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Evaluating Structural Barriers to Quality Care in the SHOW Free Clinic

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Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.

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2017-05

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Comparative Analysis of Interprofessional Clinic Models: Recommendations for Best Practice Implementation

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As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional

As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.

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2017-05

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stillHUMAN: An Educational Empowerment Program

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The purpose of this creative project was to establish the foundation of an educational program that teaches financial literacy to the local homeless population. The name of this program is stillHUMAN. The project consisted of two parts, a needs analysis

The purpose of this creative project was to establish the foundation of an educational program that teaches financial literacy to the local homeless population. The name of this program is stillHUMAN. The project consisted of two parts, a needs analysis and a prototyping phase. The needs analysis was conducted at the Phoenix Rescue Mission Center, a faith-based homeless shelter that caters to male "clients", through written surveys and one-on-one interviews. Before interviewing the clients, the team acquired IRB approval as well as consent from the Center to carry out this study. These needs were then organized into a House of Quality. We concluded from Part 1 that we would need to create 3 - 7-minute-long video modules that would be available on an online platform and covered topics including professional development, budgeting, credit, and Internet literacy. In order to commence Part 2, each team member recorded a video module. These three videos collectively conveyed instruction regarding how to write a resume, use the Internet and fill out an application online, and how to budget money. These videos were uploaded to YouTube and shown to clients at Phoenix Rescue Mission, who were each asked to fill out a feedback survey afterwards. The team plans to use these responses to improve the quality of future video modules and ultimately create a holistic lesson plan that covers all financial literacy topics the clients desire. A website was also made to store future videos. The team plans to continue with this project post-graduation. Future tasks include creating and testing the a complete lesson plan, establishing a student organization at Arizona State University and recruiting volunteers from different disciplines, and creating an on-site tutoring program so clients may receive individualized attention. Once the lesson plan is demonstrated to be effective at Phoenix Rescue Mission, we plan to administer this lesson plan at other local homeless shelters and assess its efficacy in a non-faithbased and non-male environment. After a successful financial literacy program has been created, we aim to create lesson plans for other topics, including health literacy, human rights, and basic education. Ultimately stillHUMAN will become a sustainable program that unites the efforts of students and professionals to improve the quality of life of the homeless population.

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2016-05