Journal of student-run clinics最新文献

{"title":"Characteristics of Patients with Dermatologic Conditions in a Student-Run Free Clinic: A Retrospective Study","authors":"Alexander M Hammond, Kristin N. Smith, Macartney Welborn, Victoria Dukharan, Anshul Daga, Chloe Warpinski, Oliver T. Nguyen, K. Motwani, K. Motaparthi","doi":"10.59586/jsrc.v9i1.401","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.401","url":null,"abstract":"Background: The Equal Access Clinic is a free, student-run clinic affiliated with the University of Florida in Gainesville, Florida. Four days a week, a general clinic is held at various sites, providing free healthcare to patients in North Florida. Once a month, a specialty clinic for dermatology is held based on a referral system from general clinics. We aimed to characterize patients’ demographics and diagnoses who received dermatologic care at a free clinic in North Florida. \u0000Methods: A retrospective chart review was completed for patients seen at Equal Access Clinic for a dermatology diagnosis from 2013 to 2020 (n=864). \u0000Results: One third of patients were seen for a chronic dermatology condition. Patients who were white and higher earners were more likely to travel further distances for care. \u0000Conclusions: These findings highlight the importance of improving access of dermatology care to underserved areas and may be accomplished in part by increasing access to transportation to clinics. Limitations include the retrospective nature of our chart review and the reliance on zip code to estimate median household income. Additionally, the patients in this study were seen by primary care physicians, rather than dermatologists.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46553146","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}

{"title":"COVID-19 Testing and Resources for Underserved Communities in Rural Tijuana","authors":"J. Penn","doi":"10.59586/jsrc.v9i1.391","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.391","url":null,"abstract":"Flying Samaritans at the University of California, Los Angeles (UCLA) is a 501(c)(3) nonprofit, undergraduate student-led organization which provides medical and dental care, prescription medications, and health education resources free-of-cost to two underserved, rural communities in Tijuana, Mexico. Free Coronavirus Disease 2019 (COVID-19) testing is not widely accessible in Tijuana. Pandemic-related job loss and high rates of financial instability in the communities create financial barriers which limit COVID-19 test accessibility. The COVID-19 Resources Project was developed to provide free, on-site COVID-19 rapid tests to patients at Flying Samaritans at UCLA’s monthly clinics. This project also offers reimbursement for the roundtrip cost of transportation to vaccination sites for patients who lack access to their own method of transportation, in order to eliminate barriers to getting vaccinated. Lastly, partnerships created with non-profit organizations funded this project and allowed for the provision of additional resources to the patient population. Details regarding this program’s development are provided in order to assist student-run free clinics which may be looking to start their own rapid testing and/or grant-funded projects. Lastly, COVID-19 testing is planned to continue into the future.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48450078","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}

{"title":"Patient Satisfaction and Healthcare Seeking at Three Free Clinics","authors":"Brendan Wheeldon, John Petrilli","doi":"10.59586/jsrc.v9i1.362","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.362","url":null,"abstract":"Background: Patient satisfaction is an important metric that has been associated with social determinants of health and multiple health outcomes. However, limited studies have been conducted at free clinics, particularly comparing multiple clinics. \u0000Methods: This study surveyed patient satisfaction at three free clinics in Tampa, Florida. A written survey was distributed to patients at the clinics over 6 weeks. \u0000Results: Satisfaction was generally high among the clinics, with patients from the student-run free clinic reporting the highest satisfaction. There was no significant difference in satisfaction scores among the clinics after adjusting for socioeconomic variables. Despite high satisfaction scores, only 58.8% of patients reported coming to clinic for a general check-up, and only 20.1% reported coming for a cancer screening test. \u0000Conclusions: The differences between clinics were attributable to demographic factors, highlighting the importance of considering social determinants of health when discussing satisfaction. Patients at the free clinics in this sample reported high satisfaction with their care, but self-reported low receipt of preventative care. The results may indicate that patients at free clinics would benefit from education about free clinic services and what constitutes quality healthcare.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46809648","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}

