ANNUAL REPORT 2016-2017 - University Health Center Report UHC 2016-17 2.pdfof Pharmacy. o Two...
Transcript of ANNUAL REPORT 2016-2017 - University Health Center Report UHC 2016-17 2.pdfof Pharmacy. o Two...
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UNIVERSITY HEALTH CENTER
ANNUAL REPORT
2017
Mission Statement
The University Health Center provides high quality, cost-effective health care and wellness programs topromote health and support academic success.
Vision Statement
Our vision is to be the provider of choice for health care and health information for UMD community, to berecognized as a leader in collegiate health care, to be an important source of information services for faculty
and staff, and to be an integral part of the University’s educational mission.
Values
Excellent customer service and non-judgmental patient care
Respect for all cultures and ethnicities
Open communication between providers and patients and among staff
Education and training for students and staff
Collaboration with and support of campus academic/service units
Positive relationships with state and local medical organizations
Fiscal responsibility and equitable use of resources
Continuous quality improvement throughout the organization
Integrative team approach to care
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2016-17 Goals and Accomplishments
The section below outlines progress on goals set in 2016.
Sustainability ACHIEVED-Silver Green Office status.
Assessment and Learning Outcomes ACHIEVED-Establish the Peer Education program as its own course through the Office of
Undergraduate Studies.o Our four previous year-long peer education courses (HLTH38X) in SPH have
transitioned to eight semester-long courses in UGST (PEER31X and PEER32X) andsuccessfully passed pilot and formal approval processes.
o 210 and 80 hours of academic credit were earned by Health Promotion and WellnessServices Peers/Interns and CARE Peers respectively.
ACHIEVED-Re-establish the Experiential Learning Program with University of Maryland Schoolof Pharmacy.
o Two pharmacy students completed their Introduction to Pharmacy Practice at the UHCpharmacy. In addition, one of our contract Pharmacy Technicians was accepted to thePharmacy Program at UMM!
Organizational Financial Health and Entrepreneurship ACHIEVED- Increase overall collections by 20% by allowing patients to pay at the time of
service as opposed to using Bursar billing.o Increased collection of copays and self-pay services (Behavioral Health and Physical
Therapy fees) at Registration by 191%. The amount billed to Bursar accountsdecreased by 28% during this time as well.
o The Business Units launched an effort to collect unpaid patients’ responsibilities.Billing staff sends secure email message, informs patients about their accountbalances, and accepts payment over the phone or at the Health Center (UHC) beforesending balance to the bursar account. Billing department has collected total of$19,124 over the phone since February 2017 alone and write-offs have decreased by12%.
IN PROGRESS-Implement a “cash only” billing model for the pre-travel services provided atthe UHC.
o Beginning August 1, 2017, the correct billing codes have been applied to pre-travelvisits and we hope that this will move us toward less complicated reimbursement forthese services.
Public Health ACHIEVED-Establish the framework for a Collegiate Recovery Community at the University of
Maryland.o Terps For Recovery is now a recognized student organization with 25 active members.o A recovery drop-in space was effectively piloted at the UHC with sign-ins to the space
doubling from Fall to Spring semester with at least 271 visits.o The AA meeting on campus at the Chapel has grown in student participation.
I love this course!
It's everything I
thought it would be
and more!
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o Significant progress has been made toward a supported-living option in College Park incollaboration with The Haven.
o A contract “Recovery Liaison” was hired during the 16-7 academic year to coordinatewith TFR, we hope to continue this in the Fall.
o The University has joined the Association for Recovery in Higher Education.
ACHIEVED-Undertake an antibiotic stewardship campaign that will lead to a 20% decrease inthe number of antibiotic prescriptions written from 15-16 to 16-17.
o Antibiotic prescribing for bronchitis decreased by 25% between January 1, 2016-June30, 2016 and July 1, 2016-December 31, 2016.
Space Utilization IN PROGRESS-Evaluate the functionality of the current UHC space and identify a plan for
potentially modifying the space to maximize efficiency.o An initial floorplan to build out unused space on the UHC ground floor as a new
location for The Campus Pantry has been created by Facilities Management. We arepreparing to begin fundraising for this project.
o A UHC committee is gathering, assessing and prioritizing space needs. Several minorprojects and relocations within the building have allowed more efficient use of space.
