Garrison-Foster Health Center Annual Report 2013-2014
Garrison-Foster Health Center Annual Report 2013-2014 Garrison-Foster Health Center Colby College Annual Report 2013-14 Table of Contents Annual Summary …………………………………………………………………………………………. 1 Practitioners ……………………………………………………………………………………………….. 2 Drug and Alcohol Programs …………………………………………………………………………. 4 Nursing ………………………………………………………………………………………………………. 5 Laboratory ………………………………………………………………………………………………….. 6 Sports Medicine …………………………………………………………………………………………. 11 Nutrition Consultant …………………………………………………………………………………… 13 Colby Emergency Response (CER) ………………………………………………………………. 15 Health Care Advisory Committee (HCAC) ……………………………………………………… 17 Health Promotion/Education ………………………………………………………………………. 18 SHOC (Student Health On Campus) .......................................................... 19 Health Education Needs Assessment ………………………………………………. 22 Quality and Risk Management ……………………………………………………………………. 26 Satisfaction Surveys ……………………………………………………………………….. 28 Electronic Health Record ……………………………………………………………………………. 31 Campus Involvement …………………………………………………………………………………. 32 1 Garrison-Foster Health Center Colby College Annual Report 2013-14 Medical Providers Holly Weidner, FNP The medical provider team, with over 98 years of medical experience, is staffed with 3 nurse practitioners and the Medical Director. This team provides medical services at the GFHC for acutely ill or injured students as well as for routine health care such as sports exams, well women exams, STD screening, travel clinic and work physicals. We also provide care to the athletic teams in the Health Center and at the Athletic Training Center. We cover home games for all Varsity Football and Men’s Ice Hockey. Due to the number of students that travel abroad (50% of students), we also provide a travel clinic with immunization coordination, physical exams and advice as well as care when they return for any health concerns. This year we partnered with MaineGeneral Sports Medicine to bring in two sports medicine fellows for a semester each to work with the medical director on evaluating, treating and monitoring the progress of our injured students. In spring 2013 we also added a service to our TB surveillance program to be able to provide the new treatment for Latent TB Infection that is shorter, easier to take, and with less side effects. This fall one of our nurse practitioners began a focus on managing the medical needs of our students with mental health problems. She coordinates care with the psychiatrist, counselors and dietician. We coordinate care with on site specialists including a Registered Dietician for Eating Disorders, an alcohol and drug counselor, a psychiatrist for medication management, on site counseling services and CER (Certified Emergency Responders- student EMT group). We have been streamlining the electronic medical record to better track student health; improve coordination of care between ourselves, our nurses, our athletic trainers, outside specialists, hospitals, labs and pharmacies. We also can provide up- to -date medical care through on line medical information software. The providers do annual peer audits and Best- Practice based audits . In the follow up audit of Infectious Mononucleosis and how well we identified and followed those at risk for athletic injury, we had 100% compliance . The spring audit looked at how well we met best practice guidelines for identifying and treating gastroenteritis; Most importantly, all of the care that is done at GFHC is free to the students to encourage them to seek care early without concern to cost. 2 Garrison-Foster Health Center Colby College Annual Report 2013-14 Practitioners Total Patient Activity College Providers Total Office Visits Total Nonvisit Care* Total Peer Review Paul Berkner D.O. Lydia Bolduc-Marden NP Jennifer Riddle NP Holly Weidner NP 1027 766 1517 1408 1390 1062 1009 1321 450 110 110 110 Total Visits from 2013-14 Total Visits from 2012-13 Total Visits from 2011-12 4718 4786 4357 4782 7135 6103 780 780 780 *Total Nonvisit Care: includes review of nurse visits, Emergency room visits, psychiatrist consults, CER and AT visits, and labs/x-rays follow up management. Visits by Class Class of 2014 Class of 2015 Class of 2016 Class of 2017 1087 775 (usually lower from students taking semester abroad) 1319 1474 Visits by Gender Female 2785 Male 1911 Sports Medicine Fellow Visits Total Office Visits Fall 2013 Winter/Spring 2014 323 151 172 Travel Health Clinic Initial Consult Visits 202 3 Garrison-Foster Health Center Colby College Annual Report 2013-2014 Drug and Alcohol Programs Katie Sawyer, LCPC, LADC, CCS AlcoholEdu was administered to the Class of 2017 prior to their arrival on campus in August. This online educational tool was completed by more than 99% of the class as a required element in the First Year Wellness Seminar program. This year’s data reflected similar results as in years past. Items of note include: • • • 294 students in Survey 1 (57%) indicated being non-drinkers. Of those 294 students, 52% remained non-drinkers in Survey 3, 21% became light/moderate and 27% became high risk drinkers. 291 students reported interest in attending alcohol-free activities. On Survey 3, 18% of students reported using marijuana within the last 2 weeks and 3% of students reported non-prescribed ADD medication use. Future prevention efforts will seek to reinforce choices to not drink within the first semester and the use of other illicit substances. Statistics for the year: Counselor Visits Emergency Room Visits for Alcohol Blood Alcohol Content Range 185 50 0.111-0.358 The Alcohol Education Awareness & Treatment Advisory Group (AEATAG) met twice monthly, with minutes distributed to all committee members. This year the membership of AEATAG grew to 37% of the overall committee membership. This group of 10 students also met periodically as a separate group to vet messaging and to discuss margins for shifting the drinking culture. AEATAG as a larger group has researched a formalized bystander intervention program called Midnight Mules to be implemented during on-campus parties. This program will be piloted during the 2014-20-15 school year. AEATAG also worked with Campus Life to establish a bulletin board in Pulver, which posts non-academic activities, and space to post safe drinking materials. AEATAG and other concerned parties contributed to 7 print media awareness campaigns, as further described in the Health Promotion Annual Report. 