Barriers in a Community Health Care Setting
CP13 - Why Patients Do Not Follow Through With Behavioral Health Referrals: Patient-Perceived Barriers in a Community Health Care Setting
Poster Type: Research
Track/Topic: A. T. Still University; Behavioral Health Services; Quality of Care and Quality Improvement; Social Determinants of Health
Research Objectives: The purpose of this project was to determine the obstacles which prevented patients from scheduling or attending behavioral health sessions after a referral was made. Identification of perceived barriers may allow the community health center to address gaps within the continuum of care for patients in need of such services.
Research Study Design/Methods: Inclusion criteria included a behavioral health referral made between the dates of March 1, 2020 and September 31, 2020. This project focused on patients and families who failed to schedule or attend appointments after receiving the referral. A list of patients was assembled from five Family Health Centers (FHCs) within the NYU Langone system. Patients were contacted via telephone. After verbal consent was received, participants were asked about barriers they encountered which kept them from scheduling or attending sessions. Qualitative data were collected as anecdotes and the patient-perceived barriers were sorted into general categories, such as transportation, finances, etc.
Research Principal Findings and Quantitative/Qualitative Results: 827 patients met the inclusion criteria. Of 116 contact attempts made, 68 patients were reached and 57 consented to participate (response rate of 83.8%). Analysis of completed interviews reveals a range of reasons why appointments were not scheduled or kept, including, but not limited to: provider failure to contact patients to schedule sessions; lack of communication regarding the referral itself; personal belief that they did not require behavioral health services; concerns about in-person visits during a pandemic; scheduling conflicts; non-coverage by insurance; forgetfulness; lengthy gap between referral and available appointments; dissatisfaction from prior encounters; and choosing to use outside providers.
Research Conclusions on Impact on Health Centers: While there was no singular reason behind the absenteeism, certain themes became apparent in the data. Chief among them was a breakdown in communication between providers and patients. Many patients were not aware that they had been given a behavioral health referral in the first place and there seems to be a perceived lack of follow-up done by the provider regarding appointment scheduling. In addition, other factors such as financial worries, misconceptions about behavioral health, and systemic disruptions due to the COVID-19 pandemic also played a role. The findings will be provided to the Quality Improvement team at the FHCs.
Authors:
Edmund To, OMS-II, A.T. Still University - School of Osteopathic Medicine in Arizona
Poster Type: Research
Track/Topic: A. T. Still University; Behavioral Health Services; Quality of Care and Quality Improvement; Social Determinants of Health
Research Objectives: The purpose of this project was to determine the obstacles which prevented patients from scheduling or attending behavioral health sessions after a referral was made. Identification of perceived barriers may allow the community health center to address gaps within the continuum of care for patients in need of such services.
Research Study Design/Methods: Inclusion criteria included a behavioral health referral made between the dates of March 1, 2020 and September 31, 2020. This project focused on patients and families who failed to schedule or attend appointments after receiving the referral. A list of patients was assembled from five Family Health Centers (FHCs) within the NYU Langone system. Patients were contacted via telephone. After verbal consent was received, participants were asked about barriers they encountered which kept them from scheduling or attending sessions. Qualitative data were collected as anecdotes and the patient-perceived barriers were sorted into general categories, such as transportation, finances, etc.
Research Principal Findings and Quantitative/Qualitative Results: 827 patients met the inclusion criteria. Of 116 contact attempts made, 68 patients were reached and 57 consented to participate (response rate of 83.8%). Analysis of completed interviews reveals a range of reasons why appointments were not scheduled or kept, including, but not limited to: provider failure to contact patients to schedule sessions; lack of communication regarding the referral itself; personal belief that they did not require behavioral health services; concerns about in-person visits during a pandemic; scheduling conflicts; non-coverage by insurance; forgetfulness; lengthy gap between referral and available appointments; dissatisfaction from prior encounters; and choosing to use outside providers.
Research Conclusions on Impact on Health Centers: While there was no singular reason behind the absenteeism, certain themes became apparent in the data. Chief among them was a breakdown in communication between providers and patients. Many patients were not aware that they had been given a behavioral health referral in the first place and there seems to be a perceived lack of follow-up done by the provider regarding appointment scheduling. In addition, other factors such as financial worries, misconceptions about behavioral health, and systemic disruptions due to the COVID-19 pandemic also played a role. The findings will be provided to the Quality Improvement team at the FHCs.
Authors:
Edmund To, OMS-II, A.T. Still University - School of Osteopathic Medicine in Arizona
Speaker(s):
Exploring Provider Stress and the Relationship to Recruitment and Retention in a Community Health Center System
CP14 - Exploring Provider Stress and the Relationship to Recruitment and Retention in a Community Health Center System
CP14 - Exploring Provider Stress and the Relationship to Recruitment and Retention in a Community Health Center System
Poster Type: Research
Track/Topic: A. T. Still University; Workforce
Research Objectives: The purpose of this study is to understand factors that affect primary care working conditions in community health centers and safety-net clinics and determine if there is a relationship between provider stress and recruitment and retention within the North Country HealthCare (NCHC) system.
Research Study Design/Methods: The NCHC administration asked its clinical providers to complete the Primary Care Provider Stress Checklist (PCP-SC) to assess stress in healthcare settings as it relates to the domains of patient interaction, practice management, administrative issues, education/learning, and relationships with colleagues, and work/life balance. NCHC also monitors clinical provider turnover as a part of continuous quality improvement within the organization. Using the results of the PCP-SC, organizational leadership targeted domains contributing to the stress of clinical providers for intervention and looked for interval changes in clinical provider turnover.
Research Principal Findings and Quantitative/Qualitative Results: PCP-SC was completed by 48 clinical providers in 2018 and 72 clinical providers in 2019 working at NCHC. Data analysis shows that interactions with patients, practice management, and administrative issues are the domains that contribute most to the stress in the providers of NCHC clinics. We were able to identify the specific interactions within each domain that contributed most to clinician stress. A review of the turnover rate within the NCHC health system showed a significant decrease from 2018 (27.8) to 2020 (12).
