Presentation Type
Poster
Discipline Track
Patient Care
Abstract Type
Research/Clinical
Abstract
Background: Founded in 2009, the CD Doyle Clinic is a student-run free clinic with a mission to provide high-quality equitable care to those in need, regardless of their background. Since 2020, our clinic has served residents at the Esperanza community, a state-sanctioned encampment for people experiencing homelessness in Southeast Austin. The majority of the patients that we serve navigate complex medical and psychosocial conditions. Our clinic operates as an ambulatory care center, primarily addressing acute care and psychiatric concerns. Recognizing our limits as a free clinic, we collaborate alongside community partners, such as Travis County’s CommUnityCare Mobile Health Team, to better serve our patients with ongoing chronic or preventative care needs. Coordination of these handoffs primarily takes place through email updates to patients’ on-site case managers and the Mobile Health Team, mid-week follow up calls to patients, and patient-centered “health passports" outlining pertinent information regarding follow-up care. However, insufficient standardized operational procedures and a lack of closed-loop communication about what happens after a patient concludes their CD Doyle Clinic visit have resulted in continuing care gaps, recommendations that do not consider patients’ ability to access care, and increased patient revisitation rates.
Methods:Our approach is rooted in a variety of human-centered design methodologies. We will design a stakeholder/systems journey map to illuminate the wide breadth of healthcare-related interactions our patients navigate starting from the conclusion of their CD Doyle clinic visit. Then, we will identify key stakeholders (patient’s case managers, on-site care professionals) as well as willing patients to interview regarding transitions of care from CD Doyle Clinic to longitudinal care avenues (including medication access, outpatient follow-up care, and preventative care). Moreover, we will accompany select patients on their journey accessing post-clinic care, such as leaving the community to access prescriptions. On-site tabling booths will be at the Esperanza community for residents to map out barriers to care as well as share overall perceptions of health. We will then conduct a qualitative content analysis.
Results: We have created a preliminary map to capture the diverse interactions among and flows of care among stakeholders along with relevant gaps that our patients may face (attached). We will complete interviews and observations in January to obtain further perspectives and better characterize patients’ experiences and barriers to accessing follow-up care.
Conclusions: Coordination with key community stakeholders is critical to fostering comprehensive care; therefore, it is important for CD Doyle to track and understand patients’ entire care journey beyond our clinic in order to foster trust and better health outcomes. Currently, our understanding of this process is nebulous, which has led to missed care opportunities and increased revistation rates at our clinic.
By mapping health-related interactions outside of our clinic and eliciting ongoing patient feedback, we hope to design interventions to improve follow-up care that are rooted in our patients’ stories and experiences.
Academic/Professional Position
Medical Student
Recommended Citation
Martinez, Rosa E.; de Montfort Shepherd, Alexis; Prabhu, Sahana; Se, Katie; Hariprasad, Krishna; and Mhatre, Sanika, "Leveraging a Human-Centered Design Framework to Improve Longitudinal Care at a Student Free Clinic : A Quality Improvement Initiative" (2024). Research Symposium. 44.
https://scholarworks.utrgv.edu/somrs/2024/posters/44
Included in
Leveraging a Human-Centered Design Framework to Improve Longitudinal Care at a Student Free Clinic : A Quality Improvement Initiative
Background: Founded in 2009, the CD Doyle Clinic is a student-run free clinic with a mission to provide high-quality equitable care to those in need, regardless of their background. Since 2020, our clinic has served residents at the Esperanza community, a state-sanctioned encampment for people experiencing homelessness in Southeast Austin. The majority of the patients that we serve navigate complex medical and psychosocial conditions. Our clinic operates as an ambulatory care center, primarily addressing acute care and psychiatric concerns. Recognizing our limits as a free clinic, we collaborate alongside community partners, such as Travis County’s CommUnityCare Mobile Health Team, to better serve our patients with ongoing chronic or preventative care needs. Coordination of these handoffs primarily takes place through email updates to patients’ on-site case managers and the Mobile Health Team, mid-week follow up calls to patients, and patient-centered “health passports" outlining pertinent information regarding follow-up care. However, insufficient standardized operational procedures and a lack of closed-loop communication about what happens after a patient concludes their CD Doyle Clinic visit have resulted in continuing care gaps, recommendations that do not consider patients’ ability to access care, and increased patient revisitation rates.
Methods:Our approach is rooted in a variety of human-centered design methodologies. We will design a stakeholder/systems journey map to illuminate the wide breadth of healthcare-related interactions our patients navigate starting from the conclusion of their CD Doyle clinic visit. Then, we will identify key stakeholders (patient’s case managers, on-site care professionals) as well as willing patients to interview regarding transitions of care from CD Doyle Clinic to longitudinal care avenues (including medication access, outpatient follow-up care, and preventative care). Moreover, we will accompany select patients on their journey accessing post-clinic care, such as leaving the community to access prescriptions. On-site tabling booths will be at the Esperanza community for residents to map out barriers to care as well as share overall perceptions of health. We will then conduct a qualitative content analysis.
Results: We have created a preliminary map to capture the diverse interactions among and flows of care among stakeholders along with relevant gaps that our patients may face (attached). We will complete interviews and observations in January to obtain further perspectives and better characterize patients’ experiences and barriers to accessing follow-up care.
Conclusions: Coordination with key community stakeholders is critical to fostering comprehensive care; therefore, it is important for CD Doyle to track and understand patients’ entire care journey beyond our clinic in order to foster trust and better health outcomes. Currently, our understanding of this process is nebulous, which has led to missed care opportunities and increased revistation rates at our clinic.
By mapping health-related interactions outside of our clinic and eliciting ongoing patient feedback, we hope to design interventions to improve follow-up care that are rooted in our patients’ stories and experiences.