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Interns find new ways to contribute during pandemic

Interns find new ways to contribute during pandemic

Pharm interns masked  team

Businesses and schools everywhere had to adjust how they operate over the last several months as the COVID-19 pandemic swept the country. For a group of interns – and their supervisors -- at The Providence Community Health Centers, it meant finding new, mostly virtual, ways to contribute.

Many of the interns were originally going to work at a second COVID-19 testing site. When that site did not come to fruition, new duties were designated to the 12 interns, whose work was coordinated and supervised by a variety of PCHC staff including Dr. Andrew Saal, Chief Medical Officer, and various members of the clinical, administrative, and human resources team.

“Internships are invaluable to young people looking to gain hands-on experience,” said Cheryl Perry, Vice President, Chief Marketing & Human Resources Officer at PCHC. “Their contributions help us advance our cause of creating a healthier community. This group of interns was impressive and enthusiastic and we look forward to seeing what they will do next.”

Kathryn Sullivan, who just started her senior year at North Carolina State University, was originally slated to work in the second COVID testing tent. Instead, she went to work with Dr. Jonathon Gates, Chief Medical Officer for Accountable Care, and Daniel McGuire, Director of Population Health. Here, she learned about the care gap that exists locally and nationally. She helped outreach to patients, particularly those who needed colorectal cancer screening.

Kathryn, who is originally from North Kingstown, is now applying to Physician Assistant programs as the next step in her educational journey.

Katelyn Loyo, a Providence native who graduated from E-Cubed Academy, worked directly with Graciela Morales, patient engagement coordinator, as well as other staff members. Graciela taught Katelyn how to work with patients to best direct them to resources inside and outside of PCHC.

“While speaking to patients, they talked about how happy they are with the services PCHC offers,” said Katelyn. “That’s very important for patients to feel like they’re in great hands.”

Katelyn wants to pursue a career in nursing, following in the footsteps of her grandmother who is a nurse in Guatemala.

Benjamin Coleman from North Kingstown also worked in the Accountable Care Organization with Dr. Gates, Dan McGuire, and Graciela Morales. There, his eyes were opened to PCHC’s efforts to address a patient’s health before they get sick. “Working on the ACO team taught me a lot about preventive health care and the importance of prioritizing one’s health year-round through recommended screenings, a proper diet, and an active lifestyle,” he said.

As part of the colorectal screening effort at PCHC, Ben spent time on the phone with patients, learning more about their specific challenges and he says, “the barriers that often impede Americans from receiving access to medical care.” Ben is interested in attending medical school after graduating from the University of Miami.

Amy Burt, a junior at Unity College in Maine, served her internship updating policies and performing data entry. She worked in a variety of roles and was supervised by several PCHC staff members. No matter the assignment, she said there was one consistent theme.

“The mission statement of PCHC shined through in all the tasks I was assigned,” she said. “Three core values stood out to me throughout my experience: cultural competency, compassion, and respect. All of these actions promoted a productive and safe environment.”

Amy plans on becoming a licensed clinical social worker but is still open to other career options. “I know whatever I do,” she said, “I will stay true to my goal of helping others.”

A brother and sister from North Kingstown -- Nicolette and Maximino Naya -- spent the summer interning at PCHC.

Nicolette, who just started her senior year at the University of Connecticut, thought she was returning to an internship she held previously at Tiffany & Co. When that was cancelled due to the pandemic, she took on an internship at PCHC, learning about Electronic Health Records under the guidance of Sharon Joseph, Director of Health Information and HIPPA Compliance. While Nicolette said she is not considering a career in healthcare, she learned a lot over the summer and grew appreciative of the work that goes on every day at PCHC.

Max, a student at Stetson University in Florida, intended to spend the summer studying overseas but his plan was derailed because of COVID-19. Instead, he interned at PCHC, assisting with the organization’s marketing and social media efforts, working closely with Susana Conklin, Chief of Staff. As Max is considering a career in marketing or sales, it was a perfect fit at an organization where he could feel good about contributing. “I saw firsthand that PCHC is always actively trying to better itself to be able to best serve their community,” said Max.