4 Garrison Foster Health Center Colby College Annual Report 2013-2014 Nursing Judy Whyte, RN Nursing staff at Garrison Foster Health Center collaborate with Practitioners to provide the best clinical care possible for the Students of Colby College. By supporting Colby’s 360 plan to promote wellness and healthy lifestyles for Colby students, we aim at every encounter, to educate and encourage students towards patterns of healthy self care and well being. To augment the work we do inside the health center we also participate in making Colby and healthier and safer place by involvement with Stress Buster Fairs, Influenza Vaccination clinics for staff and students –administering 661 flu shots, continued support to SHOC (Students Health on Campus) and an ongoing clinical collaboration with CER (Colby Emergency Response). Although numbers show a slight decrease due to minor changes in nursing services we continue to see high volume visits focused around upper respiratory illnesses- (cough, cold, sore throat, fever. There was higher volume this year in management of tuberculosis testing (for international students, students going abroad, and those with internship requirements). A major focus of this years nursing’s non-clinical efforts were spent again on EMR standardization, review of Nursing policies and procedures as well as Nursing Clinical Protocols in anticipation of next years AAACH accreditation. Thank You again to a very dedicated team of Colby nurses! (Robin Shafer, Laura Patterson, Helen Balgooyen, Roberta Pullen). Nursing’s Total Patient Activity 2013-2014 Total Visits Total Non visit care * Total ER referrals 2584 1851 58 2012-2013 3176 941 69 2011-2012 2724 1910 59 * Total Non visit Care includes phone consults with students/parents, Medications dispensed to students, lab/xrays follow up. 5 GARRISON-FOSTER HEALTH CENTER COLBY COLLEGE ANNUAL REPORT 2013-2014 Laboratory Summary Donna Jurdak-Roy, MT Overall, the laboratory remained consistent with previous years. There was a slight decrease in the number of patients sent to the laboratory compared to last year, but the number was consistent with years prior to last year. We saw a decrease in the percent of positive strep A screens while the percent of positive infectious mono remained the same. There was a decrease in the number of patients sent to the lab for physical testing. Practitioners are getting more comfortable with the use of the new scale and vitals sign machine available to them. There was an increase in the number of in-house lab test but final number of in-house testing was slightly lower due to the decrease in physical testing. The number of MGMC, imaging, and cardiology orders remained about the same. The laboratory was CLIA inspected and was rewarded a two-year certificate. There were no deficiencies found. This year, the lab concentrated on updating the CLIA requirement of Competency and Skills assessment for laboratory testing personnel. The inspector positively commented on the documentation of the assessment. This process may be used in the competency testing in other areas of the Health Center. The laboratory was involved in many Quality & Risk Management activities. The lab also took part in the SEXPO fair by offering free HIV testing. 6 YEARLY COMPARISON Year Total # of Tests ordered Total # of in house Tests (Colby) 3417 20062007 Total # of Patient Visits/Tickets Total # of HIV Tests Total # of Paps Total # of MGMC Lab send outs (batches) Total # of PHL send outs Total # of Imaging services Cardiology/ Respiratory Services 123 266 495 356 294 96 210 475 317 276 20 102 205 499 285 232 20 20072008 2946 20082009 20092010 20102011 20112012 20122013 2965 2070 2059stu/ 11 emp 1766 1759stu/ 7 emp 1840 2902 1702 74 138 468 192 238 22 2686 2573 1431* 101 79 549 197 297 46 2825 1451* 103 41 658 140 349 23 3,050 2001* * 2289 1,624* 36 492 151 442 28 2,965 2042 1470 State:7 1 ***Inhouse: - 27 465 149 356 20 20132014 * This total does not reflect a return visit to complete the lab order. ** During 12/11 the lab no longer runs UA QC daily *** As of January 2013, HIV testing is done in-house In-House Testing In- House Lab Test Strep A Screen Mono Test ESR Hgb KOH/Wet Prep HCG Urinalysis w/o micro Urinalysis w/micro Hemocults Influenza A & B HIV Total Total QC/Proficiency Total 626 37 663 423 48 471 10 4 14 71 77 148 93 10 103 39 12 51 170 15 185 68 2 70 23 25 48 9 3 12 156 1688 6 239 162 1927 7 Ht. Wt. In-House Physical Tests (Lab) B/P Pulse Temp Visual Acuity Respiration Total 30 30 35 10 0 9 1 115 Total Total In-House testing = 2042 Laboratory / Practitioners Statistics Practitioner Total # of Tests ordered (MGMC) batches In-House Lab test PHL (excl. HIV) Paps MGMC HIV PHL MGMC Imag. MGMC Card/Resp 56 69 7 - - 164 9 Holly Weidener, MSN, NP 167 570 49 6 - 91 4 Lydia BolducMarden, MSN, NP 117 185 33 21 - 27 5 125 506 60 - - 74 2 - - - - - - - - - - - - - - - - - - - - - 356 20 Paul Berkner, DO Jennifer Riddle MSN, NP Standing Orders (Nurse/nutriti onist protocols) Standing Orders (Lab protocols) - - Quality Control - Physical Tests - Total 465 322 36 239 115 2042 149 27 Colby College Laboratory Testing Volume Statistics 8 Practitioner Strep Mono Influ A & B Paul Berkner 15 15 Holly Weidner 168 Lydia BolducMarden Jennifer Riddle Donna Jurdak-Roy (S/O) Nurses/Lab coverage Nutritionist UA w/micro HIV 3 UA w/out micro 7 8 10 179 2 11 53 50 50 30 3 23 5 28 203 143 1 40 1 68 - - - 15 - 191 56 - 66 1 - - - - 8 - - Practitioner/Provider HCG Hemoccult Hgb WetPrep/KOH ESR Paul Berkner 1 3 7 0 1 Holly Weidner 14 13 19 60 1 Lydia BolducMarden Jennifer Riddle 11 2 10 16 7 13 5 21 17 1 Donna Jurdak-Roy (S/O) Nurses/Lab coverage Nutritionist - - 14 - - - - - - - - - - - - Practitioner/Provider Total In-house Lab Test 69 570 185 506 36 314 8 1688 Paul Berkner Holly Weidner Lydia Bolduc-Marden Jennifer Riddle Donna Jurdak-Roy (S/O) Nurses/Lab coverage Nutritionist Total Positive/Abnormal Results Tests Positive/ABN Strep A Screen Mono Test Hgb KOH/Wet Prep HCG Hemocults 42 49 16 40 1 6 9 Influenza A & B ESR 1 1 Tests Paul Berkner Holly Weidner Jennifer Riddle Nurses 0 3 4 - Lydia BolducMarden 4 4 3 13 Strep Screen Mono Hgb KOH/Wet Prep HCG Hemocults Influenza A & B ESR 5 13 4 9 20 19 5 18 13 10 - 0 1 0 0 0 0 1 4 1 0 1 0 - 1 0 0 0 - 10 Garrison-Foster Health Center Colby College Annual Report 2013-14 Sports Medicine Timothy S. Weston, M.Ed., ATC, Head Athletic Trainer 13-14 12-13 11-12 Student Athlete Initial Evaluation notes: 867 816 615 Student Athlete Sports Medicine treatment visits: 3360 4317 2065 Student Athlete Pre-participation Sport physicals: 697 680 659 Total