HEALTH SCIENCE INTERNSHIP

Joseph F. Sullivan Center

Emily Young

August-December 2016

Clemson, SC

Clemson University

Introduction: ■ A 180 hour internship is part of the curriculum for Health Sciences majors at

Clemson University.

■ Students complete a pre-internship class with Mrs. Kathleen Meyer, and then she helps to place students into an internship in a field that interests them for a future career.

■ Since I have a strong interest in working in a clinical setting as part of my future career, I was assigned the Joseph F. Sullivan Center in Clemson, SC.

■ The Sullivan Center is a clinic located on Clemson University’s campus and is run by nurse practitioners. The fact that the Sullivan Center is a run mostly by nurse practitioners sparked my interest, since I plan to attend nursing school, and eventually take part in an advanced practice nursing program.

■ My internship was a wonderful learning experience in which I learned a lot about how a healthcare facility runs.

■ This PowerPoint will provide an overview of my internship experience as a whole.

The Joseph F. Sullivan Center

■ The Joseph F. Sullivan Center is a nurse managed clinic located on Clemson University's campus in Edwards Hall.

■ The Sullivan Center uses a collaborative care model. Nurse practitioners are the primary providers, but they work with many different physicians in the area, various health educators, community outreach programs, and student interns to provide the best possible care for their patients.

■ The Sullivan Center provides healthcare for all Clemson employees, and for many underserved populations of upstate South Carolina.

Joseph F. Sullivan Center: ■ Services: – Acute care services

– Health management/disease management

– CU Well Program: A comprehensive wellness program at the Sullivan Center, comprised of the Cu4Hlth Risk Appraisal and a variety of other health resources.

– CU 4 Health Program: A workplace screening offered through Prevention Partners and the Sullivan Center.

– Special Physicals

– Medical Surveillance Program

– Immunization Clinic/Travel Clinic

– Dermatology/Aesthetician Services

– Health/Nutrition Counseling

– Acupuncture

– Recreational Therapy Fitness Assessments

Joseph F. Sullivan Center: The Sullivan Center is equipped with 3 patient rooms, a lab, a

procedure room, a health counseling suite, a room to perform Body Impedance Analysis, a conference room, and offices for staff.

Lab (below)

Exam Room (above)

Joseph F. Sullivan Center:

Vitals Station(below)

Stock Room (above)

Joseph F. Sullivan Center:

Procedure Room (below)

Sterilization Station (above)

Joseph F. Sullivan Center: Community Outreach:■ Walhalla Mobile Clinic: The purpose of this project is to provide health services

to medically underserved individuals in Oconee County.

■ Clemson Free Clinic: This clinic was established by concerned citizens and medical professionals to meet the needs of the medically underserved in Clemson, Central, Six Mile and Pendleton.

■ Migrant Health Program: This program was created to provide health services via the mobile health unit to seasonal and migrant farm workers in Pickens County. Ten weekly evening clinics are held each year during June and October.

■ Best Chance Network (BCN): The program offers eligible women the opportunity to be screened for breast and cervical cancer in Oconee, Pickens, Greenville, and Anderson counties.

Joseph Sullivan Center Mobile Unit: ■ The mobile unit is something very unique to the Sullivan Center. The mobile unit

is an RV that is equipped with two fully stocked patient rooms. It travels around different areas of the upstate providing off-site clinics for the underserved population.

Patient stations within mobile unit

Joseph F. Sullivan Center:

■ Mission: “The Joseph F. Sullivan Center will drive community health research initiatives providing innovative, real-life student learning”

Pictured: Another intern, Melissa, and I outside the Sullivan Center.

My responsibilities as an intern: ■ During my internship I will gain clinical skills in health education, wellness

activities, and management of certain projects.

■ Duties:

– Completing patient intake procedures.

– Recording vital signs, reason for visit, health history, and other charting needs.

– Working with the staff of the Sullivan Center to assess patients’ health via various tests and evaluations, such as hemoglobin, glucose, urinalysis, and pregnancy tests.

– Using online charting system: Allscripts Electronic Health Record.

– Organizing patient rooms and stock room

– Completing my assigned research project.

– Preparing materials for off-site clinics.

Duties: Gathering height and weight

Recording patient’s temperature

Recording patient’s blood pressure and pulse

Duties:

Performing urinalysis tests (see above)

Performing finger sticks to gather glucose or hemoglobin values

Spinning blood in the centrifuge

Duties

Faxing and copying medical records and other documents

Charting and performing other computer based tasks

Typical Day at the Sullivan Center:■ Usually arrived at my internship site early in the morning. Once I arrived, I

would make sure all patient rooms were stocked and look at the schedule for the day.

■ Once patients begin to arrive for appointments, I bring them back and complete all intake procedures. Some of these procedures include taking vital signs and gathering height and weight, and possibly waist circumference. Then I bring the patient to an available room and complete reason for visit and health history. Depending on the reason for visit, patients may need a hemoglobin, glucose, or pregnancy test. After receiving all information, I update whichever nurse practitioner the patient is seeing about why they are here.

■ I also look at the weeks off-site clinic schedules to see if I need to prepare any supplies. If there are off-site clinics scheduled, I prepare the bag and tray of supplies. I also prepare binders with various health information for Wise Woman clinics.

■ Most of my days are spent doing patient intake or off-site preparation, but I also have some opportunities to work on my assigned research project.

My Research Project:

My assigned research project will involve evaluation of lab management over a 3 month span (May-July 2016). During the completion of this project, I will track labs, abnormal results, follow up, and case management.

