1. The UCSF Double Helix Curriculum:
Facilitator Guide
Time: 15 minutes
Audience: First through third year residents
Objective(s): Understand ways in which we fail to provide comprehensive access for individuals that are non-English speaking, have limited literacy, or have diverse cultural backgrounds. Consider novel ways to optimize access for diverse populations.
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

2. Barriers to Comprehensive Access to Care
Adapted from the Center for Excellence in Primary Care

3. The UCSF Double Helix Curriculum:
Group Share
Describe a time in which a patient had trouble access healthcare.
Think of ways this may have been prevented.
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

4. The UCSF Double Helix Curriculum:
Access Denied
Barriers to Effective Access
Geography
Lack of language and interpretations services
Lack of proper accommodations for individuals with disabilities
Decreased health literacy
Hours of operation
Literacy requirements to accessing care
Lack of health coverage
Cultural misunderstanding
Different ethnic and/or racial groups, chronic medical conditions (i.e., mental health or substance use)
Others?
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

5. The UCSF Double Helix Curriculum:
Overcoming Barriers
Universal health coverage
Comprehensive language access
Robust cultural competency training
Improved telemedicine services
Access to phones, housing, computer/internet…
Community engagement
Engaging stakeholders
Phone visits; expanded hours
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

6. Examples of Overcoming Barriers
Telemedical cervical cancer screening program for rural women
18mos: 1812 visits serving 68/75 counties in Arkansas
Qualitative study of Spanish-speaking patients with behavioral health clinicians
Bilingual providers associated with greater privacy, trust, accurate communication
Fewer pediatricians using family members as interpreters between 2004 & 2010 (69%  57%) and more formal interpreter use (55 v. 49%)
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:
Hitt WC, et al. Telemed JE Health. 2013;19(5):403-8.
Villalobot BT et al. Psychol Serv. 2016;13(1): DeCamp LR et al. Pediatrics. 2013;132 (2).

7. The UCSF Double Helix Curriculum:
Reflection
How can access be optimized in your clinic?
Will any of your clinical practice change?
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

8. The UCSF Double Helix Curriculum:
Evaluation
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:
See evaluation sheet for thread objective