Research Conclusions on Impact on Health Centers: Recruiting and retaining a strong clinical workforce has become a pressing concern among the nation’s community health centers. An increased rate of turnover of healthcare providers in a clinic can disrupt patient care and impact organizational stability. A better understanding of the stressors that impact clinical providers can help minimize the number of vacancies, save money, improve the quality of patient care, and ensure the provision of health care services in the community. Results of this project have been used to inform the development of provider support and retention strategies for health centers within the NCHC system.
Authors:
Surekha Appikatla, MPH, Data Informatics Specialist, A.T. Still University
April Alvarez-Corona, MD, Chief Medical Officer, North Country HealthCare Inc.
Ebony Whisenant, MD, Assoc. Prof., Family Med and Public Health, Director, PCTE Fellowship, A. T. Still University, School Of Osteopathic Medicine in Arizona
Poster Type: Research
Track/Topic: A. T. Still University; Workforce
Research Objectives: The purpose of this study is to understand factors that affect primary care working conditions in community health centers and safety-net clinics and determine if there is a relationship between provider stress and recruitment and retention within the North Country HealthCare (NCHC) system.
Research Study Design/Methods: The NCHC administration asked its clinical providers to complete the Primary Care Provider Stress Checklist (PCP-SC) to assess stress in healthcare settings as it relates to the domains of patient interaction, practice management, administrative issues, education/learning, and relationships with colleagues, and work/life balance. NCHC also monitors clinical provider turnover as a part of continuous quality improvement within the organization. Using the results of the PCP-SC, organizational leadership targeted domains contributing to the stress of clinical providers for intervention and looked for interval changes in clinical provider turnover.
Research Principal Findings and Quantitative/Qualitative Results: PCP-SC was completed by 48 clinical providers in 2018 and 72 clinical providers in 2019 working at NCHC. Data analysis shows that interactions with patients, practice management, and administrative issues are the domains that contribute most to the stress in the providers of NCHC clinics. We were able to identify the specific interactions within each domain that contributed most to clinician stress. A review of the turnover rate within the NCHC health system showed a significant decrease from 2018 (27.8) to 2020 (12).
Research Conclusions on Impact on Health Centers: Recruiting and retaining a strong clinical workforce has become a pressing concern among the nation’s community health centers. An increased rate of turnover of healthcare providers in a clinic can disrupt patient care and impact organizational stability. A better understanding of the stressors that impact clinical providers can help minimize the number of vacancies, save money, improve the quality of patient care, and ensure the provision of health care services in the community. Results of this project have been used to inform the development of provider support and retention strategies for health centers within the NCHC system.
Authors:
Surekha Appikatla, MPH, Data Informatics Specialist, A.T. Still University
April Alvarez-Corona, MD, Chief Medical Officer, North Country HealthCare Inc.
Ebony Whisenant, MD, Assoc. Prof., Family Med and Public Health, Director, PCTE Fellowship, A. T. Still University, School Of Osteopathic Medicine in Arizona
Speaker(s):
Implementing a Blood Pressure Measurement Protocol to Improve the Diagnosis and Treatment of Hypertension
CP15 - Implementing a Blood Pressure Measurement Protocol to Improve the Diagnosis and Treatment of Hypertension
CP15 - Implementing a Blood Pressure Measurement Protocol to Improve the Diagnosis and Treatment of Hypertension
Poster Type: Research
Track/Topic: A. T. Still University; Quality of Care and Quality Improvement
Research Objectives: Workflow changes that enhance accurate blood pressure measurement can help with the diagnosis and treatment of hypertension and lead to improved health outcomes. The purpose of this project is to improve blood pressure measurement technique and workflow within the Family Health Centers at NYU Langone, a federally qualified health center.
Research Study Design/Methods: Patients with a known diagnosis of hypertension and/or elevated blood pressure visiting the ambulatory care practice have their blood pressure measured using American Heart Association (AHA) recommended patient preparation and measurement techniques. A dashboard to track multiple BP readings when values are outside of recommended BP target ranges was developed and a checklist documented in the electronic medical record is used to monitor adherence with the AHA guidelines in the initial patient triage by the medical assistant.
Research Principal Findings and Quantitative/Qualitative Results: Data analysis shows improved adherence to the AHA recommended patient preparation and measurement techniques within the pilot provider’s panel. During the first 16 weeks of project implementation, we noted that patients who had a BP measurement that was initially elevated during triage subsequently had a lower blood pressure when AHA recommended blood pressure measurement techniques were used to guide blood pressure measurement. For example, approximately 32% of patient encounters that showed an elevated blood pressure reading on initial triage were subsequently found to have a normal BP reading when AHA protocol was used to measure the blood pressure.
Research Conclusions on Impact on Health Centers: Accurate blood pressure measurement is essential to the diagnosis and treatment of hypertension. Inaccurate blood pressure measurement may lead to failure to identify patients with hypertension resulting in increased risk for cardiovascular disease, kidney disease, stroke, cognitive decline, and mortality. Alternatively, inaccurate blood pressure measurement may also lead to unfavorable outcomes such as adverse medication side effects, increased risk of falls in the elderly, and an increase in hospitalizations. This quality improvement project demonstrates the feasibility of implementing workflow changes that can enhance accurate blood pressure measurement techniques in an ambulatory care setting.
Authors:
Surekha Appikatla, MPH, Data Informatics Specialist, A.T. Still University
Oksana Genzer, MD, Internal Medicine Primary Care Physician/Adjunct Teaching Instructor, NYU Langone Sunset Park Family Health Center
Ebony Whisenant, MD, Assoc. Prof., Family Med and Public Health, Director, PCTE Fellowship, A. T. Still University, School Of Osteopathic Medicine in Arizona
Poster Type: Research
Track/Topic: A. T. Still University; Quality of Care and Quality Improvement
Research Objectives: Workflow changes that enhance accurate blood pressure measurement can help with the diagnosis and treatment of hypertension and lead to improved health outcomes. The purpose of this project is to improve blood pressure measurement technique and workflow within the Family Health Centers at NYU Langone, a federally qualified health center.
