Mountain Lakes Access Health Reflection

1. Mountain Lakes Access
Health Reflection
HLTH 4980
DANIELLE MATTHEWS

2. Overview
Observations of Daily Procedures
Patient File Reviews
Motivational Interview
Patient Interaction
First Steps Data Entry

3. MLAH Observations
Observed enrollment and re-enrollment
Primary need for patients was access:
Primary care
Specialty care
Dental care
Access to medical supplies
Medications
Transportation

4. MLAH Observations
Role of the case workers:
Helped navigate the enrollment process
Connected to other assistance programs
Community
Federal
Social support
Role of on-site RN:
Ensure understanding of condition before leaving the office

5. Patient File Reviews
Varying lengths of enrollment
Good examples of the usefulness of the patient assessment tools
PAM
GAIN-SS
Showed effectiveness of the program over time
Increase in knowledge and ability to manage conditions
Improvements in self-efficacy
Differences in goals
Weight goals to bachelor’s degree

6. Motivational Interview
Patient who had been enrolled in the program for a while
Difficulty reaching new goals
Help gain a new perspective
Reframing the situation
Remind of previous successes

7. Patient Interaction
Contacted a few patients for follow-up
Care transitions and “warm hand-offs”
Patient infection
Ensure appointment and continuation of care
Additional problems
Prevent worsening and ED visit
Surgical procedure
Recent discharge (3-5 days)
Pain or complications
Prevent readmission
No outcome = no income

8. Reflection
PROS
Healthcare regulations
Importance of patient-centered care
Attention to patient’s perspective of
needs
Importance of care transitions
Successful cases
Making a difference
Importance in the patient’s life
CONS
Healthcare regulations
Tough cases
Ineligibility and/or lack of appropriate
services
Variable workload

9. First Steps Data Entry
Goal: increase school readiness outcomes for children
Offers “school readiness” services:
Improve children’s health
Support parents
Access for parents for early intervention for behavioral or physical needs
Promote early education
Help transition into school

10. First Steps Data Entry
Participants:
Over 1,000 parents
About 125 kindergarten teachers and
daycare teachers
Surveys assessed:
Ability to pay for care
Ability to understand child’s needs
Access to primary care
Child and parent mental and
behavioral needs
Demographics
Home life
Employment
Education
Insurance coverage

11. Results
Not very strong correlations or high frequencies
Prevalent use of the ED for primary care even if not “significant”
Mental health- parents
Behavioral problems- children
Many parents without health insurance
Low levels of education
Less than high school

12. Reflection
PROS
Large sample population
Various social and economic factors were
considered
Evaluation
Very thorough questions
CONS
Significant” data ranges excluded many of
the responses
Literacy
Reading level
Phrasing
Answer choices
Not all inclusive or applicable
Different ranges

13. Conclusion
Being at MLAH helped me to understand more about HOP and the
enrollment process
Helped give concrete examples of what we were learning about in class
Helped work out issues for future classes