RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Educating the Future Project Date: 2/9/2009 From a health care perspective, one of the most difficult tasks in a rural setting is recruiting new physicians to the area. Grants Pass has a population around 30,000 with a wide variety of specialists to serve the population. The problem: physicians are aging and there isn't anyone willing to replace them. It has gotten so bad that the general surgeons are threatening to cut weekend call all together. The greatest hope lies in the community's youth who are likely to return to their hometown upon completion of their training. I was invited to Grants Pass High School to teach the students in the advanced medical skills class how I became interested in medicine, what I did to get into medical school and what life in school is like. It was my goal to demonstrate how much fun medicine is, and how they can go about getting into medical school. To show how much fun it is, I used hypothetical trauma scenarios and asked them what to do. The next day, I brought in 12 pigs feet along with suture material and taught them how to suture using sterile techniques. Through this process, I learned how a physician is not solely a healer, but an educator as well. It is a physician's duty to educate the community. I used the classroom to educate students about medicine, and it was clear that more than a couple of interests were sparked. Leadership Interviews Regarding Balanced Scorecards at Lower Umpqua Hospital Project Date: 9/10/2007 Quality improvement is very important in any setting, but especially in a small rural hospital where the surpluses are few, and any lapse in quality may affect community usage & therefore financial viability. The Balanced Scorecard has been proposed as an ideal way for small rural hospitals to strive for quality improvement through the idea that an organization’s mission/strategies and the execution of these are important factors in performance improvement. When Lower Umpqua Hospital joined 19 other rural Oregon hospitals it made the commitment to implement a Balanced Scorecard as way to measure performance against other such hospitals & strive for quality improvement. The purpose of this project is to assess the attitudes, perceptions & beliefs about implementation of a balanced scorecard amongst the leadership at Lower Umpqua Hospital, through key informant interviews. The 5 board members & 6 key administrative staff were interviewed; results were then summarized in an informant report to be used in future strategic planning & board meetings. Increasing Childhood Literacy Through Reach Out and Read, At The West Salem Clinic. Project Date: 7/2/2007 Reading aloud to children is an important tool to increase childhood literacy. Exposure to books at a young age helps build literacy in children. Sixteen percent of parents of young children do not read to their children at all and almost a quarter only read to them once or twice a week (1). Reach Out and Read (ROR) is a national program that seeks to increase childhood literacy rates by providing a new book to a child at each well-child check health care appointment between the ages of 6 months to 5 years. The goal of this community project was to establish an ROR program at the West Salem clinic. There were three parts to the project. The first was to contact the national ROR program to request application materials, and then compile the information needed to complete the application. The second part of the project was contacting other ROR sites around the state for information about the logistics and funding for their ROR programs. The third part of the project was to establish funding sources for both the start-up costs and the continuing costs of running the program. Grants/solicitations were submitted to various businesses and funding sources. A database of possible funding sources was created for future years to help sustain the program. Rural Healthcare Dialogue Project Project Date: 1/1/2007 Many private and public groups are currently involved in health care reform initiatives. The primary goal of this project is to decentralize and enrich the discussion of health care reform by engaging rural Oregonians in a conversation regarding their perceptions and expectations about healthcare, and to ensure that their opinions are relayed to the leaders of health care reform initiatives. Additionally, this project aims to foster leadership and activism among medical students and community members. Third year medical students will hold town-hall-style meetings in rural Oregon cities while on their required rural clerkships. These meetings will be open to the public, and provide education regarding the current state of health care in Oregon and the US, and discourse of several standardized discussion questions that focus on improved coverage and the finances of health care reform. Medical students serve as facilitators and document the general thoughts and sentiments for the group. Their results are communicated via a one-page summary document and one-page personal reflection document. At its conclusion, the findings will be shared with the Medicaid Advisory Committee, the Office of Private Health Partnerships, and the Oregon Health Policy Commission. So far, ten medical students have participated in the project, hosting meetings in eight cities. The findings to date are quite varied; however, several themes and lessons have emerged. First, many people lack understanding of the structure of our healthcare system, which creates a barrier to informed discussion. Second, the immigrant population is in favor of universal basic healthcare coverage while non-immigrants are generally opposed to coverage of non-citizens, and oppose tax increases to improve coverage. Third, students have responded positively to the experience, stating it has inspired them to continue participating in health care reform efforts. And last, rural health care providers believe that medical schools can influence future providers to practice in rural areas by recruiting students from rural cities, and by creating a rural medicine “fast track,” that specializes in training rural physicians. Rural Healthcare Dialogue Project Project Date: 1/1/2007 Many private and public groups are currently involved in health care reform initiatives. The primary goal of this project is to decentralize and enrich the discussion of health care reform by engaging rural Oregonians in a conversation regarding their perceptions and expectations about healthcare, and to ensure that their opinions are relayed to the leaders of health care reform initiatives. Additionally, this project aims to foster leadership and activism among medical students and community members. Third year medical students will hold town-hall-style meetings in rural Oregon cities while on their required rural clerkships. These meetings will be open to the public, and provide education regarding the current state of health care in Oregon and the US, and discourse of several standardized discussion questions that focus on improved coverage and the finances of health care reform. Medical students serve as facilitators and document the general thoughts and sentiments for the group. Their results are communicated via a one-page summary document and one-page personal reflection document. At its conclusion, the findings will be shared with the Medicaid Advisory Committee, the Office of Private Health Partnerships, and the Oregon Health Policy Commission. So far, ten medical students have participated