{"title":"Assessing Medication Adherence at a Student-Run Free Clinic in the Midwest","authors":"Jess Grimmond, Alex Maben, Kalika Mahato, J. Geske, M. Menning","doi":"10.59586/jsrc.v9i1.271","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.271","url":null,"abstract":"Background: One of the primary barriers to medication adherence is traversing a physical distance to a pharmacy to pick-up medications. There are few studies that have examined how socioeconomic factors affect patient medication adherence in the context of student-run free clinics (SRFC).  Low medication adherence leads to poorer patient outcomes, especially in patients with chronic diseases. \u0000Methods: This retrospective chart review aims to quantify the rate of medication adherence at this student-run free clinic using prescription pick-up rate and medication possession ratio (MPR). This study involved review of medication documentation in the electronic medical record (EMR) and charge reports of dispensed medications from the clinic’s community partner, OneWorld pharmacy. Prescriptions written for and picked up by Student Health Alliance Reaching Indigent Needy Groups (SHARING) patients between January 1, 2018, and May 31, 2020, were included for analysis. Medication adherence was calculated using MPR. \u0000Results: 1,396 prescriptions were written for 37 patients over the study period and 177 prescriptions (12.7%) were dispensed. The MPR for the patient population is 0.1128 (Standard Deviation (SD) = 0.36159). It took patients an average of 29.4 days (SD = 44.3) to pick-up medications after the prescription was sent. \u0000Discussion: At an off-campus pharmacy, SRFC patients had a low prescription pick-up rate and low medication adherence, with delayed time to prescription pick-up. Further investigations are needed to identify barriers to prescription adherence and improve adherence rates.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43846679","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}

{"title":"Development of a User-Informed Social Resource Guide to Improve Identification and Management of Psychosocial Concerns: A Model for the Free Clinic Setting","authors":"Nicholas Peoples, Mary Fang, P. Kontoyiannis, Colton Andrews, Dana Clark","doi":"10.59586/jsrc.v9i1.371","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.371","url":null,"abstract":"Background: Resource guides, which consolidate information on community resources, are an important tool for linking vulnerable patients to social and health services. Many existing guides, however, are 1) out-of-date, 2) lack user-friendly design features, and 3) lack instructions for how to access services. We describe an effort to optimize a social resource guide for people experiencing homelessness, where the process may serve as a model for other free clinic settings. \u0000Methods: From April 2021 to April 2022, we launched a phased social liaison volunteer program at HOMES Clinic, driving the development of a unique community-informed social resource guide. Specifically, we 1) collected and verified word-of-mouth data from the userbase of various social services (i.e. “street smarts”), and 2) designed a user-friendly interface with easy-to-use deliverables for patients. \u0000Results: The HOMES Social Resource Guide facilitates care coordination in both the clinic and street settings. A key design feature is that information for each resource is condensed into a 3.5x2.0” card that fits easily into pockets or wallets. The front contains logistic information (e.g., hours, location, phone) and the back describes how to qualify for and access each service. Cards are organized into a binder and provided to patients by trained volunteers in a need-based manner. Since qualifying for many services is contingent upon first meeting other milestones, the guide includes algorithms to ensure we provide all necessary information to meet any identified need. Information is re-verified/updated every six months. The platform is cost-effective: the raw materials together cost $20. \u0000Discussion: While resource guides are not a new invention, we propose that our increased emphasis on simplicity, user-friendliness, community participation, and meeting end-user needs offer clear advantages over other common design paradigms. These principles may be relevant to other free clinics in meeting the diverse needs of underserved populations.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48553811","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}