Athletic Trainer Appointments: 4754 5813 3339 Other Student Athlete visits to Nelson Center: 5273 6810 Student Athlete Non-visit care: (Secure messages to student athletes) 419 462 The Sports Medicine Department continues to provide direct medical services for 32 varsity sport teams (second highest number in NESCAC) by covering all home varsity athletic contests and certified athletic trainers traveling with football, men and women’s soccer, men’s and women’s basketball, men’s and women’s ice hockey and men’s lacrosse. Certified Athletic Trainer Megan Lander was hired in September of 2013 for our one year-interim AT position, providing primary coverage to men and women’s rugby. This worked out very well by providing both rugby teams the appropriate medical coverage. The four, full time and one interim certified athletic trainers continue to work one morning a week in the rehabilitation services room within the Garrison-Foster Health Center. This allows our department to provide medical care, for both varsity and non-varsity student athletes, at a convenient on-campus environment. There is continuous pressure on the current staff to provide additional services with regards to student athlete injury care. We continue to witness an overall increase in volume for initial injury evaluations for both out of season student varsity athletes who are engaged in off-season workouts and club sport student athletes. The Sports Medicine department employs 12-15 Colby College student workers per academic year. These students are typically hired during their first year on campus and work within our department until they graduate. Students applying for this position are required to submit a formal cover letter and resume; in addition they also take part in a formal interview. These workers provide valuable daily support to the Certified Athletic Trainers with regards to practice/game preparations. We also continue to provide educational opportunities for senior students (Athletic Trainer interns) from accredited programs within the State of Maine, to come on campus and work under the direct supervision of the staff certified athletic trainers. We have one AT student intern for the spring semester and two AT students during the fall semester. This opportunity provides each AT student with both valuable “in the field” sports medicine situations and general medical experiences with the practitioners at the health center. These Athletic Trainer student interns also give back to the local medical community by providing a 11 formal sports medicine presentation at the completion of the semester. We also now oversee a strength and conditioning intern. We have entered into formal agreements with Athletic Training Curriculum Programs at the University of Maine Presque Isle, the University of Maine at Orono and the University of Southern Maine to provide Athletic Trainer students. Currently three NESCAC institutions have 6 full time Athletic Trainers. Bowdoin is currently in the process of adding a 6th full time Athletic Trainer position for next academic year. Colby College ranks in the top two, with regards to the overall number of varsity athletic teams (not including Rugby) in NESCAC yet is ranked in the middle with regards to AT staffing. Middlebury: 31 varsity sports, 6 full time ATC’s *Williams: 32 varsity sports, 5 full time & 1 full time ATC temporary *Bowdoin: 31 varsity sports, 5 full time & 2 part time ATC’s *Amherst: 27 varsity sports, 6 full time ATC’s Tufts: 31 varsity sports, 5 full time ATC’s & 3 Part Time ATC’s *Colby: *32 varsity sports, 4 full time ATC’s & 1 full time ATC temporary (Rugby) Bates: 30 varsity sports, 4 full time ATC’s Trinity: 29 varsity sports, 4 full time ATC’s Hamilton: 29 varsity sports, 4 full time ATC’s Conn College: 27 varsity sports, 4 Full time ATC’s Wesleyan: 29 varsity sports, 3 full time ATC’s & 1 full time ATC temporary (no M/W Ice hockey) (No Football) * In addition to servicing 32 Varsity sports, we provide on-field coverage for all Men’s and Women’s Rugby practices and home games for both fall and spring seasons. Bowdoin, Williams, and Amherst are the only other NESCAC schools who provide similar coverage. 12 Garrison-Foster Health Center Colby College Annual Report 2013-14 Caroline M. Mathes, RD, LD CM Mathes Recovery Foods, LLC I have enjoyed another year as the nutrition consultant for the Garrison-Foster Health Center at Colby College. I had 30 referrals this year, slightly less than the 36 I had over the last 2 years . This is down from 59 in the 2010/11 year. The average number of visits per clients continues to be similar. It was 4.2 this year compared to 3.5 in 2012/13, 4.05 in 2011/12 and 4.25 in 2010/11. Some students required as little as 1 appointment but with wt control and eating disorders the number of visits can be 10 or higher. As typically seen, most of my students were female, 26. I saw 4 males. I felt less satisfied with the outcome of my students and its possible this had some influence on my decision to resign. Overall I really enjoyed working with students and the staff . Sharing an office with Lydia Bulduc Marden in general worked out fine. Her office is way too warm and uncomfortable and I missed having the collaboration with Lydia. Maybe that influenced my desire to resign but in reality I'm sure other arrangements could be made if I had the desire to stay. My involvement with the ED team program continued. Four women signed the contract with the ED Team program. One student with binge eating behavior dropped out fairly quickly. A second student with similar issues decreased her involvement. The 2 other women, one with anorexia and the other a new diagnosis of bulimia were challenging and were seen over the entire year. Both would benefit from continued treatment at an eating disorder treatment center which I believe they will pursue. From the nutrition standpoint they were able to stabilize their weight and maintain at a safe/ healthy level but require more work from the counseling aspect. Working with Counseling services continued to be strong but better or more frequent communication would be beneficial. Some changes are needed to clarify expectations and consequences when making a treatment plan for the ED Team program. Again, overall I'm pleased with these interactions but think more energy is needed to make changes and I don't have that desire right now. In reviewing my summary of last year I see the intent to work with the Athletic Dept to address the issue of athletes with eating disorders. I am disappointed with