Mobile Healthcare Delivery System: A Model for Global Initiatives Gloria J. McNeal, PhD, MSN, ACNS-BC, FAAN1; Irina Campbell, PhD, MPH2; Ariel Almacen, PsyD, MSN2; Haana Hamdi, PhD(c)2 1 Charles Drew University of Medicine and Science, Los Angeles, California 2 University of Medicine and Dentistry of New Jersey, Newark New Jersey
statement of the problem Numerous research studies have attributed the underutilization of primary care services by urban atrisk, low-income groups to an array of barriers to healthcare access including: inconvenient clinic locations, the prohibitive cost of public transportation, cultural and linguistic insensitivity, and a lack of health insurance. The dependence on emergency departments for the delivery of primary care services by the underserved has fueled the escalation of healthcare costs, now spiraling out of control. Improving access to care for the under- and uninsured is an imperative, if a reversal in the current widening gap in healthcare disparities is to be realized. Faith-based organizations Pre-K & K-12 schools and academies
Social Service organizations
NJCHP Substance abuse Residential Programs
Low Income Housing Units Ex-Parolee Re-entry Programs
outcomes
lessons learned
outcome 1
Maintain a broad base of supporters, casting as wide a net as possible to promote the perception of inclusion at all levels
By the end of Year 3 the Project had: • logged over 3400 scheduled patient encounters • administered nearly 75 flu vaccines • referred one-third of the patients seen to specialty services
Engage community and political leaders in all aspects of project design, planning, implementation and program evaluation, to thwart efforts of sabotage by exercising external power and influence
outcome 2 By the end of Year 3, the Project had: • increased the number of community-based agency partnerships from 6 to 25 • established site locations in 4 New Jersey cities: Newark, Elizabeth, Irvington and New Brunswick • formalized the partnership with the Robert Wood Johnson Medical School Department of Pediatrics, to screen for children with asthma, developmental delay and obesity
Nurse practitioner student with patient
Work with the media and newspaper reporters to help tell the story and achieve wider exposure
Make every effort to ensure that the staff is well recognized in all aspects of the Project and widely showcase the work of each member of the team, to strengthen staff cohesiveness
Star Ledger coverage of Project activities
outcome 3
project description This grant-funded Project utilizes an interdisciplinary collaborative approach and outcomes oriented focus for a nurse-faculty managed, university-based mobile healthcare initiative, in collaboration with the Children’s Health Fund (CHF) and UMDNJ University Hospital. The NJCHP cost effectively utilizes faculty-supervised medical and nursing students and an interdisciplinary mobile health team, in association with the clinical affiliates of UMDNJ, community-based organizations (CBOs) and faith-based healthcare agencies, to deliver free primary care services directly onsite at designated community-based locations throughout 4 major cities in New Jersey. The NCJHP is part of CHF’s national network of 24 programs in 13 states.
goals 1. to screen, identify and provide health promotion/disease management services for at-risk populations 2. to foster community involvement in the health assessment and referral process 3. to provide culturally and linguistically sensitive health promotion and disease management health education.
By the end of Year 3, the Project demonstrated achievement of the following results: • 95% of patient charts audited documented the provision of health promotion and disease management instruction • 40% of the full-time health professional staff was bilingual • 5% of the student nurses assigned to the mobile unit were bi-lingual • 10% of the educational materials were available in the Spanish language
Acknowledgements Funding for this Project was provided by the following agencies: • The Robert Wood Johnson Foundation • The Healthcare Foundation of New Jersey • The Children’s Health Fund
P roject T im eline
• Schering-Plough
http://sn.um dnj.edu/njchp
• The Health Resources and Services Administration Phases of Project Development Year 01 - Planning
strategic objectives
Year 02 - Implementation Year 03 - Evaluation
1. To conduct 300 screenings/patient encounters per month 2. To engage community support in the prevention of the spread of communicable diseases, including vaccine-preventable illnesses, tuberculosis, sexually transmitted infections, and HIV/AIDS 3. To improve community awareness of public health issues by providing health education
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Project Outcome Measures: 1) decrease in mortality/morbidity rates associated with ambulatory care sensitive (ACS) conditions in clients served as measured by clinical data; 2) increase in referrals for follow up care as measured by percent of return visits; 3) increased community involvement as measured by number of MOUs executed; 4) increased patient satisfaction as measured by surveying instruments; and, 5) increased dissemination of health information as measured by number of health packets distributed
contact me For more information, contact me: Gloria J. McNeal, PhD, MSN, ACNS-BC,FAAN Founding Dean, Mervyn M. Dymally School of Nursing Charles Drew University of Medicine and Science 1748 East 118th Street Los Angeles, CA 90059 Ph:353-563-4829/Fax:353-563-4891
[email protected]
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