Occupational Health IN PROGRESS-In the next 1-3 years, an improved system for pre-employment screening and
immunization and better monitoring of lab activity and exposures is needed in order toadequately protect employees.
o A risk assessment was presented by the Director to the Research Council and aproposed budget has been submitted to the Vice President for Administration andFinance to create appropriate Occupational Medicine infrastructure. (Attachment 2)
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o Increased communication and collaboration with units on campus whose employeesare at risk for occupationally-acquired infections and other health affects has beenimplemented (Residential Facilities, Resident Life, Facilities Management, Research).The UHC is taking on additional responsibility in the process of insuring thatemployees at risk have access to indicated vaccines and risk-related surveillance.
o The UHC has improved identification of and communication about lab associatedinjuries and exposures by adding required not elements within our electronic medicalrecord.
This section outlines progress on goals that were set in previous years and that had not yet been achievedand additional accomplishments for 2016-17.
Work-Life Initiatives
A UHC Telework and Flex-time Policy was created for UHC Exempt employees.
Thriving Workplace Initiative
A variety of recommendations from staff to improve the workplace have been implementedand include, but are not limited to…
o The UHC Business Units (Billing, Registration, Business Office, Administration andFinance) have achieved 90% of their established goals related to cross training andmutual backup. This has allowed employees to feel comfortable that work will becompleted when they are out of the office.
o The Billing Staff have started a lunch-time indoor walking group in the Health Center.o Decision-making related to certain purchases has been streamlined and delegated
away from the Executive Committee and to employees.o We have provided a higher level of transparency about the finances of the UHC to
avoid the appearance that financial decisions appear arbitrary.
Many of our Supervisors attended Thriving Workplace overview sessions and the ExecutiveCommittee will collectively attend two TWI topical workshops.
Departmental Diversity Accomplishments
The UHC conducted the Mid-Atlantic Transgender Health Conference providing ContinuingEducation to over 150 participants from more than 30 institutions and organizations in theregion.
A Diversity Orientation has been added to the standard onboarding procedure for all UHCemployees, delivered by two UHC staff members. We evaluated the effectiveness of thissession via a participant questionnaire and have determined to continue.
I learned a lot more about the University and
Health Center's policies about diversity and
inclusion and the efforts being made to ensure
that it's a priority. I learned more about internal
Health Center efforts that I didn't know about
before. I also learned about different
offices/resources on campus that deal with
diversity & inclusion and some of the services
they offer.
I liked that it was more of a discussion than a
formal presentation & both Tom and Jenna are
great at having these kinds of conversations.
I would recommend this
Diversity Orientation to a
fellow employee.
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The CARE Lead Educator delivered two bystander intervention sessions focused on biasincidents at the request of the Office of Diversity and Inclusion (ODI).
Two International Student Coffee Hours were conducted by the Student Health AdvisoryCommittee and an initial tool was created to assist this student cohort with health insuranceliteracy from feedback from the sessions.
Assessment and Learning Outcomes
PARTIALLY ACHIEVED: Benchmarking patient satisfaction ratings with health center ofsimilar size and services and improvement of patient satisfaction scores (goal set in 2014).
o With the assistance of the Student Health Advisory Committee, a new patientsatisfaction tool was adopted (the ACHA Patient Satisfaction Survey). Using a series oftrials of survey invitation format, sender, email subject line and incentives, we wereable to achieve a peak response rate of 12% to the survey.
o The Faculty and Staff Assistance Program have excellent patient satisfaction scoreswith 92% of clients reporting that they would recommend the program to others.
The UHC Continuing Medical Education program was awarded Accreditation withCommendation for a 6 year period from the Maryland State Medical Society.
To increase supervisor and employee understanding of substance abuse, the Faculty and StaffAssistance Program has presented to all Facilities Management managers on this topic.
Instructional Technology/Technology
ACHIEVED: Full implementation of an immunization compliance database (goal set in2015).
o The Immunization Data Base has been fully implemented and is being utilized forrecording immunization records for incoming students.
PARTIALLY ACHIEVED: Install smart room technology in remaining meeting rooms (goal setprior to 2014).
o The Smart Cart that was purchased with a generous parent financial gift was used toprovide 57 Step Up! trainings at the UHC. The Smart Cart was also used to deliver highquality Continuing Medical Education to our staff.
o A technology donation request for equipment for the other meeting rooms at the UHChas been submitted.
IN PROGRESS: Website Upgrade (goal set prior to 2014).o The UHC Web Site redesign process is underway with anticipated completion of
January 2018.
Mental Health
A Laboratory position was re-allocated to Mental Health/CARE to provide counseling servicesto sexual misconduct survivors and other mental health clients.