the Athletic Department that they did not appear to feel it a priority to work into their schedules a brief overview of the procedures for eating disorder treatment at Colby. Three of the four students involved in our ED Team program this year were involved with sport teams. One other athlete with bulimic behavior reportedly resolved her behavior so she was not followed in the Program. Fortunately I have enough experience and gumption to communicate with the coaches and I think for these individuals and for the coaches involved, it all worked out. But if this is a growing trend, more could and should be done to educate the coaches on eating disorders and how they are handled at Colby. Dawn Strout and I continue to collaborate to assure we are providing consistent messages to students. Katie Sawyer asked the 2 of us to do a joint presentation for First Year Wellness that was well attended with over 50 students. This was slightly different topics than presented the previous year. Again I thank you for the opportunity to serve the Colby community. As written to you earlier this month I have decided to resign. Although I have mentioned some dissatisfaction in this summary that is not the strongest reason that I am leaving. After 15 years I want to pursue some other projects to help people with wellness and healthy eating. 13 Summary of Statistic for Nutrition Services for 2013-14 Number of students: 30 Total number of visits: 133 Average number of visits per student: 4.2 Number of Females: 26 Males: 4 Athletes: 7 Women's Basketball:2 Women's Crew: 1 Women's lacrosse: 1 Women's Track: 2 Women's Swim: 1 Nutrition Concerns: These are concerns identified and discussed with students. Several students have multiple concerns hence the numbers are much higher than the 36 students seen. Anorexia Nervosa/wt gain: 3 Bulimia: 1 EDNOS (binge) : 1 Body Image/Wt control: 2 Wt Control/loss: 16 Low BMI/Wt gain: 2 unexplained wt loss: 1 WT Control/ gain: 4 Healthy Eating: 23 Vegetarian: 5 Anemia/Iron: 3 Gluten: 5 Lactose: 1 Cholesterol: 2 Sport Nutrition: 6 14 Garrison-Foster Health Center Colby College Annual Report 2013-2014 Summary of Colby Emergency Response Operations Mark Broadwin, EMT-B, Chief of Service During the 2013-2014 academic year, Colby Emergency Response (CER) responded to 125 emergency calls on campus. After the corps of officers and the Medical Director evaluated each call, it was determined that the availability of trained, professional student-rescuers on campus was, and will continue to be an invaluable resource. Transport Breakdown: CER Pt. Transported by Delta Ambulance: 29.6%, CER Pt. Transported by Security/CER: 34.4% CER Pt. Medically Cleared or Refused Transport: 12.8%, CER No Patient Treatment: 22.4% The variety of calls to which CER responded continued to increase in the 13-14 academic year. Specifically we noted an increased number of first year students sent to the ED in the first weekends of the scholastic year when compared with the 12-13 academic year. We have noted a decrease in the number of Delta transports due to alcohol while the overall amount of transports especially those done by security transport have increased. We believe that this is largely possible due to the relationship developed with both Delta Ambulance and Colby Security that has continued to strengthen throughout the academic year. It should be noted that this year CER rescuers consistently provided care that met or exceeded standards set by Maine EMS. Training CER continued its formal monthly CEH classes that were in large part taught this year by former CER chief of service John Lewis. Weekly informal trainings where held as they have been in the past. However, unlike previous years the scenarios have been formalized as an effort to train in a more realistic manner. Our officers coordinated the third annual Greater Maine Collegiate EMS Conference, which brought in peer institutions and regional and national experts on EMS. CER also attended the National Collegiate EMS conference and the Dartmouth EMS conference, where we confirmed that CER provides the gold standard in care as well as sought out new ways to further improve our organization. Furthermore, the officer promotion and general rescuer orientation programs were initiated and solidified, leading to a higher level of accountability between command officers and general rescuers. Other Ventures CER operated over first year orientation for the second time, and provided CPR training for first years and COOT leaders. CER also used this time to assist with assessments of the Athletic teams for MCMI. This help to foster a relationship between CER and the athletic trains as well. Incidents Operations remained largely incident free. Of the incidents reported, none related to patient care, and were related to interactions with students outside of the scope of an emergency call. All incidents were successfully mediated by personnel on scene, the Medical Director or the Dean of Students Office. The largest challenge facing the future of CER is the legal grey area in which we operate. While not being a legal transporting agency as defined by Maine EMS the largest percentage of CER calls result in security transports with the primary patient caregiver as the rescue 1 on duty. While this is a problem CER has faced since its partnership with security it has never been addressed in a 15 satisfactory matter. Right now all parties involved (Delta Ambulance, Thayer ED, Colby Security, and CER) agree this is best option for many of our patient a more formal system would be preferable. As recommended in the past this issue might be resolved if CER were able to obtain a vehicle as demonstrated by similar undergraduate organizations such as Bates, UVAC, or Dartmouth. 