1. Student Run Clinics Operations and Management Rani Nandiwada nandi8@gmail.com

2. Agenda Student Leadership Business Plan –Area Assessment –Needs Assessment –SWOT analysis –Resource Analysis/Community Collaborations –Operations Flow Chart –Tracking and Evaluation Student Leadership Business Plan –Area Assessment –Needs Assessment –SWOT analysis –Resource Analysis/Community Collaborations –Operations Flow Chart –Tracking and Evaluation

3. Steering Committee Make sure you have student leaders for all aspects of the clinics development Write out goals and responsibilities for each position. Let each student leader figure out for themselves how the want to reach these goals and to add new goals to their role. Make sure you have student leaders for all aspects of the clinics development Write out goals and responsibilities for each position. Let each student leader figure out for themselves how the want to reach these goals and to add new goals to their role.

4. Possible Roles Directors Operations Finance Lab/Referrals Attending Liaisons Student Liaisons Directors Operations Finance Lab/Referrals Attending Liaisons Student Liaisons

5. Business Plan

6. Area Assessment Map out other free clinics in your area Analyze services that are offered by nearby clinics Map out possible locations for your clinic Familiarize yourself with local legislations that affect you Map out other free clinics in your area Analyze services that are offered by nearby clinics Map out possible locations for your clinic Familiarize yourself with local legislations that affect you

7. Needs Assessment A set of questions to: –Identify your target population –Ensure that you are fulfilling and unmet need –Continually assess to find gaps in the care you provide –Use simple questions with categorical answers A set of questions to: –Identify your target population –Ensure that you are fulfilling and unmet need –Continually assess to find gaps in the care you provide –Use simple questions with categorical answers

8. Needs Assessment Example: 1.How often do you go to the Emergency room for urgent healthcare? Neverrarely sometimes frequently If frequently why?__________________ 2.Do you have a primary care doctor? Yes No 3. Are you able to get an appt with your doctor when you need it? YesNo 4.What are the best hours for you to see the doctor? 9 - 12 12 - 5 5 - 8 5. Are the hours your need available at your doctor’s office? Yes No Example: 1.How often do you go to the Emergency room for urgent healthcare? Neverrarely sometimes frequently If frequently why?__________________ 2.Do you have a primary care doctor? Yes No 3. Are you able to get an appt with your doctor when you need it? YesNo 4.What are the best hours for you to see the doctor? 9 - 12 12 - 5 5 - 8 5. Are the hours your need available at your doctor’s office? Yes No

9. SWOT Analysis Strengths - Lots of student interest - Support of admin Weakness -No support from administration - Starting from scratch Opportunities - ER overloaded Threats - malpractice coverage Strengths and Weakness are internal while Opportunities and Threats are external Threats in our case are more of challenges

10. Resource/Community Analysis Community Advocate or Liaison? Free Clinics that are willing to support you Attendings who are interested in volunteering Possible location sites for your clinic Community Advocate or Liaison? Free Clinics that are willing to support you Attendings who are interested in volunteering Possible location sites for your clinic

11. Business Models

12. What kind of care will you provide? –Urgent Care –Primary Care –Diabetes Care –STD Care –Mental Health –Dental Care –Alternative Medicine –Physical Therapy –Urgent Care –Primary Care –Diabetes Care –STD Care –Mental Health –Dental Care –Alternative Medicine –Physical Therapy Extra Services? Legal Clinic Social Work

13. Expansion Patient Education Programs –Cooking classes –Walking clubs –Youth Sex Education Collaborations with other student run clinics Build a referral network Patient Education Programs –Cooking classes –Walking clubs –Youth Sex Education Collaborations with other student run clinics Build a referral network

14. Skills Development Expand resources for the students Training workshops for clinical skills –CPR –Phlebotomy –Would care –First Aid Workshops on Policy Issues –Medicare, Medicaid, SCHIP Student Vigils, Lobby Days, etc Grand Rounds Training workshops for clinical skills –CPR –Phlebotomy –Would care –First Aid Workshops on Policy Issues –Medicare, Medicaid, SCHIP Student Vigils, Lobby Days, etc Grand Rounds

