C. Weiss is a first-year resident, Department of Family Medicine, Boston Medical Center, Boston, Massachusetts. At the time of writing, the author was a fourth-year medical student and co-president, JeffHOPE, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0002-9917-6596 .
A. Traczuk is a first-year resident, Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. At the time of writing, the author was a fourth-year medical student and co-president, JeffHOPE, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0003-4516-7229 .
Acad Med. 2022 Jun 1;97(6):855-857. doi: 10.1097/ACM.0000000000004480. Epub 2021 Oct 19.
Student-run free clinics (SRFCs) provide health and outreach services to underserved populations while offering medical students opportunities for service and education. Many SRFCs were forced to suspend in-person operations in early 2020 due to the COVID-19 pandemic. Before March 2020, JeffHOPE, the SRFC at Sidney Kimmel Medical College at Thomas Jefferson University, operated an evening clinic at 5 locations throughout Philadelphia each week.
JeffHOPE's response to challenges posed by COVID-19 focused on a redesign for a pilot clinic at a shelter site that expressed interest in resuming operations. The student leaders conducted a needs assessment with shelter stakeholders, including administrators and long-term residents, to identify service priorities. They also developed a list of key components for safe patient engagement and care delivery. A hybrid telehealth approach was developed to reduce in-person exposure for patients and volunteers and to involve preclinical medical students remotely. Three iPads were acquired via an internal grant.
The pilot clinic reopened in September 2020. Over the first 13 weeks of operation, 44 unique patients received care across 98 visits. Of these visits, 21 were in-person only with a clinical student and preceptor, while 77 also used the hybrid telehealth model to connect via iPad with a preclinical student. Patient visit volume was approximately 35%-40% of the pre-COVID-19 level. Of the 58 total volunteers, 11 were preclinical students who participated remotely.
Three additional JeffHOPE clinic sites have reopened since December 2020 using this hybrid telehealth model. Patient feedback, via surveys and interviews, will determine which components are retained. Other SRFCs should be encouraged to innovate and develop plans for safe resumption of services, with an appropriate approach and organizational support, despite the challenges posed by the pandemic.
学生经营的免费诊所 (SRFC) 为服务不足的人群提供医疗保健和外展服务，同时为医学生提供服务和教育机会。由于 COVID-19 大流行，许多 SRFC 被迫在 2020 年初暂停面对面运营。在 2020 年 3 月之前，杰斐逊大学 Sidney Kimmel 医学院的 SRFC JeffHOPE 每周在费城的 5 个地点运营一个晚间诊所。
JeffHOPE 对 COVID-19 带来的挑战的应对重点是为一个有兴趣恢复运营的避难所地点的试点诊所进行重新设计。学生领导与避难所利益相关者（包括管理人员和长期居民）进行了需求评估，以确定服务重点。他们还为安全的患者参与和护理交付制定了一份关键组件清单。开发了一种混合远程医疗方法，以减少患者和志愿者的面对面接触，并使临床前医学生远程参与。通过内部赠款获得了 3 个 iPad。
试点诊所于 2020 年 9 月重新开放。在运营的头 13 周内，有 44 名独特的患者接受了 98 次就诊。在这些就诊中，21 次仅与临床学生和导师进行了面对面交流，而 77 次还使用混合远程医疗模式通过 iPad 与临床前学生联系。患者就诊量约为 COVID-19 前水平的 35%-40%。在 58 名志愿者中，有 11 名是远程参与的临床前学生。
自 2020 年 12 月以来，另外三个 JeffHOPE 诊所站点已经使用这种混合远程医疗模式重新开放。通过调查和访谈收集患者反馈，将确定保留哪些组件。应鼓励其他 SRFC 创新并制定安全恢复服务的计划，尽管大流行带来了挑战，但需要采取适当的方法和组织支持。