in the project, hosting meetings in eight cities. The findings to date are quite varied; however, several themes and lessons have emerged. First, many people lack understanding of the structure of our healthcare system, which creates a barrier to informed discussion. Second, the immigrant population is in favor of universal basic healthcare coverage while non-immigrants are generally opposed to coverage of non-citizens, and oppose tax increases to improve coverage. Third, students have responded positively to the experience, stating it has inspired them to continue participating in health care reform efforts. And last, rural health care providers believe that medical schools can influence future providers to practice in rural areas by recruiting students from rural cities, and by creating a rural medicine “fast track,” that specializes in training rural physicians. Promoting Women Physicians in Tillamook County Project Date: 2/13/2006 Tillamook County not only has a shortage of primary care physicians, but it also has a shortage of women primary care physicians. There are a disproportional number of female physicians in Tillamook County compared to urban areas. 83% of primary care physicians are male in Tillamook county despite a strong demand for female primary care physicians. Dr. Parsons has repeatedly tried to recruit a female internist with no success. There are many barriers to recruiting female primary care physicians to rural areas, specifically partner job unavailability, role of primary caregiver in the family, overfeminization/overloading of their practice, and gender stereotypes/community receptivity. This paper examines these problems in depth and offers some further solutions to these barriers. It also summarizes how a program was set up to encourage young women in Tillamook to pursue scientific professions, such as physicians, in hopes that they would someday return to practice in their own community. Emergency Medical Services in Malheur County Project Date: 1/3/2005 During my rural health rotation in Ontario, Oregon, I completed a community project about the local EMS system. I gathered information by speaking with members of the EMS service including the Fire Chief of the Ontario Fire Dept., Paramedics working for Treasure Valley Paramedics, and the Medical Director of the EMS service. I also observed first hand how the system operates while riding along with the Treasure Valley Paramedics. I focused my study on how the EMS service is structured and what challenges it faces providing for the medical needs of citizens in a rural area. The main challenges that I identified are the need to cover a large, sparsely populated area, scarce resources including money, equipment, and trained personnel, and the fact that the system has a low capacity that can easily become overwhelmed. Practice Management of Tillamook’s Bay Ocean Medical Office: An Overview Project Date: 1/3/2005 The majority of medical practices are owned and managed by the physicians. Yet in medical school and residency, no course covers the skills and steps necessary to set up one’s own practice. The goal of this project was to provide an overview of the business of a medical practice based on internet resources and interviews with office personnel. In a small, rural medical practice, each staff member performs a number of duties in order for the office to run efficiently and provide quality care for the patients. Managing a medical practice requires not only seeing patients, but also understanding many other details that are never taught in medical school. Patient Participation in the Legislative Process in Klamath Falls, OR: Identifying Patterns and Perceived Obstacles Project Date: 7/5/2004 Patient initiated discussions concerning dissatisfaction with various health and health care policies are common in the rural primary care setting. Anecdotally, however, patients report not sharing these opinions with their legislators, while lawmakers describe a situation in which they feel uninformed about the ideas of the citizens in the communities they represent. A disconnect exists, whereby opportunities for constructive sharing of opinions and factual knowledge are missed. In order to describe the patterns of participation in the legislative process amongst the patients of a primarily adult Family Practice clinic, a patient survey was administered that inquired about both past experience if contacting legislators, perceived barriers to making such contact, and interest in obtaining information designed to facilitate this contact in the future. 33% of survey respondents had contacted their legislators in the past, an average of 2.6 times. 30% of those contacts were in regards to a health or health care issue. For those respondents who wanted to contact legislators but did not do so, common reasons cited included “I don’t know how to contact them”, “I’m not confident about how to present my ideas”, and “I don’t think it will make a difference”. 57% of all respondents said it would be helpful to have information about legislators and how to contact them, while 63% said having this information would make it more likely that they would contact their legislators in the future. In response to the survey answers, a patient information guide was designed in order to provide both accurate contact information for the appropriate Representatives and Senators, as well as suggestions for effective ways to communicate with legislators, and additional resources for more information. Lessons Learned from Initial Clerkship- Experience in a New Community Project Date: 7/5/2004 As the first 3rd year clerk in Grants Pass, OR, I set out to assess the expectations of the medical community regarding the rural training of OHSU medical students as well as to inform the preceptors, the hospital administration and additional medical staff regarding the goals and objectives of the rural clerkship. To achieve these goals, I conducted a focus group study that had the following specific objectives: To determine the relevance of the OHSU Rural Community Health Clerkship goals and objectives in relation to the expectations of the rural clerkship preceptors. To assess the opportunities available for clerks throughout the medical community. To assess the level of interest in increasing OHSU's footprint in Grants Pass. Transportation for Veterans to Portland VA Medical Center Project Date: 3/29/2004 Tillamook County is home of more than four thousand US Veterans. However, this is the only county in the state that does not have a van to provide transportation for its veterans to the Portland VA Medical Center. In order to have a van, the county must raise $25,000. Although the county does not have the funds to appropriate to the purchase of a van, the money can be obtatined through private sources. Proposal for a Clinical MultiTool Project Date: 7/1/2002 Deep tendon reflexes are routinely tested using suboptimal methods due to the lack of readily available reflex hammers in a Lebanon family practice clinic. Physical exam findings are therefore highly variable and lack credibility. A novel tool is suggested and described which combines a folding reflex hammer with other essential tools of the neurologic exam in an easy to carry package. Physician feedback is positive and suggests that the tool would be embraced and used by a group of physicians who would otherwise neglect an important aspect of the neurologic examination. Direction for future development is discussed. Back to subject search page or search by preceptor site