15. Types of Models Extending hours/day of an existing free clinic Finding your own space and creating a clinic space –Schools –Churches –Salvation army Extending hours/day of an existing free clinic Finding your own space and creating a clinic space –Schools –Churches –Salvation army

16. Resources What do you need to get your clinic off the ground? Exam Beds? Medical Equipment? Lab Equipment? Relationships with Pharmacies? Have a detailed itemized list of needs, expenses or places that you might get the item donated from What do you need to get your clinic off the ground? Exam Beds? Medical Equipment? Lab Equipment? Relationships with Pharmacies? Have a detailed itemized list of needs, expenses or places that you might get the item donated from

17. Patient Population Only uninsured? If its an existing clinic - see more of their patients? Serve as hub for other free clinics to refer patients they can’t see to you? Have people referred from the ER? What forms of advertisement reaches your target group of patients Only uninsured? If its an existing clinic - see more of their patients? Serve as hub for other free clinics to refer patients they can’t see to you? Have people referred from the ER? What forms of advertisement reaches your target group of patients

18. Attending Commitment/Referral Network Attending Contract for commitment How many times/procedures a year? Reminder e-mails/calls? Back up/On call Attending if the assigned Attending can not come? Is there a demand for a certain specialty? Attending Contract for commitment How many times/procedures a year? Reminder e-mails/calls? Back up/On call Attending if the assigned Attending can not come? Is there a demand for a certain specialty?

19. Student Commitment Student Contract for: attendance/absentee requirements? Mandatory Training Sessions? Additional clinic related trainings? –CPR? –Phlebotomy? –Grand Rounds –Teaching sessions Student Contract for: attendance/absentee requirements? Mandatory Training Sessions? Additional clinic related trainings? –CPR? –Phlebotomy? –Grand Rounds –Teaching sessions

20. How will students rotate through? In teams that rotate every x # of weeks? In teams that go for a block of time? How many students on a team? How many students do you want to accommodate? How much can students handle? What positions will students cover? How many students in an exam room? In teams that rotate every x # of weeks? In teams that go for a block of time? How many students on a team? How many students do you want to accommodate? How much can students handle? What positions will students cover? How many students in an exam room?

21. PositionNumber of studentsResponsibility Exam Room1 4th year 1 1st/2nd year 4th year - teaches and guides 1st/2nd year - does as much of history/exam as comfortable Lab1 Lab mentor 1 Lab assistant Mentor - is experienced Assistant - learning Reception2Front Desk - registers pts Back Room - assigns pts to teams and monitorsexam room times Clinic Manager 1Oversees flow and is go to person for issues

22. Operations flow Map out your floor plan and diagram out how both patients and students will flow through the clinic. By analyzing each step you can figure out where potential problems may occur Map out your floor plan and diagram out how both patients and students will flow through the clinic. By analyzing each step you can figure out where potential problems may occur

23. Evaluation Assess your quality of patient care Survey patients on strengths and weaknesses of their encounter Are your appointment wait times reasonable? How long does one patient encounter take? Assess your quality of patient care Survey patients on strengths and weaknesses of their encounter Are your appointment wait times reasonable? How long does one patient encounter take?

24. Way to Assess Time out clinic flow to see where bottlenecks are. Ie: Are students waiting 30 minutes to talk to the Attending? What can be changed in the flow to alleviate this? Patient Surveys on quality of care Student Surveys on their experience Time out clinic flow to see where bottlenecks are. Ie: Are students waiting 30 minutes to talk to the Attending? What can be changed in the flow to alleviate this? Patient Surveys on quality of care Student Surveys on their experience

25. Always remember…. Things do not always happen as planned. Be prepared to change your plans to adapt to whatever situation is thrown at you. The business plan is to help identify possible problems so you can prepare alternatives and solutions!!! TO BE FLEXIBLE!!!