在学生开办的免费诊所中建立妇女健康联盟:提高护理机会和质量的一种模式

Lucy Brown, Annie Gensel, E. Steele, Eric Aksu, Samantha McCarty, Kyle Baugh, Jourdan Owens, McKenzie Barber, Maryann Chimhanda
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摘要

前言:2021年初,印第安纳大学学生外展诊所(IU SOC)对宫颈细胞学和性传播感染(STI)筛查进行了内部审计,结果显示预防性筛查率低,随访不一致,从而表明有必要为印第安纳波利斯服务不足的妇女增加生殖保健服务。方法:为了增加获得机会,在妇女健康联盟(WHC)内建立了多个小组,确保对患者护理进行强有力的教育、随访和其他必要的协调。此外,卫生保健中心扩大到每月举办两次以转诊为基础的妇女保健诊所,为有各种主要问题和预防保健需要的病人提供护理。根据国家指导方针制定了湿法显微镜和性侵犯的规程,并向世界卫生大会的所有成员提供了年度培训。建立了社区伙伴关系,以扩大资源,包括超声波检查、乳房x光检查和避孕服务。结果:通过这一举措,IU SOC增加了9个月以上提供的产前和妇科服务。值得注意的是,2021年为符合筛查条件的患者提供的服务数量高于前四年的总和,包括宫颈细胞学检查(24.1%[置信区间(CI) 18.6%, 29.7%对4.2%][CI 2.9%, 5.5%]),乳房x光检查(23.1% [CI 15.8%, 30.3%]对2.3% [CI 1.0%, 3.6%]),性传播感染/人类免疫缺陷病毒(HIV)/肝炎检测(54.6% [CI 50.2%, 59.0%]对8.1% [CI 6.8%, 9.3%])。结论:鉴于WHC的成功,我们的方法可以作为其他患者群体的学生运行模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Creating a Women’s Health Coalition at a Student Run Free Clinic: A Model for Increasing Access to and Quality of Care
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.  Methods: 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. Results: 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%]). Conclusion: Given the success of the WHC, our approach may serve as a student-run model for other patient populations.
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