Our last full day in St. Thomas was full of adventure! We started off with a visit to VITEMA – the Virgin Islands Territorial Emergency Management Agency, which was awesome! We toured through their 9-1-1 dispatch area, emergency management training room (which was currently full of law enforcement officials preparing for active shooter situations), and viewed a few short tsunami videos in their main conference room. For those who may find themselves in tsunami zones in the future – signs to look out for include (1) a major earthquake (like really shaking, 7-8-9, etc.), (2) sudden significant/noticeable change in tide, and (3) a LOUD roar (way louder than jet engines) … This was an excellent experience – and we are thankful that Dr. Wright organized this opportunity before our departure!
From Vitema, we headed to the downtown district. There were three big cruise ships in today which means all the shops are open. We had an extended lunch hour to eat and explore. It was especially fun poking around the straw markets!
Next, we were off to the FQHC. We first talked with a nurse at the clinic who manages the HIV screening program and learned about her efforts at the East End Medical Center and out in the community. She and her team are really doing great work to address the high HIV incidence rates (~30%) and empower women to be assertive and speak up for their sexual health. They even offer age-appropriate programs in schools (beginning with age 11) to inform adolescents, teens, and young adults across the islands.
Finally, it was time to time to deliver our final presentation! We discussed the Diabetes & Hypertension Registry, Ambulatory Care Survey, Innovative Health Fairs, and Teamwork & Workflow Observations.
(1) Diabetes & Hypertension Registry: This was the mega project! We officially demonstrated use of this tool to capture and report diabetes & hypertension data mandated for FQHC reporting. This document has many fancy features that we hope will not only help maintain FQHC funding but also improve chronic disease management in the clinic! (Many of their clients currently have uncontrolled diabetes & hypertension.) We also offered suggestions for implementation to promote utilization.
(2) Ambulatory Care Surveys: We collected a total of 115 surveys (completed by patients in the clinic) and compared data to last year’s findings. The major results – improved satisfaction related to “prompt return on calls” and “provider takes time with you” but decreased satisfaction related to several other items, including but not limited to: “time in waiting room,” “time waiting for results,” “collection of co-pay,” and “likelihood to refer friends and family.”
(3) Innovative Health Fairs: We screened a total of 141 employees at the three Innovative health fairs in three island locations: St. Thomas, St. Croix, and Tortola (BVI). Averages included: BP (140/82), non-fasting glucose (110.5), non-fasting cholesterol (201), BMI (31.6), and waist circumference (31.5 inches). Overall, we found this population is most affected by hypertension, elevated cholesterol and overweight/obesity.
(4) Teamwork & Work Flow: Finally, we shared our observations and anecdotes related to safety, efficiency, provider preferences, communication, and teamwork in the clinic. Specifics recommendations/emphasis included: consistent hand washing, the need for additional manual BP cuffs, implementations of daily huddles, and clarification of job descriptions and provider preferences.
Our presentation was very well received! We were complemented genuinely on our work and professionalism and were sure to express our gratitude to the wonderful team at St. Thomas East End Medical Center for welcoming us into their clinic and onto their team over these last two weeks.
We have really had a wonderful experience and are so thankful to Emory University, the Lillian Carter Center, and all of the St. Thomas organizations and community members that supported our service learning experience. We also owe a tremendous THANK YOU to Dr. Wright, our incredible faculty lead, and her wonderful family (Mr. Wright, Beka, and Connor!) for hosting us on St. Thomas and making this both an educational and highly enjoyable experience!