{"title":"Understanding the Primary Care Experience in a Student-Run Free Clinic","authors":"Salmaan Kamal, April E. Hoge, Aerin Derussy, E. Austin, D. Pollio, A. Montgomery, S. Kertesz","doi":"10.59586/jsrc.v9i1.297","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.297","url":null,"abstract":"Background: Over 100 student-run free clinics (SRFCs) operate in the United States (US), typically serving uninsured populations. To date, there has been no effort to compare the patient-reported primary care experience in SRFCs to those of mainstream primary care (PC) clinics serving similar populations. In this study, we surveyed patients at Equal Access Birmingham (EAB), an SRFC, and compared our results to those from two PC clinics serving homeless-experienced clientele. \u0000Methods: We surveyed 60 EAB patients with the validated “Primary Care Quality-Homeless” survey. It generates an overall score and 4 subscale scores (clinician-patient Relationship, perceived inter-provider Cooperation, Accessibility/Coordination, Homeless-Specific Needs). We compared EAB’s ratings to those published for a Veterans Affairs (VA) mainstream PC (n=150) clinic and a homeless-tailored non-VA Health Care for the Homeless (HCH) program (n=195). \u0000Results: EAB’s ratings were similar to those of the mainstream VA clinic (p>0.4). EAB scored lower than the homeless-tailored non-VA HCH program in each subscale, though the difference did not achieve statistical significance. EAB patients most often praised the staff’s interpersonal skills. Items in which >25% of respondents gave a negative rating concerned wait times (29%), coordination of care (65%), and perceptions of provider skill (43%). \u0000Conclusions: Despite constrained resources, an SRFC scored comparably to a mainstream VA PC setting. SRFCs will play a continuing role in care of uninsured individuals, and while these data suggest SRFC patient experiences are mostly favorable, additional resources may be required to approximate the care experience achieved in clinics tailored for homeless persons.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42759597","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}

{"title":"Creating a Women’s Health Coalition at a Student Run Free Clinic: A Model for Increasing Access to and Quality of Care","authors":"Lucy Brown, Annie Gensel, E. Steele, Eric Aksu, Samantha McCarty, Kyle Baugh, Jourdan Owens, McKenzie Barber, Maryann Chimhanda","doi":"10.59586/jsrc.v9i1.366","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.366","url":null,"abstract":"Introduction: At the beginning of 2021, the Indiana University Student Outreach Clinic (IU SOC) conducted an internal audit of cervical cytology and sexually transmitted infection (STI) screening, which showed low rates of preventive screenings and inconsistent follow-up, thereby demonstrating a need to increase reproductive healthcare access to underserved women in Indianapolis.  \u0000Methods: To increase access, multiple teams were created within the Women’s Health Coalition (WHC), ensuring robust education, follow-up, and other necessary coordination for patient care. Additionally, the WHC expanded to host a twice-monthly referral-based women’s health clinic that provided care for patients with various chief concerns and preventive care needs. Protocols for wet-mount microscopy and sexual assault were created based on national guidelines, and annual training were provided to all members of the WHC. Community partnerships were formed to expand resources, including ultrasounds, mammograms, and contraception services. \u0000Results: The IU SOC increased the prenatal and gynecological services offered over nine months through this initiative. Notably, a higher number of services were offered to patients who qualified for screenings in 2021 than in the prior four years combined, including cervical cytology (24.1% [Confidence Interval (CI) 18.6%, 29.7% vs. 4.2%] [CI 2.9%, 5.5%]), mammogram referrals (23.1% [CI 15.8%, 30.3%] vs. 2.3% [CI 1.0%, 3.6%]), and STI/human immunodeficiency virus (HIV)/Hepatitis testing (54.6% [CI 50.2%, 59.0%] vs 8.1% [CI 6.8%, 9.3%]). \u0000Conclusion: Given the success of the WHC, our approach may serve as a student-run model for other patient populations.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42314765","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}

{"title":"The Intentional Interprofessional Education Model: A Conceptual Framework to Achieve an Interprofessional, Team-Based Approach in a Student Run Clinic","authors":"Jessica Nelson, Emma Hart, Eliana L Otero-Bell, H. Rogers, Lindsay Fox, Anthony Fleg","doi":"10.59586/jsrc.v9i1.350","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.350","url":null,"abstract":"We introduce the conceptual framework of the Intentional Interprofessional Education (Intentional IPE) Model based on the understanding that it takes mindfulness and intentionality for interprofessional teams to build relationships and work together effectively in a structured manner at a Student-Run Clinic (SRC). This Intentional IPE Model developed organically through experiences and conversations over several years among patients, students, and faculty at a SRC in Albuquerque, New Mexico, serving men experiencing homelessness. Teamwork is at the heart of the Intentional IPE Model, and it is also centered on the following values: curiosity, reflective listening, role exploration, vulnerability, respect, mentorship, and patient partnership. For students and faculty to engage in deep and productive interprofessional learning, professional health philosophies, priorities, and roles must be laid out, and curiosity should be encouraged. Our reflective paper emphasizes the ways the Intentional IPE Model can enhance student-faculty-patient experiences in SRC settings","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42645466","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}

