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  • The COVID-19 Pandemic as an Opportunity for Operational Innovation at 2 Student-Run Free Clinics. Journal of primary care & community health Ruiz Colón, G. D., Mulaney, B. n., Reed, R. E., Ha, S. K., Yuan, V. n., Liu, X. n., Cao, S. n., Ambati, V. S., Hernandez, B. n., Cáceres, W. n., Charon, M. n., Singh, B. n. ; 12: 2150132721993631

    Abstract

    The onset of the COVID-19 pandemic and subsequent county shelter-in-place order forced the Cardinal Free Clinics (CFCs), Stanford University's 2 student-run free clinics, to close in March 2020. As student-run free clinics adhering to university-guided COVID policies, we have not been able to see patients in person since March of 2020. However, the closure of our in-person operations provided our student management team with an opportunity to innovate. In consultation with Stanford's Telehealth team and educators, we rapidly developed a telehealth clinic model for our patients. We adapted available telehealth guidelines to meet our patient care needs and educational objectives, which manifested in 3 key innovations: reconfigured clinic operations, an evidence-based social needs screen to more effectively assess and address social needs alongside medical needs, and a new telehealth training module for student volunteers. After 6?months of piloting our telehealth services, we believe that these changes have made our services and operations more robust and provided benefit to both our patients and volunteers. Despite an uncertain and evolving public health landscape, we are confident that these developments will strengthen the future operations of the CFCs.

    View details for DOI 10.1177/2150132721993631

    View details for PubMedID 33615883

  • Physicians Leading Physicians: A Physician Engagement Intervention Decreases Inappropriate Use of IICU Level of Care Accommodations. American journal of medical quality : the official journal of the American College of Medical Quality Ruiz Colón, G. n., Yang, J. n., Svec, D. n., Heidenreich, P. n., Britt, P. n., Smith, M. n., Sharp, C. n., Shieh, L. n. 2021

    Abstract

    Following the adoption of an acuity-adaptable unit model in an academic medical center, a $13M increase in cost of intermediate intensive care unit (IICU) accommodations was observed. The authors followed A3 methodology to determine the root cause of this increase and developed a 3-prong intervention centered on physician engagement, given that physicians have the ability to order a patient's level of care. This intervention consisted of: (1) identifying physician champions to promote appropriate IICU use, (2) visual changes to essential electronic medical record tools, and (3) data-driven feedback to physician champions. In the year following intervention deployment, average IICU length of stay decreased from 1.08 to 0.62 days and average IICU use decreased from 21.4% to 12.3%, corresponding to ~$5.7M cost savings with no significant change in balancing measures observed. Together, these results demonstrate that a multicomponent intervention aimed at engaging physicians reduced inappropriate IICU use with no increase in adverse events.

    View details for DOI 10.1097/01.JMQ.0000735480.43566.f9

    View details for PubMedID 33883423

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