Research Study Design/Methods: Patients with a known diagnosis of hypertension and/or elevated blood pressure visiting the ambulatory care practice have their blood pressure measured using American Heart Association (AHA) recommended patient preparation and measurement techniques. A dashboard to track multiple BP readings when values are outside of recommended BP target ranges was developed and a checklist documented in the electronic medical record is used to monitor adherence with the AHA guidelines in the initial patient triage by the medical assistant.
Research Principal Findings and Quantitative/Qualitative Results: Data analysis shows improved adherence to the AHA recommended patient preparation and measurement techniques within the pilot provider’s panel. During the first 16 weeks of project implementation, we noted that patients who had a BP measurement that was initially elevated during triage subsequently had a lower blood pressure when AHA recommended blood pressure measurement techniques were used to guide blood pressure measurement. For example, approximately 32% of patient encounters that showed an elevated blood pressure reading on initial triage were subsequently found to have a normal BP reading when AHA protocol was used to measure the blood pressure.
Research Conclusions on Impact on Health Centers: Accurate blood pressure measurement is essential to the diagnosis and treatment of hypertension. Inaccurate blood pressure measurement may lead to failure to identify patients with hypertension resulting in increased risk for cardiovascular disease, kidney disease, stroke, cognitive decline, and mortality. Alternatively, inaccurate blood pressure measurement may also lead to unfavorable outcomes such as adverse medication side effects, increased risk of falls in the elderly, and an increase in hospitalizations. This quality improvement project demonstrates the feasibility of implementing workflow changes that can enhance accurate blood pressure measurement techniques in an ambulatory care setting.
Authors:
Surekha Appikatla, MPH, Data Informatics Specialist, A.T. Still University
Oksana Genzer, MD, Internal Medicine Primary Care Physician/Adjunct Teaching Instructor, NYU Langone Sunset Park Family Health Center
Ebony Whisenant, MD, Assoc. Prof., Family Med and Public Health, Director, PCTE Fellowship, A. T. Still University, School Of Osteopathic Medicine in Arizona
Speaker(s):
Addressing Food Insecurity by Increasing Awareness of Local Resources in Centreville, Illinois
CP16 - Addressing Food Insecurity by Increasing Awareness of Local Resources in Centreville, Illinois
CP16 - Addressing Food Insecurity by Increasing Awareness of Local Resources in Centreville, Illinois
Poster Type: Innovation
Primary Funding Source: A.T. Still University School of Osteopathic Medicine in Arizona
Category: A. T. Still University; Expanding Access to Care and Other Services; Social Determinants of Health
Issue or Challenge: The city of Centreville, Illinois is a food desert with 80.1% of residents living beyond 1/2 mile from a supermarket or grocery store and 32.0% of housing units report not having access to a vehicle according to the United States Department of Agriculture. This combination has been shown to lead to adverse health outcomes.
Description of Innovation: We created a pamphlet that included information on organizations providing resources within a 5-mile radius of Touchette Regional Hospital located in Centreville, IL. The pamphlet included contact information and websites for food pantries, Southern Illinois Healthcare Foundation (SIHF) clinics, oral health providers, and women’s shelters. Given the nature of the COVID-19 pandemic, we ensured each organization was open and available prior to including it in the pamphlet. Information on Eligibility criteria and application instructions for WIC, SNAP, and disability were also included. Also, on the pamphlet was a QR code to an optional internet survey asking for feedback on the pamphlet, leaving room for us to improve this resource in the future. These pamphlets were distributed to the community inside free food packages prepared by the Touchette Regional Hospital Bicycle Food Mission (TRHBFM). TRHBFM is a weekly donation-driven initiative that aims to address food insecurity in the area by preparing and distributing hot, nutritious meals to anyone who requests one. To further help this community, we provided TRHBFM with bundles of disposable face masks to include in food packages with our pamphlet to help provide protection against COVID-19 infection.
Impact or Result: While the larger impact on health outcomes may not fully be known in the short term, the objective of promoting local nutritional and healthcare resources was met. In a 9-week period, approximately 6,000 disposable face masks and 2,000 copies of the pamphlet were distributed along with fresh meals throughout five routes. On average, 222 pamphlets and 666 masks were distributed weekly over 9 weeks. The quantity of distributed pamphlets may not correlate with unique recipients due to overlap in community members who received weekly meals. The health center saw an appreciable growth and increase in donations for the program when comparing week 1 to week 9. Weekly meal production increased from 200 to almost 900 due to a budget increase of $300/week over that time period. More importantly, as the program grew, increasing numbers of community members volunteered to help those at greatest risk, including the elderly and homeless.
Replicating this Innovation: A similar model could be implemented at other organizations with their own state-specific guidelines. Food insecurity is a common theme across many communities throughout the United States. A TRHBFM-like program could be feasible to implement in other organizations as it requires only a handful of dedicated volunteers and kitchen facilities. In its early stages, the TRHBFM was producing around 200 meals with a $500 weekly budget for ingredients and supplies. After 12 weeks, the weekly budget had increased to $800 allowing for the production of nearly 900 meals. Program marketing on social media and the implementation of an online donation system has allowed the program to continue its operations exclusively on donations. We believe such an approach can make this innovation applicable in other organizations.
Author(s):
Victor Huerta, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Teri Nguyen-Guo, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Molly Shipman, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Jeremy Brown, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Karen Chen, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Jade Jones, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Kirstie Mabitad, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Syed Raheem, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Alexa Stephenson, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Aliza Tan, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Alan Tran, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Poster Type: Innovation
Primary Funding Source: A.T. Still University School of Osteopathic Medicine in Arizona
Category: A. T. Still University; Expanding Access to Care and Other Services; Social Determinants of Health
Issue or Challenge: The city of Centreville, Illinois is a food desert with 80.1% of residents living beyond 1/2 mile from a supermarket or grocery store and 32.0% of housing units report not having access to a vehicle according to the United States Department of Agriculture. This combination has been shown to lead to adverse health outcomes.