16 Garrison-Foster Health Center Colby College Annual Report 2013-2014 Health Care Advisory Com m ittee M atthew Archibald, faculty co-chair The Health Care Advisory Committee at Colby College during the year 2013-204 consisted of the following faculty and students: Paul Berkner, Matthew Archibald (faculty co-chair), Tariq Ahmed, Lisa Arellano, Valerie Dionne, Eric Johnson, Kelly Ling, Mark Broadwin (student co chair), Eric Kim and Kaitlyn O'Connell. The charge of the committee is to serve in an advisory capacity to the Medical Director (Berkner) and the Dean of the College regarding matters related to health services and education on the Colby campus. During the year 2013-2014 the committee addressed a number of issues related to health on the Colby campus. Some of these issues were carried over from the previous year (2012-2013) while others were new to the 2013-2014 session. During the 2013-2014 session the committee compiled information necessary to purchase seven AED devices for installment across campus. The source of funds for purchase and installment remains uncertain. The committee also revised the Patient Bill of Rights and Responsibilities on display at the Garrison-Foster Health Center. Rights and responsibilities include central ideas related to patient privacy, disclosure and confidentiality of information, patient participation in healthcare decision-making and transparency of policies. Two items of ongoing business during the year that will carry over to the 2014-2015 session concern the sexual assault response program and a request for addressing the counseling center's lack of resources. With respect to sexual assault programming at Colby, Emily Schuesterbauer and Dean Paul Johnston attended several committee meetings to talk about the Title IX requirements for reporting of sexual assault incidents and Colby's proactive position with regard to those guidelines. This involves offering training workshops for peer educators in the freshman and sophomore classes. Related programming is under development in the counseling center. It focuses on a peer alcohol intervention program. The committee also discussed ongoing problems the counseling center is experiencing with regard to limited space and lack of a fulltime administrator. The counseling center's resource problems, it is argued, are detrimental to the provision of adequate behavioral health services for Colby students. Both of these items will be under discussion during the 2014-2015 session. New business for 2014-2015 has yet to be undertaken but will entail the health center re accreditation which takes place in the spring of2015. 17 Garrison-Foster Health Center Colby College Annual Report 2013-2014 Health Promotion Submitted by Chairperson: Katie Sawyer, LCPC, LADC, CCS First Year Wellness Seminars As in years past, first year wellness seminars are a graduation requirement. Students complete 4 seminars and also must complete AlcoholEdu. The following seminar options were offered this year: • • • • • • • • • • • • • • • How to Survive the Weekend with River Huston. Four Stages of Drinking with Mike Green Stand Up and Speak Out: Becoming an Active Bystander Against Sexual Violence Mental Health Narratives Behind Happy Faces: Talking about Mental Illness with Ross Szabo From Conflict to Connection: The Fundamentals of Nonviolent Communication with Peggy Smith Am I Enough? A Survival Guide for the Incoming Freshman, with Scott Fried Vagina Monologues Spiritual Wellness: Rest and Reflection Body Talks Got guts?: How to live fully. Project Unbreakable A Healthy Me The Natural High - Take Advantage of Your Neuroplasticity Sex Derobed Partnered Activities Significant advances were made in creating valuable health promotion partnerships with other campus departments. The following are highlights from a successful year: • • • • Seven print media campaigns about safe drinking were executed in conjunction with Campus Life and AEATAG Athletics, the Dean of Faculty’s Office, and the Dean of Students’ Office distributed talking points for safe drinking conversations between faculty/staff and students on 3 weekends that are known to involve high-risk drinking. Katie Sawyer was invited to speak to three athletic teams, a Sociology Jan Plan course, and the Community Advisors about alcohol and marijuana use. Additional collaborations for workshops, funding, and idea generation were held with the following departments: Gender and Sexual Diversity, Religious and Spiritual Life, Allecia Reid, PhD and Ed Yeterian, PhD of the Psychology Department, Alumni Relations, Scheduling, Media Resources, Information Technology, and the Registrar’s Office. SHOC See separate SHOC report. 18 Garrison-Foster Health Center Colby College Annual Report 2013-2014 Student Health On Campus (SHOC) My Phuong Tong, Co-President Sydney Hammond, Co-President This past semester, SHOC organized a variety of events to ensure that Colby students are holistically healthy and to continue to become more of a presence on campus. Members included: co-presidents My Phuong Tong (’14) and Sydney Hammond (’14), treasurer Ai Phuong Tong (’15), secretary Ginger Brooker (’14), Ines Castro (’14), Daniel Forsman (’14), Vincent Galea (’15), Anna Rabasco (’15), Karen Chen (’15), Megan MacKenzie (’15), Anna Doyle (’15), Anna Spencer (’16), and Emma Clay (J ’16). Ai Phuong and Ginger were copresidents of Active Minds and they went to SHOC meetings in order to collaborate with the group on their events. Katie Sawyer, Jing Ye, and Lydia Bolduc-Marden all supported SHOC as advisors and supervisors. SHOC members helped to plan events, swipe at wellness seminars, table, promote events, and attend event put on by SHOC. This year, SHOC stopped writing for the Colby Echo in order to focus on health-themed weeks and events. Themed Weeks/Events: Alcohol Awareness Week • Monday Oct 21: Perceived norms in Pulver 10 am - 4 pm How much do you drink? How much do other students drink? Stop by our table in Pulver and help us get a conversation started. • Tuesday Oct 22: 7 PM: Mike Green talk, Lorimer Chapel. 9 PM: Alcohol Trivia in the Pub. (All ages welcome, 21+ bring ID) • Wednesday Oct 23: Red Solo Cup Day! 10 AM - 4PM: Stop by our table in Pulver to decorate a solo cup with your thoughts about alcohol/substance use at Colby. Red Solo Cup Campaign: A visual campaign that offers students a chance to engage in a discourse about why you choose to drink responsibly. Tabling in the SPA on October 23, 10am-4pm 4 PM: Jaws of Life Demonstration in Marylow lot. A visual demonstration of the tragic effects of drunk driving. Jaws of Life demo offered by the Waterville Fire Department held in Foss Parking lot on October 2 Thursday Oct 24: 12-4 PM: Mocktails in Pulver! Stop by our table and try a delicious alcohol-free beverage! 