Abstract
This report arises from the intersection of service learning and population health at an academic medical center. At the University of California, San Francisco (UCSF), the Office of Population Health and Accountable Care (OPHAC) employs health care navigators to help patients access and benefit from high-value care. In early 2020, facing COVID-19, UCSF leaders asked OPHAC to help patients and employees navigate testing, treatment, tracing, and returning to work protocols. OPHAC established a COVID hotline to route callers to the appropriate resources, but needed to increase the capacity of the navigator workforce. To address this need, OPHAC turned to UCSF's service learning program for undergraduates, the Patient Support Corps (PSC). In this program, UC Berkeley undergraduates earn academic credit in exchange for serving as unpaid patient navigators. In July 2020, OPHAC provided administrative funding for the PSC to recruit and deploy students as COVID hotline navigators. In September 2020, the PSC deployed 20 students collectively representing 2.0 full-time equivalent navigators. After training and observation, and with supervision and escalation pathways, students were able to fill half-day shifts and perform near the level of staff navigators. Key facilitators relevant to success reflected both PSC and OPHAC strengths. The PSC onboards student interns as institutional affiliates, giving them access to key information technology systems, and trains them in privacy and other regulatory requirements so they can work directly with patients. OPHAC strengths included a learning health systems culture that fosters peer mentoring and collaboration. A key challenge was that, even after training, students required around 10 h of supervised practice before being able to take calls independently. As a result, students rolled on to the hotline in waves rather than all at once. Post-COVID, OPHAC is planning to use student navigators for outreach. Meanwhile, the PSC is collaborating with pipeline programs in hopes of offering this internship experience to more students from backgrounds that are under-represented in healthcare. Other campuses in the University of California system are interested in replicating this program. Adopters see the opportunity to increase capacity and diversity while developing the next generation of health and allied health professionals.
Highlights
DESCRIPTION OF THE NATURE OF THE PROBLEM BEING ADDRESSED AND RATIONALE FOR THE PROPOSED INNOVATIONThis case study reports on a collaboration that represents the intersection of two major trends: service learning in education [1,2,3,4] and population health in health care [5, 6]
In early 2020, population health programs faced an influx of demand from patients who were potentially exposed to coronavirus infection and who needed help with testing, treatment, and tracing services related to COVID-19 [7]
Undergraduate institutions have launched service learning programs to ensure that students are exposed to high impact practices such as internships [8,9,10,11]
Summary
This case study reports on a collaboration that represents the intersection of two major trends: service learning in education [1,2,3,4] and population health in health care [5, 6]. Within UCSF, key parties to this case study included UCSF’s Patient Support Corps (PSC) and the Office of Population Health and Accountable Care (OPHAC); and UCSF patients and employees concerned about obtaining testing, treatment, tracing, and return-to-work services relevant to COVID-19. Population Health Outreach In late 2020, the OPHAC shifted some navigator capacity from the COVID hotline back to regular care management activities, including outreach to patients with chronic conditions. Between January 27 and March 3, 2021, the students worked on outreach tasks relevant to patients with hypertension They learn how to case-find and contact patients for hypertension follow up, documenting their outreach encounter in the medical record, and scheduling patients for appointment in the 2 weeks with their primary care physician. A key lesson here was that we attempted competency checking too early for some students who needed more time observing navigators, and practicing under supervision
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