Description of Innovation: We created a pamphlet that included information on organizations providing resources within a 5-mile radius of Touchette Regional Hospital located in Centreville, IL. The pamphlet included contact information and websites for food pantries, Southern Illinois Healthcare Foundation (SIHF) clinics, oral health providers, and women’s shelters. Given the nature of the COVID-19 pandemic, we ensured each organization was open and available prior to including it in the pamphlet. Information on Eligibility criteria and application instructions for WIC, SNAP, and disability were also included. Also, on the pamphlet was a QR code to an optional internet survey asking for feedback on the pamphlet, leaving room for us to improve this resource in the future. These pamphlets were distributed to the community inside free food packages prepared by the Touchette Regional Hospital Bicycle Food Mission (TRHBFM). TRHBFM is a weekly donation-driven initiative that aims to address food insecurity in the area by preparing and distributing hot, nutritious meals to anyone who requests one. To further help this community, we provided TRHBFM with bundles of disposable face masks to include in food packages with our pamphlet to help provide protection against COVID-19 infection.
Impact or Result: While the larger impact on health outcomes may not fully be known in the short term, the objective of promoting local nutritional and healthcare resources was met. In a 9-week period, approximately 6,000 disposable face masks and 2,000 copies of the pamphlet were distributed along with fresh meals throughout five routes. On average, 222 pamphlets and 666 masks were distributed weekly over 9 weeks. The quantity of distributed pamphlets may not correlate with unique recipients due to overlap in community members who received weekly meals. The health center saw an appreciable growth and increase in donations for the program when comparing week 1 to week 9. Weekly meal production increased from 200 to almost 900 due to a budget increase of $300/week over that time period. More importantly, as the program grew, increasing numbers of community members volunteered to help those at greatest risk, including the elderly and homeless.
Replicating this Innovation: A similar model could be implemented at other organizations with their own state-specific guidelines. Food insecurity is a common theme across many communities throughout the United States. A TRHBFM-like program could be feasible to implement in other organizations as it requires only a handful of dedicated volunteers and kitchen facilities. In its early stages, the TRHBFM was producing around 200 meals with a $500 weekly budget for ingredients and supplies. After 12 weeks, the weekly budget had increased to $800 allowing for the production of nearly 900 meals. Program marketing on social media and the implementation of an online donation system has allowed the program to continue its operations exclusively on donations. We believe such an approach can make this innovation applicable in other organizations.
Author(s):
Victor Huerta, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Teri Nguyen-Guo, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Molly Shipman, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Jeremy Brown, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Karen Chen, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Jade Jones, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Kirstie Mabitad, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Syed Raheem, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Alexa Stephenson, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Aliza Tan, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Alan Tran, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Speaker(s):
Provider Preferences Regarding the Benefits and Challenges of Utilizing Telemedicine
CP17 - Provider Preferences Regarding the Benefits and Challenges of Utilizing Telemedicine
CP17 - Provider Preferences Regarding the Benefits and Challenges of Utilizing Telemedicine
Poster Type: Research
Track/Topic: A. T. Still University
Research Objectives: The utilization of telemedicine in place of in-person appointments has become more common due to the COVID-19 pandemic. By assessing healthcare providers’ likes and dislikes of using telemedicine in the greater Portland, Oregon area, a better understanding may be developed to formulate recommendations aimed at improving the telemedicine experience.
Research Study Design/Methods: A survey was developed to assess provider preferences, likes and dislikes of utilizing telemedicine during the COVID-19 pandemic. This survey was sent out via email to providers (MD, DO, NP etc…) at thirty-one sites from three different organizations within the Northwest Regional Primary Care Community Health Centers network. Upon completion of the data collection period, survey responses will be analyzed to determine trends in the benefits, challenges, and effective uses of telemedicine among the participants. This information will then be shared with clinic administrators and participants with the intent of aiding improvement in telemedicine encounters.
Research Principal Findings and Quantitative/Qualitative Results: We have reached out to over 270 providers accessed through employee list-serves at each clinic. Responses will be collected from 3/15/2021 until 04/20/2021. We plan to compile the survey results to examine providers’ experiences with telemedicine during the COVID-19 pandemic. Additionally, we intend to identify the types of patient encounters (e.g. dermatologic) that providers have found to be the most effective through telemedicine. We will use this information to provide specific recommendations to the clinic administration in order to inform their decisions regarding the telemedicine process.
Research Conclusions on Impact on Health Centers: With a high volume of patient visits occurring remotely, we wanted to assess providers’ satisfaction in providing effective patient-centered care through telemedicine. We will use our survey results to determine what aspects of telemedicine providers identify as effective and ineffective. We will then compile the results and distribute it to all participating clinics in the Northwest Regional Primary Care Community Health Centers with the hope of providing insight to help them make improvements to the telemedicine process.
Authors:
Theresa Chiappe, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Poster Type: Research
Track/Topic: A. T. Still University
Research Objectives: The utilization of telemedicine in place of in-person appointments has become more common due to the COVID-19 pandemic. By assessing healthcare providers’ likes and dislikes of using telemedicine in the greater Portland, Oregon area, a better understanding may be developed to formulate recommendations aimed at improving the telemedicine experience.
Research Study Design/Methods: A survey was developed to assess provider preferences, likes and dislikes of utilizing telemedicine during the COVID-19 pandemic. This survey was sent out via email to providers (MD, DO, NP etc…) at thirty-one sites from three different organizations within the Northwest Regional Primary Care Community Health Centers network. Upon completion of the data collection period, survey responses will be analyzed to determine trends in the benefits, challenges, and effective uses of telemedicine among the participants. This information will then be shared with clinic administrators and participants with the intent of aiding improvement in telemedicine encounters.