In an effort to focus counseling services provided at the MHS to those students concurrentlyreceiving medication management and to focus on the purpose and strengths of the , callersnot perceived to need medication were immediately referred to the Counseling Center.
In an attempt to decrease the likelihood of employee turnover in our Mental Health Service,over $120,000 was reallocated to increase salaries that were below regional benchmarks.
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Grants and Fundraising
The UHC cooperated on a project with the Food and Drug Administration to evaluate theeffectiveness of several temperature measuring devices (non-contact thermometers). Theproject total budget is $134,998 covering around $20,000 in UHC expenses.
Two grants were awarded to CARE from the Governor’s Office of Crime Control andPrevention…$287,027 over 2 years for Outreach, Therapy and Advocacy.
Health Promotion and Wellness Services successfully used a $10,000 Moving MarylandForward grant to develop services to transgender students and improve provider proficiencyin providing Trans care.
Parent and Family Affairs and Pepsi gave over $6,000 to support efforts benefiting students inrecovery and Step Up! implementation.
An individual donor gave over $6,000 to support students in recovery.
Congratulations to you and your colleagues in the University Health
Center for the success of “Transforming Maryland: Training for
Excellence in Transgender Healthcare.” I am thrilled the alterations to
your grant that we discussed at the mid-cycle review proved to be
exceptionally successful.
-Luke Jensen, Office of Diversity and Inclusion
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2017-18 Goals
Thriving workplace initiative Improve interpersonal communication between employees based on challenges identified at our
Supervisor Strategic Planning Meeting. Success in this area will be demonstrated by positiveresponses on the Thriving Workplace survey that address communication.
Improve interdepartmental communication and referrals between Mental Health and Primary Careto expand the capacity of the UHC to manage students on psychiatric medications and improvepatient care.
Departmental Diversity Evaluate our vestibule space to improve accessibility to those who are visually impaired. In addition,
to insure the overall accessibility of the UHC. Further improve our service to international students as measured by feedback gathered by the
Student Health Advisory Committee.
Assessment and Learning Outcomes Increase our patient satisfaction survey responses to 2,400 to achieve interpretable data based on
our total visits and improve scores on overall satisfaction and the likelihood that patients wouldrecommend the UHC to a friend. (Attachment 1)
Public Health Fully implement additional immunization requirements for 2018 incoming students (meningitis and
tetanus/diphtheria and pertussis vaccines). Participate in the effective launch of a recovery supported living space in College Park and expand
recovery related programming in cooperation with The Haven at College. Work with campus partners to make progress toward full implementation of the recommendations
from the President’s Sexual Assault Prevention Task Force. Substantially improve the operation of the international student immunization onboarding process.
Patient Care Operations Increase the efficiency of care In Medical Units by assigning a Registered Nurse to work within each
Unit and by establishing Nurse Advice Phone and Electronic Communication Lines.
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Director
David McBride
Associate Director
Deirdre Younger
IT Staff
MR/Appts Supervisor
Denise Weiss
MR/AppointmentsStaff
Pharmacy Supervisor
Marie Powell-Daly
Pharmacy Staff
Radiology Tech
Physical Therapy
Arlene Hernandez
HousekeepingSupervisor
Linden Wilson
Housekeeping Staff
Assistant Director,Mental Health
Marta Hopkinson
SUIT Supervisor
Laura Place
SUIT Staff
FSAP Supervisor
Tom Ruggieri
FSAP Staff
Mental HealthPsychiatry Staff
Mental HealthCounseling Supervisor
Jeri Boliek
Mental HealthCounseling Staff
Mental Health FrontDesk Supervisor
Kit Johnson
Mental Health FrontDesk Staff
Assistant Director,CARE
Fatima Taylor
CARE Staff
Assistant Director,Health Promotion
Julia Matute
Health Promotion Staff
Marketing Staff
Massage/
Acupuncture Staff
Assistant Director forBusiness and Finance
John Randrian
Billing Manager
Jeff McDonald
Billing Staff Business Office Staff
Registration Manager
Nancy Heckman
Registration Staff
Laboratory Manager
Stephanie Webster-Sesay
Lab Staff
Clinical Director
HeatherTeitelbaum
Walk In Supervisor
Joy Howard
Walk In Medical Staff
Walk In NursingSupervisor
Rita Devens
Walk In/First FloorNursing/MA Staff
PC/WH NursingSupervisor
Linda Legrand
PC/WH MA Staff
Immunization/AllerySupervisor
Tina Thorburn
Immunization Staff
PC/WH Medical Staff
Occupational HealthCoordinator
Rebekah Giannakos
Occupational HealthNurse
AdministrativeAssistant
Marilyn McDonald
HR/BusinessCoordinator
Elizabeth Zapata
Executive Committee
Supervisors
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Key Statistics
Of note, we have intentionally increased promotion of appointment based visits which has allowed us to improve waiting times and increase
continuity for those students who care about that issue. Web booked appointments have shown to be increasingly popular with students, as the
chart reveals. Our missed appointment rate for scheduled visits remains very low, around 4%.
