The Impact of Student Hotspotting on Patients & the Jefferson Health System

Introduction “Super-utilizers”, patients with five or more hospital admissions in the past year, account for half of all healthcare expenditures and present a significant financial burden to our healthcare system. In Pennsylvania “super-utilizers” result in $1.25 billion of healthcare spending and Philadelphia has the highest number of “super-utilizers” in the state. To address this crisis, Jefferson University serves as one of four new national hubs for student hotspotting. Teams of interprofessional health professions students along with faculty and staff advisors enroll “super-utilizers” and provide targeted interventions to address social determinants of health, reduce hospitalizations and improve patient outcomes. Methods To examine the impact of this program on patients, objective healthcare outcomes were obtained from EPIC. Costs were obtained from the hospital Care Coordination team and national average figures to examine the impact on the Jefferson health system. Data were collected from six months pre-, during, and post-intervention for the hotspotting intervention group and for a matched control group of non-program participants. Pre- and post-intervention analysis was performed using random effects Poisson regression. Results Pre- and post-intervention analysis found a 6% reduction in ED visits, 48% reduction in the number of outpatient visits, 18% reduction in total days in hospital, and 14% reduction in 30 day readmissions for the intervention vs. the control group. Average total costs of care decreased for both the experimental and control group with a 36% cost reduction per patient in the intervention group. Conclusion Participation in student hotspotting is a promising way to help address the needs of “super-utilizes”. Student hotspotting appears to have a positive impact on reducing the costs of care and improving health outcomes for high utilizer patients

Client Centered Simulation: Practicing Interprofessional Teamwork with Standardized Patients

Background Interprofessional education (IPE) prepares students to work in collaborative teams (Burin et al., 2009). Educators use a variety of methods to develop and enhance teamwork skills (Fox et al., 2018). Standardized patient (SP) simulations allow students to practice skills in safe environments (Herge et al., 2013) and respond to situations as they would under natural conditions (McGaghie, 1999). As an active learning experience, SP simulations help students break through the “illusion of understanding” (Syinicki & McKeachie, 2001 p. 190). Kirkpatrick posits a hierarchy of changes as a result of training/education (Kirkpatric, 1979). At the highest level is transfer of learning to change behavior. Assessment of IPE influenced behavior change is limited and most assessments measure satisfaction, attitudes and knowledge (Abu-Rish et al., 2012). Team Care Planning is a simulated discharge meeting with an elderly female patient who had a CVA and her adult daughter played by standardized patients. It was developed in 2009 as Clinical Discharge Scenario as part of a Geriatric Education Center grant. Goals for this learning activity are: Health care professions students will: identify roles and responsibilities of professionals on the healthcare team and practice communication and collaboration in an interprofessional team simulation