Research Principal Findings and Quantitative/Qualitative Results: We have reached out to over 270 providers accessed through employee list-serves at each clinic. Responses will be collected from 3/15/2021 until 04/20/2021. We plan to compile the survey results to examine providers’ experiences with telemedicine during the COVID-19 pandemic. Additionally, we intend to identify the types of patient encounters (e.g. dermatologic) that providers have found to be the most effective through telemedicine. We will use this information to provide specific recommendations to the clinic administration in order to inform their decisions regarding the telemedicine process.
Research Conclusions on Impact on Health Centers: With a high volume of patient visits occurring remotely, we wanted to assess providers’ satisfaction in providing effective patient-centered care through telemedicine. We will use our survey results to determine what aspects of telemedicine providers identify as effective and ineffective. We will then compile the results and distribute it to all participating clinics in the Northwest Regional Primary Care Community Health Centers with the hope of providing insight to help them make improvements to the telemedicine process.
Authors:
Theresa Chiappe, OMS-II, A.T. Still University School of Osteopathic Medicine in Arizona
Speaker(s):
Piloted Enhancements to a Screening, Brief Intervention, and Referral to Treatment Program in the FQHC Setting
CP18 - Piloted Enhancements to a Screening, Brief Intervention, and Referral to Treatment Program in the FQHC Setting
CP18 - Piloted Enhancements to a Screening, Brief Intervention, and Referral to Treatment Program in the FQHC Setting
Poster Type: Innovation
Primary Funding Source: The piloted enhancements to the SBIRT workflow are currently funded by a five-year grant from SAMHSA (September 2018 - September 2023)
Category: Behavioral Health Services
Issue or Challenge: Access Community Health Network (ACCESS), one of the largest networks of federally qualified health centers in the nation, has sustained a universal Screening, Brief Intervention, and Referral to Treatment (SBIRT) program across all 35 of its Chicagoland health centers since 2015. Although medical assistants have consistently completed annual patient screenings for alcohol and drug use since the program launched, positivity rates were low compared to known rates in the general population. Furthermore, medical providers struggled to find time during the encounter to prioritize preventive interventions for patients that screen low, albeit positive, on alcohol and drug use screenings.
Description of Innovation: In 2019, ACCESS began to pilot an enhanced SBIRT program that embeds a designated SBIRT paraprofessional, or Community Health Specialist (CHS), at each of five pilot health centers. The CHS is integrated into the care team to screen patients for alcohol and substance use, conduct a brief intervention in the form of a motivational interview with patients with potentially risky use, and facilitate referrals to integrated behavioral health services, onsite medication-assisted recovery (MAR), and external treatment services, as appropriate.
Impact or Result: In the first two years of the pilot program, the ability to detect positive patients at SBIRT pilot sites greatly improved. ACCESS CHSs screened over 5,800 patients. Among patients that screened positive (19%), over half (55%) indicated marijuana use at least once in the past thirty days, and rates of daily marijuana use exceeded that of daily alcohol use (24% of positive-screened patients compared to 11%). CHSs consistently delivered motivational interviews to over 99% of patients identified for SBIRT services. In addition, a higher-than-expected number of SBIRT patients, including negative-screened patients, met with an ACCESS behavioral health consultant within six months of their initial CHS encounter.
Replicating this Innovation: ACCESS has only piloted the enhanced SBIRT workflow within our own organization. However, thorough evaluation of our SBIRT CHS training activities found important take-aways for other organizations interested in integrating similar roles into their care team. To prepare CHSs to deliver consistent and effective motivational interviews, we found that trainings must be spaced out gradually over multiple months to allow time for staff to test new concepts in the field between trainings. Effective training must also include both interactive group activities (role plays, peer feedback, analyzing videos), and individual coaching. Trainings at ACCESS were conducted by a member of the Motivational Interviewing Network of Trainers (MINT).
Author(s):
Amber Kraft, PhD, Evaluation Specialist, Access Community Health Network
Poster Type: Innovation
Primary Funding Source: The piloted enhancements to the SBIRT workflow are currently funded by a five-year grant from SAMHSA (September 2018 - September 2023)
Category: Behavioral Health Services
Issue or Challenge: Access Community Health Network (ACCESS), one of the largest networks of federally qualified health centers in the nation, has sustained a universal Screening, Brief Intervention, and Referral to Treatment (SBIRT) program across all 35 of its Chicagoland health centers since 2015. Although medical assistants have consistently completed annual patient screenings for alcohol and drug use since the program launched, positivity rates were low compared to known rates in the general population. Furthermore, medical providers struggled to find time during the encounter to prioritize preventive interventions for patients that screen low, albeit positive, on alcohol and drug use screenings.
Description of Innovation: In 2019, ACCESS began to pilot an enhanced SBIRT program that embeds a designated SBIRT paraprofessional, or Community Health Specialist (CHS), at each of five pilot health centers. The CHS is integrated into the care team to screen patients for alcohol and substance use, conduct a brief intervention in the form of a motivational interview with patients with potentially risky use, and facilitate referrals to integrated behavioral health services, onsite medication-assisted recovery (MAR), and external treatment services, as appropriate.
Impact or Result: In the first two years of the pilot program, the ability to detect positive patients at SBIRT pilot sites greatly improved. ACCESS CHSs screened over 5,800 patients. Among patients that screened positive (19%), over half (55%) indicated marijuana use at least once in the past thirty days, and rates of daily marijuana use exceeded that of daily alcohol use (24% of positive-screened patients compared to 11%). CHSs consistently delivered motivational interviews to over 99% of patients identified for SBIRT services. In addition, a higher-than-expected number of SBIRT patients, including negative-screened patients, met with an ACCESS behavioral health consultant within six months of their initial CHS encounter.