38,687
17,475 19,668
26,398
5,0455,229
7,728
1,024
24,941
8,268
14,071
997 1,313
37,658
17,296 16,702
23,003
7,8014,967
7,557
817
23,618
7,777
13,066
1,0711,240
37,995
15,85115,397
19,897
11,146
4,763
5,788
652
24,941
10,864 13,788
1,178 1,822
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
Medical Services Provided 16-17
6/1/2016-5/31/2017 6/1/2015-5/31/2016 6/1/2014-5/31/2015
10
952
9
160
9
315
6
4363
760 9
17
110 22
3
974
11,
419
1,8
08
4,09
9 4,7
18
814 1,0
45
87
656 95
6
11
,524
1,8
50
3,9
25 4,4
65
1,0
10
97
2
107
1,0
41
1,0
30
T O T A L M E N T A LH E A L T H V I S I T S
U N I Q U EM E N T A L H E A L T H
P A T I E N T S
I N D I V I D U A LV I S I T
M E DM A N A G E M E N T
I N I T I A LE V A L U A T I O N
T R I A G E V I S I T R E F E R R A L V I S I T G R O U P F S A P T O T A LV I S I T S
MENTAL HEALTH SERVICES PROVIDED
6/1/2016-5/31/2017 6/1/2015-5/31/2016 6/1/2014-5/31/2015
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Explanations for visit volume decrease in Mental Health:
There were no trainees in the Mental Health Service this past academic year leading to somedecrease in patient volume. Licensed therapists have been more reluctant to engage trainees as thehigh acuity of patients is perceived as transferring more risk to the staff therapists as supervisors ofcare.
There has been a downward trend in the number of group services. Reasons for this include thetransfer of a large eating disorder group to the Counseling Center, fewer/no trainees to co-facilitategroups and the perception that illness severity makes some students less appropriate for grouptreatment.
Staff departures and difficulty with recruiting have led to ups and downs in prescriber FTE. Collateral work for students with more severe illness is not captured by our visit tracking
mechanisms, but it can limit the time available for patient care.
MENTAL HEALTH SEVERITY INDICATORS
2016-2017 2015-2016 2014-2015
ER Referrals forPsychiatric Crisis
101 67 44
% reporting suicidalityon intake
35% 35% 31%
% reporting past suicideattempt on intake
10% 8% 10%
% reporting self-injury(ex. cutting) on intake
36%(19% cutting)
29% 25%
Our severity indicators continue to speak to a patient population with increasingly intense psychiatric illness
and a low level of positive coping skills (as demonstrated by the high cutting percentage).
A field indicating the need for extended care was added to our Mental Health notes in 2016-17 and it
indicates the 280 students were considered to be “unstable” and therefore could not safely be referred into
the community.
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SUIT (Substance Use Intervention and Treatment)
Substance use among SUIT clients
A proportionally higher number of students have used marijuana, tobacco, stimulants, benzodiazepines, cocaine, LSD, MDMA,
mushrooms and Salvia. There was an increase of about 35 students evaluated who met criteria for Cannabis Use Disorder. Of
note, students who regularly use marijuana are more likely to use cocaine, amphetamines and hallucinogens based on recent
publication.
Effectivness of SUIT Interventions
To assess the effectiveness of their interventions, SUIT has begun to measure a variety of behaviors that clients intend to employ
before and after their visits. Intention to engage in personal protective behaviors increased in all areas.
