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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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Evaluation of an Interprofessional Model of Healthcare Delivery in the SHOW Community Initiative

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Over the past seven years, the Student Health Outreach for Wellness (SHOW) Community Initiative has served vulnerable populations in Maricopa County through a volunteer workforce of providers, graduate health professional students, and undergraduates from all three of Arizona’s public universities.

Over the past seven years, the Student Health Outreach for Wellness (SHOW) Community Initiative has served vulnerable populations in Maricopa County through a volunteer workforce of providers, graduate health professional students, and undergraduates from all three of Arizona’s public universities. With an interprofessional volunteer base, SHOW has managed to transition its health education and screenings from a clinic-based setting to community-based settings. These new clinical outreach programs within SHOW present unique challenges to maintaining the integrity of interprofessional, team-based care, and new evaluative tools are needed to provide feedback for improvement. Now, as a pioneer site for the National Center for Interprofessional Practice and Education, SHOW must continue to conduct internal research to evaluate their innovative model of care. For this project, the four core competency domains for interprofessional collaborative practice were used to outline proposals for the implementation of several new evaluative measures: the Assessment for Collaborative Environments (ACE-15), the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), patient satisfaction surveys, and critical incident reporting. These tools and protocols are necessary to solidify SHOW as a national model for interprofessional education and practice.

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2020-05