Replicating this Innovation: ACCESS has only piloted the enhanced SBIRT workflow within our own organization. However, thorough evaluation of our SBIRT CHS training activities found important take-aways for other organizations interested in integrating similar roles into their care team. To prepare CHSs to deliver consistent and effective motivational interviews, we found that trainings must be spaced out gradually over multiple months to allow time for staff to test new concepts in the field between trainings. Effective training must also include both interactive group activities (role plays, peer feedback, analyzing videos), and individual coaching. Trainings at ACCESS were conducted by a member of the Motivational Interviewing Network of Trainers (MINT).
Author(s):
Amber Kraft, PhD, Evaluation Specialist, Access Community Health Network
Speaker(s):
Implementation of an Outpatient Alcohol Withdrawal Protocol at an Urban Community Health Center
CP19 - Implementation of an Outpatient Alcohol Withdrawal Protocol at an Urban Community Health Center
CP19 - Implementation of an Outpatient Alcohol Withdrawal Protocol at an Urban Community Health Center
Poster Type: Innovation
Category: Behavioral Health Services
Issue or Challenge: The World Health Organization reports alcohol use disorder (AUD) impacts up to 5% of people worldwide. Of those with a moderate to severe alcohol use disorder, 50% will experience withdrawal symptoms which can include anxiety, sleep disturbance, tremors, seizures, delirium tremens, and death. A barrier to treatment for individuals with an AUD is the lack of detoxification services to assist in safely managing withdrawal symptoms. Outpatient treatment of mild to moderate withdrawal has been demonstrated to be safe, patient-centered, cost effective and is supported by American Society of Addiction Medicine guidelines but was not widely available in our setting.
Description of Innovation: With the intent to reduce barriers to safe treatment for lower risk patients with AUD who require medication for withdrawal, the medication assisted treatment (MAT) team in our CHC piloted an outpatient withdrawal management protocol. The protocol, which is being published elsewhere, incorporated the freely available PAWSS (Prediction of Alcohol Withdrawal Severity Scale) and CIWA (Clinical Institute Withdrawal Assessment) along with several other characteristics to risk-stratify patients who were interested in stopping drinking. Eligibility was determined for outpatient treatment (with non-benzodiazepine medications or benzodiazepine medications) versus referral to higher level of care. Providers and staff were educated about the outpatient treatment protocol at a staff meeting and patients who were identified as wanting to stop drinking were referred to our integrated addiction counselor and MAT providers for an intake visit. After initiation of the treatment protocol, daily follow up visits (either in person or telehealth) were scheduled for medication and counseling as well as a one week follow up visit to initiate maintenance treatment. Our clinic developed note templates for our electronic medical record that incorporated decision aids and we developed patient handouts and materials.
Impact or Result: Since implementing this protocol in our clinic in August of 2020 a total of 19 patients have been referred for assistance with stopping drinking. 15 of these patients were successfully able to stop drinking during the outpatient withdrawal protocol and 14 were transitioned onto maintenance medication for alcohol use disorder during follow up in our addiction clinic.Overall, we have also had a notable increase in patients receiving maintenance medication for alcohol use disorder. In the 2 quarters preceding implementation, our clinic averaged 43 patients receiving oral naltrexone, 6 receiving IM-depo naltrexone, and 7 receiving oral acamprosate. In the 2 quarters since implementation, our clinic averaged 60 patients receiving oral naltrexone, 12 receiving IM-depo naltrexone and 13 receiving acamprosate representing a 40%, 100% and 86% increase in prescriptions for maintenance medications treating alcohol use disorder.
Replicating this Innovation: The use of an algorithm and note template provides a framework to help guide treatment decisions in the outpatient setting. It has successfully been used by providers throughout our clinic and outside of the MAT clinic given the straightforward guidance. It could easily be replicated in other organizations.
Author(s):
Daniel White, MD, Assistant Professor, Denver Health
Jessica Cram, LAC, LPCC, Licensed Addiction Counselor, Denver Health
Jessica Bull, MD, Assistant Professor, Denver Health and Hospital Authority
Raeanna Simcoe, MD, Senior Instructor, Denver Health and Hospital Authority
Poster Type: Innovation
Category: Behavioral Health Services
Issue or Challenge: The World Health Organization reports alcohol use disorder (AUD) impacts up to 5% of people worldwide. Of those with a moderate to severe alcohol use disorder, 50% will experience withdrawal symptoms which can include anxiety, sleep disturbance, tremors, seizures, delirium tremens, and death. A barrier to treatment for individuals with an AUD is the lack of detoxification services to assist in safely managing withdrawal symptoms. Outpatient treatment of mild to moderate withdrawal has been demonstrated to be safe, patient-centered, cost effective and is supported by American Society of Addiction Medicine guidelines but was not widely available in our setting.
Description of Innovation: With the intent to reduce barriers to safe treatment for lower risk patients with AUD who require medication for withdrawal, the medication assisted treatment (MAT) team in our CHC piloted an outpatient withdrawal management protocol. The protocol, which is being published elsewhere, incorporated the freely available PAWSS (Prediction of Alcohol Withdrawal Severity Scale) and CIWA (Clinical Institute Withdrawal Assessment) along with several other characteristics to risk-stratify patients who were interested in stopping drinking. Eligibility was determined for outpatient treatment (with non-benzodiazepine medications or benzodiazepine medications) versus referral to higher level of care. Providers and staff were educated about the outpatient treatment protocol at a staff meeting and patients who were identified as wanting to stop drinking were referred to our integrated addiction counselor and MAT providers for an intake visit. After initiation of the treatment protocol, daily follow up visits (either in person or telehealth) were scheduled for medication and counseling as well as a one week follow up visit to initiate maintenance treatment. Our clinic developed note templates for our electronic medical record that incorporated decision aids and we developed patient handouts and materials.