■ I completed this project by using the Allscripts charting system to track specific patients and how their case was managed.

■ Documents were created to exhibit whether or not cases were properly managed, and conclusions and suggestions were made.

■ During this project, I became familiar with how to read patients charts in depth and how to interpret lab results.

Project: ■ Methods: ■ Assignment: Evaluate lab management over the past 3 months (May-July 2016). During the

completion of this project, labs, abnormal results, follow up, and case management were tracked over a 3 month span.

■ EHR program, Allscripts, was used to view patients’ charts.

– Within patients’ charts, patient history, face-sheet (showing previous appointments and counseling attempts), results, and demographics sections were all utilized.

■ Patients lab results were reviewed based on Wise Woman follow up algorithm to determine whether or not they needed follow up.

– Health history was also taken into account.

■ Patients pap smear results were reviewed for abnormalities.

■ Used face-sheet section of chart to determine when patients came for follow up and whether or not they received any health counseling phone calls.

■ Used demographics section of chart to determine patients’ primary language spoken.

■ Compiled all information into Excel spreadsheet then created images to demonstrate results.

■ Created PowerPoint on research project that compiled all information and results.

Project■ Results:

■ Out of the 104 patients who received WW labs, there were 10 who had abnormal results and 6 of the 10 did not receive follow up.

– 2 of these were due to the fact that the client did not answer the phone and never called back. Both patients spoke English.

– 4 patients did not have specific reasons documented for their lack of follow up.

– Demographics:

■ 3 of these patients spoke English.

■ 2 spoke Spanish.

■ 1 patient’s language was undefined.

■ Out of the 58 women who received pap smears, all women with abnormal results received follow up.

■ Out of the 83 patients who should have received health counseling, 38 did not even get an attempt at health counseling.

– English speaking: 10

– Spanish speaking: 25

– Undefined: 3

Project■ Conclusions and Suggestions:– The study produced very valuable information about the Joseph F. Sullivan Center’s lab management

from May-July 2016. Results could aid the Sullivan Center in their continued strive for excellence. The results that were gathered did not show extreme discrepancies in follow up, but they did show that some patients did not receive proper follow up and case management. One issue that the data demonstrated was that on certain clinic days, patients’ language was not documented in demographics and therefore was later inputted as undefined. This could be fixed by making sure that patients put their preferred language in the paperwork, and double checking that it gets put into the chart. One thing brought to light by the results I gathered was that Spanish speaking patients rarely get health counseling compared to English speaking patients. Finally, something that creates an issue with both follow up and health counseling attempts is lack of patient response. The Sullivan Center may not have any control on whether a patients respond to their phones calls and/or letters, but the JFSC can always keep trying to get into contact with the patient. One thing that the JFSC may want to focus on is stressing the important of follow up when they leave patients messages. Many people struggle with health literacy, and they may not understand the severity of their condition and the importance of follow up. This study was very informative and can continue to be a great tool to evaluate case management. One thing I recommend to future students who may take part in a similar study is to make sure to document what value was abnormal within the labs (triglycerides, cholesterol, hemoglobin, etc.).

Project: Relation to objectives and goals:

■ My Intervention Evaluation goal was directly related to my research project. This goal was established because it pertained to my assigned research project that had to be completed by the end of the semester. I followed case management for the months of May-July 2016. I utilized the electronic health record system Allscripts and other materials Caitlin Moore provided me with. I created a presentation and presented to the staff of the Sullivan Center at their weekly staff meeting.

– Goal: By the end of my internship, I will be able to explain the effectiveness and diligence of the Sullivan Center’s various labs (over the last 3 months: May-July). This explanation will be done via a presentation for the Sullivan Center staff.

■ My Health planning goal was also related to my research project. This goal was reached by completing my project, because I learned how to track and evaluate case management of Wise Woman labs and pap smears at the Best Chance Network clinics from May-July 2016.

– Goal: By the end of my internship, I will be able to review/evaluate labs including how they are managed, tracking the labs, and reviewing abnormalities, follow up procedures, and how the case was managed.

Internship Outcomes:

■ Being able to complete my internship at the Sullivan Center has been such a great experience, and it helped to prepare me for my future as a healthcare provider. My internship reinforced my career goals and taught me many things about the healthcare field as a whole.

– I came to a better understanding about how a healthcare practice runs.

– I feel more prepared to start and complete nursing school.

– I came to a better understanding of myself professionally and personally

– I learned very useful communication skills that will help me to be a better healthcare provider in the future.

– I understand the importance of preventative care in the medical field.

Internship Outcomes:■ Completing my internship at the Sullivan Center helped me to gain a better

understanding of myself personally and professionally. It reinforced my future goals of being a healthcare provider. It provided me with a valuable experience that made me confident in my plans to attend nursing school and become a nurse anesthetist or possibly nurse practitioner.

Conclusion

■ My experience at the Sullivan Center has been amazing. I learned so much from everyone I worked with and wouldn’t trade the experience for anything. This internship has been invaluable to my future. I learned so much about how a clinic works and all the components that it takes to run a healthcare facility. Caitlin Moore, Elizabeth Garcia, and all the other staff of the Sullivan Center were so wonderful to work with. They were always helpful and demonstrated how to be great healthcare providers. Multiple members of the staff talked to me about my future and gave me great advice. I am so glad that I got to take part in this particular internship and work with the staff of the Sullivan Center. My internship has been such a good learning experience and I would suggest that all students take part in an internship in an area of career interest.