CHIUS Student Clinic Pilot Run Workflow and Student
Transcription
CHIUS Student Clinic Pilot Run Workflow and Student
CHIUS Student Clinic Pilot Run Workflow and Student Responsibilities CLINIC OBJECTIVES 1. Address the gaps in chronic disease management in Vancouver’s vulnerable population (Diabetes, Pain). 2. Foster a sense of civic and social accountability 3. Provide an interdisciplinary clinic experience for Health Sciences students at UBC and the opportunity to learn and develop clinical expertise alongside other health professional students. 4. Provide supervised professional skill practice without clinical productivity constraints 5. Broaden world views and expose students to impact of the social determinants on health 6. Promote awareness of different professional roles and how they interact as part of a team. 7. Promote development of communication and collaboration skills for interacting with other members of the interprofessional team. LEARNING OBJECTIVES Increased awareness of UBC HHS graduates to community needs Increased understanding of the expertise that each disciplines brings to the solution of health issues WORKFLOW ● There will be a maximum of 5 students, each from a different Health Sciences faculty, scheduled per clinic shift to work together as the I nterprofessional Team . ● One of the students (more senior/experienced) will be selected as the Shift Supervisor . Prior to Clinic Shift Step 1. Eligible clients will be referred to the CHIUS StudentRun Clinic (SRC) by his/her family physician at 3B. Student Responsibilities: ● None Step 2. Referral forms review Student Responsibilities: ● Shift supervisor will review referral forms for all new patients of the day and summarize main issues. Step 1. ● Shift supervisor will be responsible for presenting the summaries to the rest of the interprofessional team on the day of the clinic shift. . Day of Clinic Shift ● Interprofessional team will arrive at 9am, one hour before the start of clinic. A. Before the start of clinic Step 1. Client chart review (duration: 3045 minutes) Student Responsibilities: ● Interprofessional team will review charts of all clients scheduled for the day and obtain pertinent information. ● Interprofessional team will perform background reading/research around the cases prior to seeing client as necessary. Step 2. Role delegation (duration: 15 minutes) Student Responsibilities: ● The interprofessional team , together with preceptors, will identify which services might be most appropriate for each client (eg: medication review by pharmacy, vaccination by nursing, counselling by dietetics, etc.) ● The interprofessional team , with assistance from preceptors, will determine which two students will be most suitable to perform the initial assessment for each new client. ● Shift supervisor will finalize role delegations for the day. B. During clinic Workflow for new intakes Step 1. Initial assessment (30 minutes) Student Responsibilities: ● The two students previously selected will greet client in waiting room and invite client into examination room. ● The two students will take a complete history and document into EMR. Students not involved in the initial assessment can use this time to: ● Do additional background reading or research regarding the clients’ cases as necessary. ● Participate in group education sessions for other clients at the clinic if available. ● See clients who are in the clinic for followup appointments. ● Review referral forms for new patients for the next clinic Step 2. Case conference (1520 minutes) Student Responsibilities: ● The two students engaged in initial assessment will reconvene with rest of the interprofessional team as well as preceptors to present the client’s case in conference room. ● The interprofessional team , with input and assistance from preceptors, will identify missing information (if any) and/or examinations required. ● The interprofessional team , with input and assistance from preceptors, will also collectively come up with an appropriate diagnosis and/or care plan for the patient. ● Issues identified and interventions required will be categorized into acute or longterm. Step 3. Care Plan Communication (1015 minutes) Student Responsibilities: ● The two students involved in the initial assessment will return to the client with their preceptors and perform any additional history taking and/or examinations as necessary. ● The two students with their preceptors will also communicate the care plan that has been previously established by the interprofessional team . ● The patient can then choose to receive intervention during the current appointment or defer until next appointment. Step 4. ClientCentred Intervention (30 minutes maximum) Students Responsibilities: ● If client chooses to receive acute interventions at the current appointment, interventions can be delivered as: ○ individual consults by a particular student of an appropriate field with his/her preceptor ■ eg: pharmacy student performing a medication review with pharmacist preceptor OR ○ a multidisciplinary consult (ie: 2 or more students together with their preceptors) ■ eg: OT and PT students together with their preceptors NOTE: If a preceptor is not on site, he/she be consulted prior to the provision of any interventions (eg: by phone) ● Students will only perform/deliver interventions up to their comfort level under the guidance of their preceptor as appropriate. Step 5. Arrange FollowUp Appointment (5 minutes) Student Responsibilities: ● The student last to see the client will direct the patient to the office assistant to make a followup appointment. C. After clinic Step 1. Debrief (15 minutes) Students Responsibilities: ● The interprofessional team and all preceptors will meet in the conference room at the end of the day to: a. Summarize cases seen throughout the day and learning points b. Evaluate what went well and what required improvement c. Evaluate metrics Step 2. Review SOAP notes (15 minutes) Students Responsibilities: ● The shift supervisor will review all SOAP notes for the day.