Elizabeth Pekar from North Kingstown is a senior at The George Washington University. She worked with clinical pharmacist Lillian Nieves, who she describes as “extremely knowledgeable, kind, and a great teacher,” during her internship. Elizabeth, who wants to become a Physician Assistant, said she learned a lot during her time in the pharmacy including “common practices and protocols to detailed population health projects that Lillian is working on to better the PCHC community. I have also learned about the amazing work that PCHC is doing to provide equal access to healthcare, which is not only extremely encouraging, but inspiring.”

Elizabeth is pictured on the right, along with (from left to right) Lea Diaz, PCHC Certified Technician II, Gabrielle Davis, Pharmacy Summer Intern, and clinical pharmacist Lillian Nieves.

Kristina Krashovats, who is originally from Russia and attends Truman State University in Missouri, learned about the multiple factors that can influence health care finances. She was not one of the summer interns originally targeted to work in the COVID tent; instead, she applied for a competitive internship slot at PCHC and was chosen because of her background and interest in finance.

While she has focused on banking and other industries as a finance major, it was her first time working in health care. “Before the internship, I prepared by reading “accounting for healthcare” textbooks,” said Kristina. “All the numbers were given to me. For example, revenue was simply the product of charge per visit and total number of visits.”

Her real life experience was different as Kristina learned much more about analyzing statistics, profitability, and even anatomy to more deeply understand the world of healthcare finance.

“I had to figure out all the potential cost sources and activities involved in the process of treatment, and collaborate with specialists like an opthalmologist to ensure my assumptions and research conclusions were valid,” said Kristina. “This was definitely a new and exciting experience for me.”

chat skypeAnastasia Paraliticci, a North Kingstown native who is a student at the University of Rhode Island, worked over the summer as an intern in community outreach. She helped “inform the public about how to access health care, services which many people were not aware of”, while working with Adriana Vargas, Director of Community Outreach. Anastasia enjoyed speaking Spanish with Adriana (which she says is “something I don’t get to do very often outside of my household.”) She also saw the importance of relationships in community outreach, noting that Adriana “is very outgoing and knows everyone in Providence and all surrounding communities.”

“Student interns always bring a fresh perspective,” said Adriana of her time mentoring Anastasia and other interns. “Their analytical, writing, research, project and interpersonal skills make a great difference in the work being done here. This has been the case with Anastasia who brought many skills, and most important, a wiliness and readiness to support the advancement of many projects.”


highest quality health center Award

PCHC recognized as one of the nation's highest quality health centers

hcql goldThe Providence Community Health Centers have been recognized as one of the nation's top clinically performing community health centers, receiving coveted "gold tier" status from the Health Resources and Services Administration. This distinction places The Providence Community Health Centers (PCHC) among the top 10% of health centers nationally for high quality care for patients across the life spectrum.

On August 25, 2020, the U.S. Department of Health and Human Services, through the Health Resources and Services Administration (HRSA), announced over $117 million in Quality Improvement Awards to 1,318 health centers. Community health centers will use these funds to further strengthen quality improvement activities and expand quality primary health care service delivery.

HRSA provides quality improvement awards to promote high quality care, efficiency, and value of the health care services provided by the nation's health centers, and to celebrate their recent achievements in providing high quality care to nearly 30 million patients. These awards recognize the highest performing health centers nationwide as well as those health centers that have made significant quality improvement gains from the previous year.

The Health Center Quality Leader Award earned PCHC an additional $315,000 to continue its quality improvement and patient safety initiatives. The eight community health centers in Rhode Island received awards totaling $1,239,266.

"Our entire team works tirelessly to improve the health of all Rhode Islanders regardless of cultural background, social barriers, or ability to pay," said Merrill Thomas, President and CEO of PCHC. "We are proud to care for more than 60,000 people every year with a wide range of health services that address the physical and mental health needs of our patients."

Health centers deliver comprehensive care to people who are low-income, uninsured or face other obstacles to getting health care. HRSA's Quality Improvement Awards recognize health centers for the following health achievements:

* Improving cost-efficient care delivery, while also increasing quality of care;
* Reducing health disparities;
* Increasing both the number of patients served and the patients' ability to access comprehensive services;
* Advancing the use of health information technology;
* Delivering patient-centered care;

"By promoting high quality care across the eight health centers, we are changing the lives of thousands of our neighbors," said Andrew Saal, MD, MPH, Vice President & Chief Medical Officer at PCHC. "The numbers tell a story; for over 50 years, we have been honored to serve the families of our community. But our goal is to provide extraordinary care to everyone regardless of their ability to pay."

