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As health care systems across the United States have mounted COVID-19 preparedness and response efforts, many have turned to novel solutions to ensure adequate staffing to meet the growing and evolving health care needs during the pandemic. One of the most common approaches has been to mobilize health professions students to use their skills and training to respond to the current needs of the health care system.
Medical students, in particular, have been innovating in inspiring ways from coordinating childcare for frontline health care workers to translating COVID-19 health information materials in 30+ languages to securing PPEs. Medical students without the option to graduate early are also taking on a variety of critical care delivery tasks. Three key areas of care delivery where medical students are contributing during the pandemic are during assessment and triage, throughout a patient’s hospitalization, and at discharge:
Triage — Medical students are staffing phone triage hotlines to help COVID-19 symptomatic patients determine appropriate next steps. For example, medical student volunteers at the Warren Alpert Medical School of Brown University are collaborating with Rhode Island’s Department of Health to support triage efforts in the following ways
- Taking undifferentiated calls and working in partnership with state nurses and social workers to help answer questions and direct callers to appropriate follow up
- Notifying COVID+ individuals of test results, obtaining salient clinical information, and providing care instructions for them and those they have encountered. In addition, students obtain a detailed list of close contacts.
- Conducting contact tracing in partnership with the National Guard
Medical students at Brown, including James Scharfen, Tammy Yu, Michael Zaskey, Julia Festa, and Cat Garcia have developed and continuously refined a set of workflows, scripts, and associated materials.
At the University of Minnesota, Drs. Karyn Baum and Brian Hilliard, developed a full course curriculum (and course syllabus) in 11 days for 3rd- and 4th-year medical students that, in part, has them supporting the MHealth Fairview System Operations Center in assessing, placing, and transferring patients to optimize flow.
Support During Hospitalizations — The severe restrictions on visitors has created many challenges for providers, patients, and their loved ones. In response, Katherine Hochman, MD, of NYU Langone Health, developed NYU Family Connect. Through this program, medical students are trained to obtain clinically salient information from a patient’s chart and to then virtually “sit-in” on rounds to get the most current information on how the patient is doing. Armed with this knowledge, students call the patient’s loved ones to provide updates.
Discharge Support — Medical students, including 3rd-year Alicia Asturias at the UC of San Diego School of Medicine, created a virtual scribe program to help attendings draft discharge orders for COVID-19 patients. Students use their knowledge of electronic medical records to write discharge summaries from home. The goal of the program is to reduce work-flow burden for frontline staff and to help keep hospital beds open to ensure the health system is not overwhelmed.
As part of the above-mentioned effort at the University of Minnesota, medical students are also trained to review charts and prepare draft discharge summaries from afar. In an interprofessional first, they also, in conjunction with Professors Scott Chapman and Diana Langworthy from the College of Pharmacy, developed a pharmacy course to allow senior pharmacy students to work in tandem with medical students. Pharmacy students take an initial pass at medication reconciliation. In addition, medical and pharmacy students take part in interprofessional online journal clubs on COVID-related topics such as hypercoagulation and hydroxychloroquine to further their awareness and understanding.
The initiative and resourcefulness of these students and faculty demonstrate the myriad ways that the health care workforce is innovating and adapting to meet the magnitude of need brought on by the pandemic. Others can benefit from the ingenuity and generosity of those noted above by adapting these materials to meet the unique needs of their own communities and to “pay it forward” by continuing to share, learn, and improve together.
Keziah Imbeah, MSc, is a research assistant for the IHI Innovation Team. Saranya Loehrer, MD, MPH, is IHI's Head of Innovation.
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