277
150
97
23 37 2441 29 27
11 3 5 4 6 3 2 1
0
50
100
150
200
250
300
Substance Use In SUIT Clients
# of Students AY 2016-17 # of Students AY 15-16
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Drink or use less at a time
Drink or use less often
Eat before drinking
Skip the pregame
Know what you're drinking (how much alcohol, how many…
Alternate alcoholic and non-alcoholic drinks
Drink or use only when planned
Plan in advance how much to drink or use
Take a break from drinking or use (abstinence break)
Avoid drinking when you feel bad emotionally
Get support for other problems
Ask friends to help keep you safer and more accountable
Other type of change
Percentage of Each Change Strategy Identified Per Note/Visit atSAIP Intake and SAIP Exit
% at SAIP Exit % at SAIP Intake
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CARE SERVICES PROVIDED
Presenting concern new clients (a client may havemultiple concerns
16-17 15-16 14-15
Relationship violence 19 28 20
Sexual assault 69 73 82
Stalking 12 10 3
Child abuse 5 10 12
Sexual Harassment 6 7 6
Other CARE issue 24 16 4
Other non-CAREissue 3 4 9
Unique CAREclients/allservices
Unique newclients
Uniquecounseling
clients
Uniqueadvocacy
clients
Totalpsychotherap
y sessions
Total inperson
advocacysessions
Crisis calls
6/1/2016-5/31/2017 144 122 69 135 895 245 80
6/1/6015-5/31/2016 139 132 29 124 709 260 81
6/1/2014-5/31/2015 136 136 39 125 646 216 56
0
100
200
300
400
500
600
700
800
900
1000
Care Services Provided by Year
Step UP! Presentation Totals
6/1/16-5/31/17
6/1/15-5/31/16
6/1/14-5/31/15
Step Up!presentations
132 109 32
# incomingstudentsreached
3713 1706
Total studentsreached
4850 3161 1618
PURPOSEThe Health Promotion and Wellness Services unit at the University of Maryland Health Center aims to promote the holistic wellbeing of students through comprehensive and collaborative programming, peer education, sharing of accurate and relevant health information and resources, and providing empathic wellness consultations and coaching for the campus community. We recognize that how we think about wellness is affected by our culture and our life experiences. We strive to support inclusive, accessible, and diverse health and wellness opportunities. Our dynamic services are provided to empower students to develop a strong foundation to optimize their capacity to learn, reach their potential, enhance resiliency, and achieve their goals throughout their academic career and beyond.
Goals1. To facilitate the adoption and maintenance of positive health behaviors and wellness practices.2. To collaborate with Health Center staff in the delivery of client education services.3. To provide experiential opportunities for peer educators and interns.4. To increase awareness of Health Center programs and services.5. To increase knowledge of personal and community wellness.
ALCOHOL AND OTHER DRUGS COMPLEMENTARY ANDALTERNATIVE MEDICINE
Meditation Total Served1519
Massage and AcupunctureTotal Clients
755Total Visits
1,352
PEER EDUCATION ANDSTUDENT INVOLVEMENT
Peer Educators (3 programs)34 Peers
570 hours trained186 credits earned
Student Nutrition Advocates/Nutrition Coaches
6 Coaches90.5 hours trained
Interns/Independent Study2 interns
1020 hours worked24 credits earned
Student Health AdvisoryCommittee
40 members/volunteers40+ hours trained
NUTRITION
Nutrition Counseling345
Nutrition Coaching (NC)198
NC Client Hours495
PT+ (Recwell+NC)26
Outreach 3,319
UMD WEEKENDS Listserv5,271
Smoking Cessation Clients14
WELLNESS PROGRAMS
Total Outreach 6,120
Wags for WellnessParticipants
1,804
GENERAL OUTREACHAND MARKETING
Person to Person Outreach7,687
Social Media Outreach4,735
WebsiteUsers 199,940
Sessions 333,389Pageviews 584,34058.18% (new visits)
41.82 % (returning visits)
Media and PublicationsCoverageArticles 23
NOTES• HPWS Staff partnered with CARE to Stop Violence to deliver bystander intervention.• 2 New Alcohol and Other Drug Programs Piloted with posi-tive results!1. Sober Slam 36 Participants2. Higher Education Program 120 Participants
SEXUAL HEALTH
Outreach6,010
Outreach activities include tabling activities, large scale programming (FLF, Freefest, MD Day, Terportu-nity, Commuter Breakfast, campus-wide outreach, Condom Fashion, Wellness Expo, Dietetic Events, some specific audiences, etc.; generally facilitated by peer educators and professional staff.
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Attachment 1-Patient Satisfaction Results and Benchmarks-Spring 2017
% at top 2 tiers UMD 81.3 All Schools 82.5
Overall Satisfaction Avg UMD 4.29 All Schools 4.36
GOAL: Avg 4.5, 90% top 2 tiers Based on Big 10 Health Centers
% at top 2 tiers UMD 85.4 All Schools 85.4
Recommend Avg UMD 4.21 All Schools 4.30
GOAL: Avg 4.5, 90% top 2 tiers Based on Big 10 Health Center