Dr. Saal highlighted several quality measures that demonstrate PCHC's impact:

  • PCHC is responsible for 10% of all deliveries of newborns in Rhode Island. Despite patients often facing barriers to care, newborns from the PCHC OB program had some of the healthiest birth weights in the state.
  • Every child should have a series of 24 vaccines completed before their second birthday. The national average for health centers immunizing children is under 40%. Last year, PCHC fully immunized 72% of its children before their second birthday.
  • PCHC helped close the health disparities between racial and ethnic groups. HRSA recognized PCHC with a special award for reducing the differences in blood pressure and diabetes outcomes for Black and Latinx patients.
  • The health center teams, in collaboration with the Integrated Behavioral Health Department, screened 90% of all health center patients for depression last year.
  • In just one year, the dental team made tremendous improvements in the rate of dental sealants in children, raising the rate from 42% to 55%.
PCHC utilizing mailed tests to ensure Colorectal Cancer Screening continues

PCHC utilizing mailed tests to ensure Colorectal Cancer Screening continues

Since March, most routine health screenings have been delayed because of the COVID-19 pandemic. Providence Community Health Centers (PCHC) is creatively addressing the need for colorectal cancer screening with tests that are mailed to the patient’s home, completed, and returned by mail to be tested in a laboratory.

The fecal immunochemical test (FIT) is an inexpensive, at-home colorectal cancer screening method that checks for traces of blood and proteins in the patient’s stool that cannot be seen by the naked eye. Patients with suspicious test results are scheduled for a follow-up colonoscopy. About 1 out of 7 FIT tests results are abnormal, but an abnormal FIT test does not mean cancer is present, only that a colonoscopy is necessary to find out why there was microscopic blood in the stool. The first tests were mailed out by PCHC earlier this month, with a total of 3,700 patients currently in need of screening this year. Learn more about the tests here: https://www.providencechc.org/colorectal-cancer/

PCHC utilized data from its Electronic Medical Record to identify patients who needed screening and did not have a test ordered or had not completed a previously-scheduled test. While FIT is not as accurate as a traditional colonoscopy, it allows for effective screening in remote health care settings, making it very useful during times of mandated social distancing. FIT testing, in addition to being more acceptable to many patients, also frees up limited colonoscopy appointments for patients likely to need them, and the FIT test can be completed in the privacy of patients home – without taking a day off work or childcare and finding a responsible adult to escort you after the anesthesia used during a colonoscopy.

“At a time when most routine health screenings have been delayed, FIT screening is a valuable tool that allows us to continue screening at-risk populations for colorectal cancer,” said Dr. Jonathan Gates, Chief Medical Officer for Accountable Care at PCHC. “Despite the COVID-19 pandemic, we must continue to find creative ways to advocate for disease prevention and detection. FIT testing is preferred by many patients who would not otherwise accept the more invasive colonoscopic screening.”

The process in completing a FIT test is a simple one. A kit including a small stick and bottle are mailed to the patient’s home. The patient uses the stick to obtain a small stool sample, which they place in the bottle. That sample is then mailed back to PCHC’s electronically interfaced lab, East Side Clinical Laboratory in most cases. The test is then conducted in a laboratory with technicians searching for small amounts of blood in the stool that are often undetectable with the human eye.

FIT tests are only good for a year by U.S. Preventive Services Task Force guidelines; by contrast, a colonoscopy – if totally normal – is good for 10 years.  But a one year reprieve from colonoscopy in today’s world can make all the difference, using our limited colonoscopy appointments on the patients most likely to have abnormalities or colorectal cancer.

FIT testing isn’t for everyone – patients with a family history of early colorectal cancer, those who have had irradiation to the abdomen, and those with past abnormal colonoscopies or known inflammatory bowel disease such as Crohn’s disease or Ulcerative Colitis are not candidates for FIT Testing. Patients with hereditary genetic predispositions to colon cancer (HNPCC and Familial Adenoma Polyposis are two) also require colonoscopy as the only test.

Still, FIT testing is a useful tool in diagnosing colorectal cancer, which is the second-highest cause of cancer deaths in the United States. It is estimated that nearly 23 million adults aged 50 to 75 are past due for screening, and an estimated 53,000 Americans will die from colorectal cancer this year.


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