Impact or Result: Since implementing this protocol in our clinic in August of 2020 a total of 19 patients have been referred for assistance with stopping drinking. 15 of these patients were successfully able to stop drinking during the outpatient withdrawal protocol and 14 were transitioned onto maintenance medication for alcohol use disorder during follow up in our addiction clinic.Overall, we have also had a notable increase in patients receiving maintenance medication for alcohol use disorder. In the 2 quarters preceding implementation, our clinic averaged 43 patients receiving oral naltrexone, 6 receiving IM-depo naltrexone, and 7 receiving oral acamprosate. In the 2 quarters since implementation, our clinic averaged 60 patients receiving oral naltrexone, 12 receiving IM-depo naltrexone and 13 receiving acamprosate representing a 40%, 100% and 86% increase in prescriptions for maintenance medications treating alcohol use disorder.
Replicating this Innovation: The use of an algorithm and note template provides a framework to help guide treatment decisions in the outpatient setting. It has successfully been used by providers throughout our clinic and outside of the MAT clinic given the straightforward guidance. It could easily be replicated in other organizations.
Author(s):
Daniel White, MD, Assistant Professor, Denver Health
Jessica Cram, LAC, LPCC, Licensed Addiction Counselor, Denver Health
Jessica Bull, MD, Assistant Professor, Denver Health and Hospital Authority
Raeanna Simcoe, MD, Senior Instructor, Denver Health and Hospital Authority
Speaker(s):
2019 Uniform Data System Report: An Analysis of Asian American-, Native Hawaiian-, and Pacific Islander-Serving Health Centers
CP20 - 2019 Uniform Data System Report: An Analysis of Asian American-, Native Hawaiian-, and Pacific Islander-Serving Health Centers
CP20 - 2019 Uniform Data System Report: An Analysis of Asian American-, Native Hawaiian-, and Pacific Islander-Serving Health Centers
Poster Type: Research
Track/Topic: Demonstrating Value; Expanding Access to Care and Other Services; Improving Care for Special Populations; Quality of Care and Quality Improvement; Social Determinants of Health; Workforce
Research Objectives: Asian American (AAs), Native Hawaiian (NHs), and Pacific Islanders (PIs) are the fastest-growing major racial or ethnic group in the United States and its territories. AAPCHO analyzed the UDS data of AA-, NH-, and PI-serving health centers to assess health disparities, workforce development trends, and recommendations to improve population health.
Research Study Design/Methods: AAPCHO analyzed health center and patient data using the Uniform Data System (UDS), an annual reporting system by the Health Resources and Services Administration (HRSA) for health centers. AAPCHO identified AA-, NH-, and PI-serving health centers as the top 10% of health centers in terms of the number of AA, NH, and PI patients served at the health center in 2019 and NH- and PI-serving health centers as health centers that served greater or equal to 1,000 NH and PI patients combined in 2019.
Research Principal Findings and Quantitative/Qualitative Results: On average, AA-, NH-, and PI-serving and NH- and PI-serving health centers had more full-time Enabling Services staff than health centers nationally. Compared to the national health center average, both AA-, and PI-serving and NH- and PI-serving health centers reported a higher proportion of limited English proficient, low-income, Medicaid, and publicly insured patients. However, and PI-serving and NH- and PI-serving health centers demonstrated higher rates of childhood immunization, cervical cancer screening, and controlled hypertension than the national average.
Research Conclusions on Impact on Health Centers: Overall, AA-, NH-, and PI-serving and NH- and PI-serving health centers had a higher proportion of patients with social risk factors, but demonstrated higher quality of care in several areas. The higher quality of care may be attributable to the health centers’ higher rates of Enabling Services staff. These results inform how health centers serving AA, NH, and PI populations can prioritize their resources. Investing in more Enabling Services staff at AA-, and PI-serving and NH- and PI-serving health centers may decrease health disparities for AA, and PI patients.
Authors:
Sakura Miyazaki, Program Manager, Training and Technical Assistance, AAPCHO
Vivian Li, MS, Research Analyst, AAPCHO
Joe Lee, MSHA, Director of Strategic Initiatives and Partnerships, Association of Asian Pacific Community Health Organizations
Albert Ayson, Associate Director, Training and Technical Assistance, AAPCHO
Poster Type: Research
Track/Topic: Demonstrating Value; Expanding Access to Care and Other Services; Improving Care for Special Populations; Quality of Care and Quality Improvement; Social Determinants of Health; Workforce
Research Objectives: Asian American (AAs), Native Hawaiian (NHs), and Pacific Islanders (PIs) are the fastest-growing major racial or ethnic group in the United States and its territories. AAPCHO analyzed the UDS data of AA-, NH-, and PI-serving health centers to assess health disparities, workforce development trends, and recommendations to improve population health.
Research Study Design/Methods: AAPCHO analyzed health center and patient data using the Uniform Data System (UDS), an annual reporting system by the Health Resources and Services Administration (HRSA) for health centers. AAPCHO identified AA-, NH-, and PI-serving health centers as the top 10% of health centers in terms of the number of AA, NH, and PI patients served at the health center in 2019 and NH- and PI-serving health centers as health centers that served greater or equal to 1,000 NH and PI patients combined in 2019.
Research Principal Findings and Quantitative/Qualitative Results: On average, AA-, NH-, and PI-serving and NH- and PI-serving health centers had more full-time Enabling Services staff than health centers nationally. Compared to the national health center average, both AA-, and PI-serving and NH- and PI-serving health centers reported a higher proportion of limited English proficient, low-income, Medicaid, and publicly insured patients. However, and PI-serving and NH- and PI-serving health centers demonstrated higher rates of childhood immunization, cervical cancer screening, and controlled hypertension than the national average.
Research Conclusions on Impact on Health Centers: Overall, AA-, NH-, and PI-serving and NH- and PI-serving health centers had a higher proportion of patients with social risk factors, but demonstrated higher quality of care in several areas. The higher quality of care may be attributable to the health centers’ higher rates of Enabling Services staff. These results inform how health centers serving AA, NH, and PI populations can prioritize their resources. Investing in more Enabling Services staff at AA-, and PI-serving and NH- and PI-serving health centers may decrease health disparities for AA, and PI patients.
