1. The Weill Cornell Community Clinic Student Advisory Committee:
A Model for Maintenance and Growth
Megan Riddle and Josh Salvi
Executive Directors, The Weill Cornell Community Clinic, Weill Cornell Medical College, New York, NY 10021
A goal of the Weill Cornell Community Clinic is to provide comprehensive health care to our patients that extends beyond primary care to include such services as mental health, women’s health, pharmacy, and referrals. Key to the successful maintenance and expansion of our service offerings is the organizational structure of the Clinic, led by the Student Advisory Committee. As part of the Committee, medical students learn firsthand the challenges of managing a clinic and running a non-profit organization, along with the difficulties that underserved patients face in attaining high quality health care. Thus the Student Advisory Committee provides a unique addition to medical school education while also improving the services the Weill Cornell Community Clinic can offer our patients.
Abstract
Expanded Patient Services
Clinic Leadership Structure
Organizational Flexibility
The Committee is divided into two teams, each led by two directors, Executive and Clinical, to manage administrative and patient-focused operations. One to three medical students, most of whom are first year students, hold each of seventeen positions on the Committee, ranging from patient scheduling to community outreach to data management.
Board members are encouraged to take initiative and have been key to recent expansion of the services offered by the Clinic.
Mental Health Nights – On a weekly basis, students, partnered with a Licensed Clinical Social Worker, screen all patients to assess their mental status and social welfare. This is further coupled with a screen for insurance status. Based upon the results of this interview, the patient may then be directed to take part in the monthly Mental Health Clinic. Guided by a student chair and an attending psychiatrist, we have been running this program successfully for over two years, partially funded by a grant written by the student chair. C. MIRANDA (Poster #14)
Women’s Clinic – Every three weeks, a volunteer gynecologist partnered with student clinicians provide screening, treatment, and education during the Women’s Clinic. The Women’s Clinic chair has successfully expanded this program, increasing the number of patients seen and securing sustaining physician support.
By re-assessing the composition of board positions annually before new board members are appointed, roles can be created or adjust to better meet the needs of the Clinic.
Quality Assurance: Reflecting the need to measure the success and safety of the clinic while also increasing efficiency, the directors created a new position to assess the quality of care and use of resources at the clinic.
Insurance Screening/Social Work: The chair of this position coordinates with licensed clinical social workers to screen patients and enroll eligible patients in free and low cost plans. While initially created as separate roles, the joint position better reflects the cooperative roles of themedical students and social workers and encourages collaboration. A. KUTSENKO (Poster #30) and A. CHINITZ (Poster #12)
Increased Student Involvement
Problem Solving
Board members lead programs that increase opportunities for students to become involved in the Clinic.
Continuity of care – The student chair of the continuity of care program oversees a group of medical students who, starting in their first year, are each matched with one of our more medically fragile patients. The student is then present at all patient visits and helps guide the patient through the healthcare system. Such consistent interactions enable student and patient to develop a rapport and strengthen feelings of empathy and understanding.
Patient education – Given the prevalence of cardiovascular disease, obesity, and smoking, and the lack of knowledge regarding diet and healthy living, the WCCC has launched a patient education initiative to address these needs. Currently, the patient education coordinators are developing nutrition counseling and smoking cessation programs. Both will utilize students to provide counseling and support to patients, both over the phone and in person, thus increasing opportunities for patient-student interactions. S. UMARJEE (Poster #20)
By specializing in a particular aspect of clinical operations, committee members become experts in their area, able to identify problems and develop creative solutions to ensure the Clinic runs smoothly.
Pharmacy – A particular concern with our clinic’s model is the delivery of high quality medications at the lowest cost possible to each patient (if possible, free). This requires unique approaches, including a partnership with Dispensary of Hope, Prescription Assistance Program enrollment, and improved tracking systems.
Research and Data Management – These students become particularly adept at noticing trends in the clinic and working with other chairs, such as Quality Assurance and Pharmacy to improve tracking.
Fundraising and Grants – Funding a student-run clinic is difficult, and these students have been integral in determining sources of funding and pursuing unique routes to obtain the necessary funds to provide high quality care to our patients.
Community Building
By specializing in their different roles, members of the board establish strong relationships with their collaborators within the medical college, the hospital, and the community. They act as ambassadors for the clinic, creating ties and garnering support for our work.
Community outreach : The “Heart to Heart Program” was created by WCMC students and, in collaboration with the WCMC Physician Assistant Program, Hunter College Nursing School, and WCMC’s Clinical and Translational Science Center, provides screening for cardiovascular disease risk factors in low-income communities. The program increases awareness of WCCC both within the institution and in the larger community. K CHRISTIANER (Melbourne, 2/5, 10:00-10:50am)
Referrals: The clinic has negotiated low-cost referral agreements with a number of departments in the hospital and the physician’s organization; the referrals chairs strengthen the relationships with these departments and work to establish new ones.