9 PM: Join residents of East for some tea at their weekly ThirsTEA Thursday. Mental Health Awareness Week Monday, Nov 11 10 AM - 2 PM: ULifeline Self Evaluator - Pulver 12 - 1 PM: Meet the Colby Counselors - Pulver 19 Mental Health Narratives – November 11, 7pm – 8pm, in Ostrove Auditorium Tuesday, Nov 12 10 AM - 2 PM: ULifeline Self Evaluator - Pulver 3:30 - 5 PM: Learning Differences Fair – Pugh 7pm-8pm, Ostrove Auditorium—Behind Happy Faces: Talking about Mental Illness – Ross Szabo Wednesday, Nov 13 10 AM - 4 PM: Pulver Mindful Munchies - snack on some brain food Awareness Campaign - take a photo and take a stand against stigma Cards - to tell friends that you care about them! Thursday, Nov 14 10 AM - 4 PM: Mindful Munchies, Awareness Campaign, & Care Cards - Pulver Spring Break Bags — March 20, 10am-3pm, SPA tabling Colby students were offered free goodie bags to encourage staying protected this spring break. They contained condoms, Emergen-C, chapstick, Band-Aids, Wet Wipes, and safe sex information. Love Your Body Week – February 24-28 Body Mapping: The goal was to get people to mark and acknowledge the parts of their body that they have a good or bad relationship with. Shred Your Negativity: We allowed people to write whatever they want then put it through the shredder. White Board Pictures: Took pictures with people holding signs saying “My best feature is…” Mindful Munchies: We made regular, vegan, and gluten-free bags containing good snack foods! Natural High Week – April 7-11, co-sponsored with Active Minds The Natural High - Take Advantage of Your Neuroplasticity — Tuesday April 8 7pm-8pm, in Ostrove Auditorium o Anne Uecker, a Pediatric Neuropsychologist from MaineGeneral Medical Center, and our very own Melissa Glenn, Professor of Psychology, presented on increasing brain plasticity using the "natural high". SEXPO — April 24, 12pm-5pm, Lo Po The goal of this event is to educate students about safe sex and to celebrate healthy sex habits. SHOC hired a sex educator to host a discussion table. A fun variety of higher quality condoms were displayed next to Bedsider's information about different methods of birth control. Health Center staff were stationed nearby to administer free HIV/STD testing for all students. SHOC provided complimentary flowers to promote dating and little acts of kindness on campus. There was a "Decorate Your Boobies" booth where participants could decorate boobie cookies to encourage students to feel comfortable with their body parts. In addition, there was an aphrodisiac booth where students sampled foods that are considered natural aphrodisiacs, such as almonds, avocado, chocolate truffles, honey sticks, and pomegranate juice. Several other on campus and community organizations tables to provide a mix of messaging about healthy sexuality. 20 Stressbusters Fair — December 5, 1pm-4pm, and May 7, 1pm-5pm in Pulver • • • • Massages offered by 7 certified masseuses. Wood chopping to release physical tension Yoga and mediation sessions Mindful Munchies; healthy study snacks Sex Narratives (Sex Derobed) — April 9 8pm – 9pm, in Ostrove Auditorium Sponsored by SHOC, students read anonymous narratives about sex, social norms, and relationships, all submitted by current Colby students. First Year Seminars SHOC students staffed 13 First Year Wellness Seminars. Alcohol Pledges AEATAG has started a new initiative called "Student Pledge." The idea is to set a goal for yourself on Friday for the weekend. (Drink healthfully, get enough sleep, get all your work done, go to meditation class, etc.) People who pledge get an email on Monday morning reminding them of the pledge so they can see how they did. SHOC reps tabled in Pulver today most Fridays during the first semester, but also encouraged students to do it independently at any time on myColby. Healthy Relationships Dialogue 7pm-8pm, October 30 in the Pugh Center Gender and Sexual Diversity Program staff members and SHOC members facilitated a Healthy Relationships Community Dialogue. This is an opportunity to discuss strategies for ensuring that our campus fosters healthy intimate partner relationships--regardless of gender and/or sexual identity. Bedsider Representatives: This year two of our SHOC members became campus representatives for Bedsider.com a sex positive organization that aims to educate the general public on contraceptive methods and their success rates. 21 Garrison-Foster Health Center Colby College 2014 Health Education Needs Assessment Submitted by: Katie Sawyer, LCPC, LADC, CCS Purpose The Health Education program at Colby College is designed to provide physical, emotional, and spiritual wellness education to students 18-22 years old in the midst of a private, academically rigorous liberal arts experience. These students are faced with developmental challenges, transition challenges, and endless opportunity for growth. The guidance provided through Advising Deans, the Garrison-Foster Health Center, Counseling Services, Campus Life, and various student groups is supplemented through the work of the Health Education program. Data Information regarding the current state of student wellness at Colby has been gathered from the sources listed below. GFHC Utilization 2013-2014 1600 1400 1200 1413 1000 800 600 Students receiving services 400 200 0 68 Sick or Preventative Attended 1 or more Care AOD counseling session 52 ER Transport for AOD 22 2012 NESCAC Survey Data 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 80% 63% 32% 29% Colby students 12% Drink occasionally or often 6+ drinks Have gotten during behind in greatest school work drinking event due to in last 2 weeks drinking Had an Marijuana use unwanted in last 30 days sexual experience due to own drinking GFHC Testing 2013-2014 180 160 140 156 149 120 100 80 60 40 39 20 0 STI Tests Pregnancy Tests HIV Tests 23 Colby Security Report 2013 9 8 8 7 6 5 Reported events 4 3 2 1 0 Forcible Sex Offenses Counseling Services Utilization 2013-2014 45.00% 40.00% 41% 35.00% 30.00% 25.00% 20.00% 15.00% 19.10% 10.00% 5.00% 0.00% Colby Students Receiving Individual Class of 2014, Sometime During Colby Career Counseling (of total population), 2013-2014 24 Counseling Services: Most Common Presenting Concerns 20132014 60.00% 50.00% 55.50% 40.00% 34.50% 30.00% 32.80% 32.80% Adjustment Concerns Body Image/Eating Concerns 20.00% 29.40% 10.00% 0.00% Anxiety/Stress Depression/Mood (Unipolar) Relationship Concerns Interpretation As in most college communities, Colby students cope with challenges to their sexual, physical and mental health; body image and relationships; and the consequences of decisions made. They confront sexual violence and substance use in self and others. Last year, 79% of students accessed services through the Garrison Foster Health Center and 19.1% engaged in Counseling Services. For the many students that seek help, many more never make their need known. Colby’s health education plan must provide enough information to students so that they can manage lower level need proactively and know the warning signs and available resources if need should escalate. Plan