Pulaski Clinic IPE Evaluation

Patient scheduling:
Patient scheduling is a difficult task. We tried to complete the
schedule so that OT and counseling would alternate but it was hard
due to many factors. One factor was the patients. They could only
come in at certain times, or there would only be one spot left. So, it
would work out that we would have three OT patients in a row or two
counseling patients in a row. It seemed hard for Dr. Bierman and Sheila
to accommodate for waiting times when patients were scheduled back
to back. Another factor was the workers of the clinic. Some of the
understandings of time necessary per patient were not clear between
all members who participated in scheduling. Again, making the time
patients waited longer due to the provider not having enough time
booked for each patient.
Lastly, a lot of the times, when a patient is signed up just for OT or
just for counseling the opposite field would go in and see the patients
Again this sometimes would cause a backup. Although assessments
are necessary it sometimes lead to longer wait times and in some
cases patients being in the office for hours at a time.

Patient wait times:

Being able to see how the clinic operates on all days of the week,
Mondays are the slowest. On Thursdays, Hanks is able to bee three

patients in 1 hour by himself; that is just not possible with the IPE team
due to the nature of the visits that we have. We took into account of
the different fields being addressed as well as Monday being a
teaching day. Sheila and Dr. Bierman have to stop and teach us how to
do a lot of different tasks. This requires more time.
Suggestions:
Maybe if the patients could already have a sheet of questions Sheila
and Dr. Bierman ask every session answered already it could speed up
the process. Or if we created a time limit that each patient received.
Because sometimes patients are waiting for up to 90 to 120 minutes;
we believe this might cause them to lose interest in our program.
Another idea is to have handouts that answer questions with common
health concerns that come into the clinic.

Appointment Cancelations:
Patients are normally scheduled follow-ups upon exiting their
current appointments. They are given appointment cards as reminders.
Additionally, patients are called on the Thursday or Friday before the
scheduled Monday appointment. Sometimes patients will seem aware
of the appointment and agree to coming in- and not show on Monday.
It is hard to stay on top of clients to remind them due to instances
when phones are not working or if they are scheduled early in the
morning and simply do not answer the week before. Canceling or

rescheduling appointments is not held against clients however no

shows are recorded as a negative encounter in a chart. When patients
continuously do not show up for appointments it negatively impacts
other patients as well as the students because we miss out on
opportunities to learn or practice. It is understandable that reliance or
compliance may be the reasons that people are seen in the clinic,
however a better procedure about attendance may help the situation.
Suggestions:
Since the Free Clinic has a policy about 2 no call no show
appointments- maybe the RU clinic should adopt/follow this rule as
well. Perhaps if patients were aware that the Monday appointments
carried the same rules and policies, attendance would be better. Or at
least we may be able to know ahead of time when patients can not
come, instead of them just not showing up.

Patient satisfaction:
Overlooking the two surveys sent and watching the patient
interaction within the clinic, the overall impression is that the patients
are satisfied and thankful. On the two surveys both patients marked
down for waiting time, and I think that is because of the long times
spent with patients. When clients are in the waiting room due to
providers still being in with other patients for long periods of time it
can negatively impact their sense of our time management. Many

times clients rely on public transportation and it can be a difficult task

just to get to the clinic- but to have to wait over 45 minutes past their
scheduled time to see a doctor would be frustrating for anyone. Other
items on the list marked down were the facility. That is a difficult topic
to fix due to the lack of money. We dont know if the patients
understand the work Linda and Debbie have put in to make the clinic
to what it is now. From what Debbie told volunteers during orientation
the looks of the Clinic as well as work ethic has transformed
completely.

Patient outcome study:

Initially the idea of the study made sense to see how the patients were
improving. While administering the HIPPA form and consent forms, it
sometimes seemed to intimidate the clients or even that they didnt
fully understand the purpose of the study. It was a concern that if we
were making education materials for clients at low reading levels- was
it realistic for them to understand the consent form in its entirety.
Another concern with this is that if clients did not understand the
purpose of the study, it might cause them to become more anxious
and guarded.

Suggestions:

For the study, it could be helpful to have a fact sheet that lays out the
purpose and goals in more understandable terms. Additionally, it could
be helpful to use clients whom are more comfortable with the providers
already. For example, maybe there should be a 1 month or 2 visit
requirement before we start advertising the study to clients so that
they are not feeling bombarded on their first several visits.

Education groups on Monday:

The Monday educational groups were planned for clinic clients as
well as people from Daily Bread. As of now- none of the clinic patients
have come to the groups that were set up. The groups are not really
groups, but more of a hand out for the daily bread recipients. Although
we are still able to help those individuals, the overall goal was not
achieved. Initially this was supposed to be a set time frame for
individuals to learn about the topics as well as the students being able
to lead and help educate the group members. The OT students are not
able to come in time to interact with the daily bread group, and the
daily bread individuals are not as intrigued by our presence each week.
It seems as if they may feel targeted as already low-income or
needy- making their involvement in our education something that is
less appreciated. Some of the staff has related it to feeling like we are
one of the kiosks in the mall that you purposely turn your head away
at.

Suggestions:
Possibly getting together with outside agencies to have a better space
for the groups would be best. For example, the YMCA would allow us to
reach a larger audience and make community connections to our
healthcare goals. Overall, the idea of group education was just not
met due to attendance rates and availability of the audience we were
aiming for. The goals of the groups may need to be evaluated as we
see the outcomes of the annex activities from this semester come to
an end.