Increasing Women’s Healthcare Access at a Student Run Free Clinic by Creating a Women’s Health Coalition

Abstract

Introduction/Problem: The Indiana University Student Outreach Clinic (IU-SOC) was established to bridge gaps in primary care-based medical, dental, social and legal services to uninsured and underinsured Indiana residents. A bimonthly women’s clinic was later created to provide medical care to those with obstetric and gynecologic needs. Even with the introduction of a women’s clinic, mammogram referrals were not always being conducted, Pap smears were being deferred, and sexually transmitted infections (STIs) were not being treated appropriately. Here, we describe how the concept of the women’s clinic was expanded to a multidisciplinary coalition of medical students and a certified OB/GYN physician advisor dedicated to women’s health to address women-specific concerns. Methods/Interventions: A 62 person team was created ​to address each of the needs we identified in the clinic regarding women’s health. This team consisted of a finance chair, volunteer chair, clinic managers (CM), patient navigators (PN), appointment coordinators (AC), WH liaisons, education specialists, and quality improvement (QI) researchers. Eleven team leaders were created to assist with managing the different elements of the growing team. Results: Fifty-eight patients were referred to the WH PN team to help assist patients obtaining higher level care, 11 of which were successfully referred to date. Eight pregnant patients were seen at the clinic this year, an increase from six over the past three years combined. Fifty-six pap smears were completed this year, an increase from 37 over the past five years combined. STI, HIV, and hepatitis testing was performed on 281 patients, an increase from 149 from the past five years combined. Thirty-one patients were referred to a new twice monthly WH clinic to be evaluated by an OB/GYN or obstetrics-trained family medicine provider not previously accessible at the clinic. Labetalol, RhoGAM, and glucose tolerance tests were added to clinic resources to improve prenatal care. Protocols were written for sexual assault, abnormal uterine bleeding (AUB), dysmenorrhea, HPV, and medications approved in pregnancy to standarize patient care. A new microscope was obtained to improve the ability to perform wet mounts. Conclusion: With the creation of the WHC, our volunteers have bridged gaps in medical care. Important and prevalent female reproductive and sexual health issues, like AUB, IPV, cervical and breast cancer screenings, and others are handled with the appropriate level of urgency and thoroughness they require. Nearly equally as important, we have trained and built a community of students who are passionate about women’s health ensuring sustainability.