Practical information on health issues and resources must be disseminated to all students throughout their Colby career. Our Health Education program will provide this information via the Wellness Requirement, Student Health on Campus (SHOC) programs, outreach by staff, collaboration with Wellness theme housing, and media campaigns. At minimum, the following topics will be addressed: Common Physical Wellness Issues Sexual Health Sexual Violence Prevention Mental Health Concerns, particularly anxiety, stress reduction, mood, adjustment, body image/eating, and relationships Alcohol and Drug Harm Reduction 25 Garrison-Foster Health Center Colby College Annual Report 2013-2014 Quality and Risk Management Committee Submitted by Chairperson: Katie Sawyer, LCPC, LADC, CCS Current members: Paul Berkner, Tim Weston, Donna Jurdak-Roy, Christina Steeves, Judy Whyte, Katie Sawyer The Quality and Risk Management Committee met 1-3 times per month throughout the 2013-2014 academic year. The primary focus of the committee’s work was a comprehensive review of our Policies and Procedures Manual, in anticipation of our 2015 reaccreditation. Inaccuracies and inefficiencies were addressed, including a restatement of the Patient Bill of Rights and Accountabilities and an update of the fee schedule. The Quality and Risk Management Committee completed the following studies and peer reviews of clinical documentation: • Mono Study: This was a re-visit of a study initially completed in 2012-2013, and sought to further evaluate whether 1) The student is identified at diagnosis as involved in activities that increase risk for splenic rupture; 2) A diagnosis of Infectious Mononucleosis is added at time of infection; and 3) Documentation exists that the AT was notified. All goals were met; no further study indicated. • Pharyngitis Antibiotic Usage Study: This was a re-visit of a study initially completed in 2012-2013, and sought to further evaluate documentation of two or more positive criteria on patients that are deemed clinically “sick” and treated presumptively. This goal was met; no further study indicated. • Concussion Peer Review: This peer review was initially completed in 2009-10, with deficiencies monitored and resolved during the interim years. In 2013-2014, the peer review explored documentation of symptom score at initial encounter, vitals, and communication between providers. Vital sign goal unmet for Athletic Trainers; peer review to be repeated with this group only. • Referral Study: This study was initially completed in 2012 and finalized in 2014 to explore the receipt of return records for students referred to non-GFHC providers. All goals were met; no further study indicated. • Allergic Reaction Protocol Peer Review: This peer review addressed consistency with treatment of moderate to severe symptoms per protocol, an unmet goal from a study completed in 2013. This goal was met; no further study indicated. • Pre- participation Referral Peer Review: This peer review continued to evaluate comprehensive documentation of the pre-participation exams of athletes. The goal to update Social History with appropriate team affiliation was unmet; peer review to be repeated for this goal. • Allergy/Med Summary Update Peer Review (practitioner): This peer review was begun in 2012 to determine documentation of review of allergies and medications among providers. This year, an outside peer review revealed compliance; outside peer review in the fall will confirm these results. • Student Athlete Status/Vitals/Medications/Allergies Peer Review (nurses): This peer review recognized documentation of several key points of information. The goal for documentation of student athlete status was unmet; peer review to be repeated for this goal. • Flu Shot Study: This study established the number of students with self-reported asthma who receive a flu vaccination from GFHC. Data indicates many high risk students may go unvaccinated; study to be repeated after launch of education campaign. 26 • Diarrhea/Abdominal Pain Best Practices Study: This study compared documentation of presenting symptoms and education regarding follow-up as compared to best practice guidelines. Goals to document signs/symptoms of dehydration and for assessment of risk for bacterial or parasitic infection were not met; study of these goals will be repeated. The following educational sessions were completed: • Blood Borne Pathogens – Judy Whyte, RN 8/26/13 • On-Ice Emergency Drill – Tim Weston • Orthopedic Patient Reviews – Dr. Lemos 12/6/13, 5/9/14 • Risk Management – Dan Siff 1/27/14 • Infectious Disease – Dr. Stephen Sears 1/22/14 • FERPA – Jerry Crouter 1/13/14 • Neuro optometry – Dr. Tom Gordon 2/19/14 Evaluation of services: The Garrison-Foster Health Center conducted Fall and Spring satisfaction surveys for both the medical clinic and the Nelson Center. The Nelson Center also distributed surveys in the Winter to capture these athletes. Suggestion boxes are always available. Ongoing medical records reviews are conducted by appropriate supervisory personnel. Any variance in quality noted by a member of the GFHC staff is reported through the electronic health record and reviewed by the Medical Director and the Quality and Risk Management Committee. Results are reported to staff at least once per semester. Accreditation: The GFHC continues to be accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC), and looks forward to a successful survey in the Spring of 2015. 27 Health Center Survey Spring 2014 - 319 patients/74 respondents (23%) 1. I received services from: (check all that apply) Spring 2014 Response Percent Answer Options 72.6% 46.6% 15.1% 16.4% 4.1% 1.4% 2.7% 15.1% Provider (Doctor, Physician Assistant, Nurse Practitioner) Nurse Laboratory Athletic Trainer Massage Therapist Nutritionist Substance Abuse Counselor Psychiatrist answered question skipped question Response Count 53 34 11 12 3 1 2 11 73 1 Fall 2013 Response Percent Response Count 71.8% 35.3% 12.9% 18.8% 1.2% 3.5% 7.1% 5.9% 61 30 11 16 1 3 6 5 85 0 Response Percent Response Count 50.0% 34.5% 8.3% 6.0% 1.2% 42 29 7 5 1 8 84 1 Response Percent Response Count 57.1% 35.7% 1.2% 4.8% 1.2% 48 30 1 4 1 5 84 1 Response Percent Response Count 63.5% 25.9% 2.4% 5.9% 2.4% 54 22 2 5 2 7 85 0 2. The check-in kiosk is easy to use. Response Percent Answer Options Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if you answered Disagree or Strongly Disagree 43.2% 40.5% 10.8% 4.1% 1.4% answered question skipped question Response Count 32 30 8 3 1 8 74 0 3. The office staff is