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Capturing and presenting high-quality data can be challenging for free clinics due to lack of resources and technology avoidance. If free clinics are unable to present impactful data to current and potential donors, this may limit funding and restrict care provided to underserved and vulnerable populations. The following is a

Capturing and presenting high-quality data can be challenging for free clinics due to lack of resources and technology avoidance. If free clinics are unable to present impactful data to current and potential donors, this may limit funding and restrict care provided to underserved and vulnerable populations. The following is a quality improvement project which addresses utilization of information systems within a free clinic. For one month, volunteer providers completed appointment summary forms for each patient seen in the clinic. Electronic form submissions (E=110) were compared to paper form submissions (P=196), with quality of data determined by form completeness scores. Welch’s t-test was used to determine statistical significance between electronic and paper form completeness scores (E=9.7, P=8.5) (p < .001). Findings suggest that utilization of electronic data collection tools within a free clinic produce more complete and accurate data. Barriers associated with technology utilization in this under-resourced environment were substantial. Findings related to overcoming some of these barriers may be useful for future exploration of health information technology utilization in under-resourced and technology avoidant settings. Results warrant future investigation of the relationship between quality of free clinic data, information management systems, provider willingness to utilize technology and funding opportunities in free clinics.
Created2021-04-24
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Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost, yet screening rates remain suboptimal.

This project evaluated an evidence-based intervention

Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost, yet screening rates remain suboptimal.

This project evaluated an evidence-based intervention to increase cervical cancer screening among underserved women in a federally qualified health center (FQHC). Female patients ages 21 to 65 years without history of hysterectomy (n=1,710) were sent reminders to their phones through the electronic health record (EHR). The message included educational material about the screening process and an announcement regarding government aid for free or reduced cost screening.

The number of patients who made an appointment after receiving the message was assessed two months later. In total, 156 responses were collected, and 28 patients made an appointment for screening. The most frequently observed category of Ethnicity was Hispanic/Latina (n = 24, 86%). The most frequently observed category of Insurance was Title X (n = 13, 46%). The observations for Age had an average of 41.04 (SD = 9.93). Using an EHR communication function to send motivational reminders has shown some promise for increasing cervical cancer screening, thereby reducing cervical cancer mortality among the underserved.

ContributorsBabb, Maria (Author) / Link, Denise (Thesis advisor)
Created2020-04-18
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Description

Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening

Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening can identify high-risk individuals with using the patient health questionnaire (PHQ-9).

The objective of this project is to determine if screening identifies depression in the homeless and how it impacts healthcare access. Setting is a local organization in Phoenix offering shelter to homeless individuals. An evidence-based project was implemented over two months in 2019 using convenience sampling. Intervention included depression screening using the PHQ-9, referring to primary care and tracking appointment times. IRB approval obtained from Arizona State University, privacy discussed, and consent obtained prior to data collection. Participants were assigned a random number to protect privacy.

A chart audit tool was used to obtain sociodemographics and insurance status. Descriptive statistics used and analyzed using Intellectus. Sample size was (n = 18), age (M = 35) most were White-non-Hispanic, 44% had a high school diploma and 78% were insured. Mean score was 7.72, three were previously diagnosed and not referred. Three were referred with a turnaround appointment time of one, two and seven days respectively. No significant correlation found between age and depression severity. A significant correlation found between previous diagnosis and depression severity. Attention to PHQ-9 varied among providers and not always addressed. Future projects should focus on improving collaboration between this facility and providers, increasing screening and ensuring adequate follow up and treatment.

ContributorsParamo, Cinthia Arredondo (Author) / Thrall, Charlotte (Thesis advisor)
Created2020-05-04
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Description

The utilization of suicide risk assessment tools is a critical component of a comprehensive approach to suicide risk assessment. However, some professionals hesitate to utilize screening tools routinely in practice. A project was undertaken to determine if the utilization of the Columbia-Suicide Severity Scale (C-SSRS) improved staff confidence in assessing

The utilization of suicide risk assessment tools is a critical component of a comprehensive approach to suicide risk assessment. However, some professionals hesitate to utilize screening tools routinely in practice. A project was undertaken to determine if the utilization of the Columbia-Suicide Severity Scale (C-SSRS) improved staff confidence in assessing suicide risk. Professionals within a psychiatric urgent care in Scottsdale, Arizona were provided with
training on the C-SSRS. Participants then utilized the C-SSRS at triage with patients presenting with depression and/or suicidality over a two-month period.

Self confidence in assessing suicide risk was evaluated utilizing The Efficacy in Assessing and Managing Suicide Risk Scale (SETSP-S). The acceptability and usability of the C-SSRS was evaluated utilizing The System Usability Scale (SUS). Findings of the Wilcoxon Signed Ranks test indicated changes in pre and posttest assessment scores as significant in seven of the eight assessment parameters. In addition, Cohen's effect size value suggested medium or large clinical significance in these same assessment parameters.

Evidence suggests that efficient and effective assessment can improve staff confidence in assessing for suicidality and may improve morbidity and mortality rates for patients. The utilization of tools such as the C*SSRS could reduce health care costs associated with unnecessary hospital admissions as well as rehospitalizations. The routine utilization of assessment tools such as the C-SSRS many also be beneficial to healthcare specialties outside of behavioral health such as emergency departments and urgent care settings.

ContributorsBerry, Robin (Author) / Chen, Angela Chia-Chen (Thesis advisor)
Created2018-04-28