Authors:
Sakura Miyazaki, Program Manager, Training and Technical Assistance, AAPCHO
Vivian Li, MS, Research Analyst, AAPCHO
Joe Lee, MSHA, Director of Strategic Initiatives and Partnerships, Association of Asian Pacific Community Health Organizations
Albert Ayson, Associate Director, Training and Technical Assistance, AAPCHO
Speaker(s):
CP21 - New Immigrant Case Management: Responding to the Southwest Border Crisis in a New Jersey FQHC
CP21 - New Immigrant Case Management: Responding to the Southwest Border Crisis in a New Jersey FQHC
Poster Type: Innovation
Category: Expanding Access to Care and Other Services; Patient and Community Engagement; Public Health Crises; Social Determinants of Health; Workforce
Issue or Challenge: Zufall Health Center (ZHC) in New Jersey has seen hundreds of Central American child immigrants arrive over the past decade to our centers. These children are an extremely high-risk cohort, with particular need for assistance with school enrollment and linkage to legal services. While we have dedicated case management services for other high-risk populations (seniors, patients with mental illness or HIV), we have not had this available to new immigrant children and families. Using Americorps staff, Zufall has begun a program to identify new immigrant children within our practices and connect them with legal and social services.
Description of Innovation: In response to ongoing and increasing numbers of recently arrived migrant children, Zufall has begun a “New Patient Assistance” (NPA) program to provide case management to unaccompanied minors. Most significantly, the program has integrated a legal services linkage process where children are connected with pro bono or low-cost legal immigration services that can provide representation. There is no constitutional right to representation in immigration court, and it has been clearly shown that children who have representation are far more likely to have successful immigration cases. Many of these patients are not yet registered for public school, which is necessary for a successful asylum case, as well as for ongoing child development. NPA case managers assist with school registration, as well as with applications for Pandemic Rental Assistance; the Special Program for Women, Infants, and Children (WIC); and hospital charity care, by serving as translators and assisting with technology. Additionally, information is provided about local food pantries and other social services, and interested patients are referred to Zufall’s behavioral health services, as well as other medical and dental services as needed.
Impact or Result: Since the program was initiated in September 2020, NPA case managers have worked with 53 unaccompanied minors and 205 families. This has resulted in the connection of 59 of these patients with immigration attorneys and the registration of 8 children for public school. All patients have been provided information on local food pantries and social service programs. Legal services were reviewed with all families, and referral information was provided if a direct referral connection was not made. Given the current several-year wait time for resolution of typical immigration cases, it is difficult to assess the effect of this program on success within the court system. Regardless, the NPA referral process continues to wield considerable and measurable effect in breaking down barriers that our newly arrived immigrant children face. It is imperative that innovative and ground level programs continue to develop and evolve to meet the needs of this high-risk population.
Replicating this Innovation: This program is easily replicable and scalable within other health centers. FQHCs have a proven track record for case management, and understand the complex interplay of social factors that impact immigrant health. Furthermore, integrated and Trauma Informed Care that is offered at FQHCs make them an ideal location for this type of innovation. Medical-legal partnerships should be considered as standard enabling services offered at FQHCs. Americorps volunteers have been well placed to do this work in our organization.
Author(s):
Douglas Bishop, MD, Family Medicine Physician, Zufall Health Center
Poster Type: Innovation
Category: Expanding Access to Care and Other Services; Patient and Community Engagement; Public Health Crises; Social Determinants of Health; Workforce
Issue or Challenge: Zufall Health Center (ZHC) in New Jersey has seen hundreds of Central American child immigrants arrive over the past decade to our centers. These children are an extremely high-risk cohort, with particular need for assistance with school enrollment and linkage to legal services. While we have dedicated case management services for other high-risk populations (seniors, patients with mental illness or HIV), we have not had this available to new immigrant children and families. Using Americorps staff, Zufall has begun a program to identify new immigrant children within our practices and connect them with legal and social services.
Description of Innovation: In response to ongoing and increasing numbers of recently arrived migrant children, Zufall has begun a “New Patient Assistance” (NPA) program to provide case management to unaccompanied minors. Most significantly, the program has integrated a legal services linkage process where children are connected with pro bono or low-cost legal immigration services that can provide representation. There is no constitutional right to representation in immigration court, and it has been clearly shown that children who have representation are far more likely to have successful immigration cases. Many of these patients are not yet registered for public school, which is necessary for a successful asylum case, as well as for ongoing child development. NPA case managers assist with school registration, as well as with applications for Pandemic Rental Assistance; the Special Program for Women, Infants, and Children (WIC); and hospital charity care, by serving as translators and assisting with technology. Additionally, information is provided about local food pantries and other social services, and interested patients are referred to Zufall’s behavioral health services, as well as other medical and dental services as needed.
Impact or Result: Since the program was initiated in September 2020, NPA case managers have worked with 53 unaccompanied minors and 205 families. This has resulted in the connection of 59 of these patients with immigration attorneys and the registration of 8 children for public school. All patients have been provided information on local food pantries and social service programs. Legal services were reviewed with all families, and referral information was provided if a direct referral connection was not made. Given the current several-year wait time for resolution of typical immigration cases, it is difficult to assess the effect of this program on success within the court system. Regardless, the NPA referral process continues to wield considerable and measurable effect in breaking down barriers that our newly arrived immigrant children face. It is imperative that innovative and ground level programs continue to develop and evolve to meet the needs of this high-risk population.
Replicating this Innovation: This program is easily replicable and scalable within other health centers. FQHCs have a proven track record for case management, and understand the complex interplay of social factors that impact immigrant health. Furthermore, integrated and Trauma Informed Care that is offered at FQHCs make them an ideal location for this type of innovation. Medical-legal partnerships should be considered as standard enabling services offered at FQHCs. Americorps volunteers have been well placed to do this work in our organization.
Author(s):
Douglas Bishop, MD, Family Medicine Physician, Zufall Health Center
Speaker(s):