courteous and helpful Answer Options Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if answered Disagree or Strongly Disagree Response Percent 52.7% 47.3% 0.0% 0.0% 0.0% answered question skipped question Response Count 39 35 0 0 0 3 74 0 4. I was seen within 20 minutes of my appointment time. Answer Options Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if answered Disagree or Strongly Disagree Response Percent 48.6% 41.9% 2.7% 5.4% 1.4% answered question skipped question Response Count 36 31 2 4 1 5 74 0 28 5. I felt comfortable with my provider. Answer Options Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if answered Disagree or Strongly Disagree Spring 2014 Response Percent 60.8% 33.8% 4.1% 1.4% 0.0% answered question skipped question Response Count 45 25 3 1 0 2 74 0 Fall 2013 Response Percent Response Count 62.4% 31.8% 3.5% 2.4% 0.0% 53 27 3 2 0 5 85 0 Response Percent Response Count 57.1% 33.3% 4.8% 2.4% 2.4% 48 28 4 2 2 1 84 1 Response Percent Response Count 51.8% 35.3% 8.2% 3.5% 1.2% 44 30 7 3 1 3 85 0 Response Percent Response Count 50.6% 41.0% 4.8% 2.4% 1.2% 42 34 4 2 1 1 83 2 6. I felt that my provider was competent. Answer Options Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if answered Disagree or Strongly Disagree Response Percent 47.3% 43.2% 8.1% 1.4% 0.0% answered question skipped question Response Count 35 32 6 1 0 2 74 0 7. I understood my diagnosis and treatment. Answer Options Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if answered Disagree or Strongly Disagree Response Percent 42.5% 49.3% 6.8% 1.4% 0.0% answered question skipped question Response Count 31 36 5 1 0 2 73 1 8. I felt that my concerns were discussed and my questions were answered. Answer Options Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if answered Disagree or Strongly Disagree Response Percent 45.9% 41.9% 8.1% 4.1% 0.0% answered question skipped question Response Count 34 31 6 3 0 3 74 0 29 9. I received satisfactory follow-up care (if applicable) Spring 2014 Response Percent Answer Options Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if answered Disagree or Strongly Disagree Response Count Strongly Agree Agree No Opinion Disagree Strongly Disagree answered question skipped question Fall 2013 Response Percent Response Count 34.3% 31.3% 34.3% 0.0% 0.0% 23 21 23 0 0 0 72 13 Response Percent Response Count 44.0% 41.7% 11.9% 0.0% 2.4% 37 35 10 0 2 3 84 1 4 67 7 10. My visit to the Health Center met my expectations. Response Percent Answer Options 36.5% 55.4% 4.1% 2.7% 1.4% Strongly Agree Agree No Opinion Disagree Strongly Disagree Please comment if answered Disagree or Strongly Disagree answered question skipped question Response Count 27 41 3 2 1 3 74 0 11. Do you have any other comments regarding your recent visit? Answer Options answered question skipped question Response Count Response Count 9 9 65 9 9 76 12. In an effort to improve the overall quality of your experience we would like your feedback. Please provide either an e-mail address or phone number if you would like us to contact you. Answer Options answered question skipped question Response Count Response Count 2 2 72 2 2 83 13. If you have any further questions or concerns, please make an appointment to speak with Dr. Paul Berkner (ext. 4460) or Jim Terhune, VicePresident of Student Affairs and Dean of Students (ext. 4782). Answer Options answered question skipped question Response Count Response Count 0 0 74 0 0 85 30 Garrison-Foster Health Center Colby College Annual Report 2013-2014 Electronic Health Record Committee Christina Steeves The EHR committee is comprised of one member from each area of the Health Center: Donna Jurdak-Roy - Laboratory Amanda Meyer - Sports Medicine Holly Weidner – Practitioners Robin Shafer – Nursing Christina Steeves – Office Our group met several times each semester to collaborate on projects that are essential in order for the EHR to meet the needs of all end users. Since each area of the Health Center has it’s own unique role and work-flow, it is vital that we work together prior to making even small changes to any of the applications or templates. Since there is not a designated IT person in Health Services to work on projects and provide support to users, it is all the more essential that our committee function as a team. Last summer our EHR vendor upgraded our system. This caused about a dozen issues that we became aware of on start up in the fall. It took a coordinated effort amongst our team to work together and with the vendor to resolve the issues. It really was a true team effort to fix those problems. Over the semester break Robin Shafer and Christina Steeves worked to make improvements in the appearance and function of the EHR. They built several Reason for Visit template sets to help providers with efficiency and patient safety. On the clinical side we continue to work on developing templates to improve documentation for the Practitioners, Nurses, Athletic Trainers, Nutrition Consultant, CER, Psychiatry, and Drug and Alcohol Counseling. Next year we plan to resume work on the template projects. On-line scheduling and building the insurance database are other projects we would like to accomplish. The addition of either staff or special project hours would go a long way to help us attain those goals. 31 Garrison-Foster Health Center Colby College Annual Report 2013-14 Campus Involvement AEATAG Paul Berkner Katie Sawyer Campus Conversations on Race Holly Weidner Campus Safety Committee Paul Berkner CER (Colby Emergency Response), Advisor Paul Berkner Holly Weidner College Advisory Committee Paul Berkner COOT Leader/Hall Staff Orientation Paul Berkner Judy Milliken Katie Sawyer CPR Recertification Instructors Tim Weston Christina Steeves Flu Shot Clinics Helen Balgooyen Robin Shafer Judy Milliken Laura Patterson Goldfarb Advisory Committee Lydia –Bolduc-Marden Health Care Advisory Committee Paul Berkner Jan-Plan – EMT Coordinator Jennifer Riddle Mental Health Task Force Lydia Bolduc-Marden OCS Re-Entry Resource Katie Sawyer Sexual Assault Task Force Lydia Bolduc-Marden Sexual Violence Prevention Advisory Committee Katie Sawyer Sex Fair Donna Jurdak-Roy SHOC (Student Health On Campus) Katie Sawyer Robin Shafer Lydia Bolduc-Marden 32 Stress Busters Fair Laura Patterson Lydia Bolduc-Marden Robin Shafer Wellness Working Group Laura Patterson Wellness House Liaison Katie Sawyer Departmental Involvement: QM Committee Paul Berkner Christina Steeves Tim Weston Katie Sawyer Donna Jurdak-Roy 33
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