{"title":"Evaluating the Prescribing Patterns of Antihypertensive Medications in a Student-Run Free Clinic","authors":"Sandra Cabezas, Kahkashan Grant, J. Clark","doi":"10.59586/jsrc.v9i1.364","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.364","url":null,"abstract":"Background: Hypertension is one of the most widespread disease states and a high-risk factor for developing other cardiovascular diseases such as stroke and coronary disease. In the uninsured population, uncontrolled blood pressure is primarily due to limited access to healthcare. While there has been a review to assess the quality of hypertension management provided at the Building Relationships and Initiatives Dedicated to Gaining Equality (BRIDGE) Clinic, this study will evaluate the prescribing patterns of antihypertensives at the clinic and assess whether the clinic is adhering to current treatment guidelines. \u0000Methods: A retrospective chart review was performed for BRIDGE patients 18 years and older that were diagnosed with hypertension between 2012 and 2021. The drug classes studied included thiazide diuretics, calcium channel blockers (CCBs), angiotensin-converting-enzyme inhibitors (ACEI), and angiotensin receptor blockers (ARBs). The initial and maintenance doses were compared to Food and Drug Administration (FDA)-recommended dosing to determine if the appropriate doses were prescribed. \u0000Results: A total of 123 patient charts were reviewed. 54.7% of patients with Stage 1 hypertension were initially started on only one medication. For Stage 1 maintenance, 47.3% of the patients were continued on only one medication. In patients with Stage 2, 45.8 % were initially started on a combination of 2 or more medications. For Stage 2 maintenance, 79.2% of the patients were continued on a combination of 2 or more medications. Patients with Stage 1 had prescribing patterns that did not adhere to guidelines while most Stage 2 patients adhered to guidelines. \u0000Conclusions: The results suggest that the BRIDGE Healthcare Clinic may be prescribing antihypertensive medications that do not entirely follow the prescribing patterns recommended by the Joint National Committee (JNC) 8 guidelines, which may impact effective treatment outcomes.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48555797","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}

{"title":"Implementation of Training Protocols Addressing Equitable Care in US Student-Run Clinics","authors":"Aashka Shah, Nathan Barger, Jessica Ding, Raissa Li, Kuhan A. Mahendraraj, Shrey Patel, Clinton Pong","doi":"10.59586/jsrc.v9i1.352","DOIUrl":"https://doi.org/10.59586/jsrc.v9i1.352","url":null,"abstract":"Background: Student-run clinics (SRCs) provide free healthcare to surrounding communities—oftentimes underserved communities. In these clinics, medical students see a wide array of patients under the supervision of physicians. SRCs have helped to fill a gap in primary care and provide an opportunity for students to refine their clinical skills. However, no uniform training program exists across all student-run clinics. This study aims to assess and analyze the quality and characterization of these training programs to inform future trainings and ultimately provide more equitable care to the communities being served by SRCs. Methods: A nine-question survey was sent out by email to 96 clinics across the United States. Upon obtaining data, the study team de-identified the results. Two independent raters coded the survey responses using an inductive approach. Themes were derived from responses and summarized into nominal codes. \u0000Results: The populations served by the clinics that responded in decreasing order of magnitude were underinsured/uninsured (83%); immigrant/non-English speaking populations (75%); black, indigenous, and people of color (67%); homeless (67%); low-income (67%); sex workers (17%); youth (8%); and injection drug users (8%). Nine (75%) clinics had some form of training for volunteers and 3 (25%) offered no formal trainings. 75% of all clinics surveyed offered both “cultural competency” and “general introduction to systems training.” The majority of clinics partnered with local hospitals/clinics (50%). Other community partners included mental health and homeless agencies, local pharmacies, and schools. Two (17%) of the clinics surveyed did not have any community partners. \u0000Conclusion: SRCs offer a unique solution towards bridging the gap in health inequity in America. The study shows possible gaps in training among schools in the US. Although some schools have adopted formal, standardized training programs, many do not encompass instruction on topics including cultural humility, trauma-informed care, de-escalation, and population-specific care.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46312879","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}