Community Acquired Pneumonia

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Student Run Homeless Clinic Orientation
2011-2012
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SRHC History

• Started by UCLA Dept of Family Medicine in 1989
• 22nd year
• Over 10,500 patients seen
• Salvation Army West Los Angeles Transitional
  Housing 1989
• Samoshel 1993
• Winter Shelters 2008
• Society of Student-Run Free Clinics 2009

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The SRHC Mission and Goals

• Mission
• To provide respectful and compassionate high
  quality healthcare services to homeless men,
  women, and children
• Goals
• To provide a Community Service Learning
  opportunity for medical students
• To provide free medical care to a most
  vulnerable population with little or no access to
  health services

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SRHC Objectives

• Assess and develop treatment plans for a
  population with little resources to manage their
  health
• Learn about medical and social issues unique to
  the homeless population
• Develop preventive healthcare interventions for
  vulnerable populations
• Provide hands-on clinical learning opportunities
  for MSI/IIs
• Provide advanced practice and teaching
  opportunities for MSIII/IVs
• Develop interdisciplinary strategies

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The Three Clinics

• Santa Monica Shelter, aka Samoshel year round
• 2nd 4th Saturdays of every month, 9 am-12 pm
• 505 Olympic Blvd Santa Monica, CA 90401
• Winter Shelter Clinics Dec 1-March 15
• West Los Angeles National Guard Armory
• 1300 Federal Avenue, Los Angeles, CA 90025
• Every Monday, 6-9 pm
•  Glendale
• 220 E. Colorado Street, Glendale, CA 91205
• Every other Thursday, 6-9 pm

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Samoshel

• Part of the Ocean Park Community Center-OPCC
  since September 2005 (formerly Salvation Army,
  Step Up on Second)
• Approximately 110 residents
• On-site services
• case management
• counseling
• 12-step meetings
• housing referrals
• employment assistance

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Winter Shelters

• 2 Winter Shelters in the Los Angeles Area
• LAHSA Los Angeles Homeless Services Authority
• EIMAGO subsidiary of Union Rescue Mission
• Dec 1 March 15
• Most destitute of the homeless
• A cot and hot meal for the night
• SRHC will expand number of WS sites THIS YEAR

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Our Role

• The Samoshel clinic focuses on providing free
  health care services
• General physical exams
• Basic primary care treatment
• Preventive health services
• Referrals to appropriate facilities for
  additional testing, imaging, and treatment 

•  

The most common complaints? URI, dermatological
issues, hypertension, asthma Medications
available? Antibiotics, antiHTN, asthma/allergy,
antacids, NSAIDs, topical creams
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SRHC Selective/Elective Requirements
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Selective MSI MSII

• 16 students
• Period of Participation September 2011 - June
  2012
• Fulfills requirements for one selective in either
  the first or the second year

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Selective Requirements

• Orientation Session
• 6 clinics
• Attendance at least 2 noon-lectures
• Attendance at the Mid-Year (January) and end of
  year (May) Reflection Sessions
• All requirements must be completed by June 1, 2012

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Elective MSIII MSIV

• Period of Participation
• MSIII July 2011 - June 2012
• MSIV July 2011 - May 2012
• FP253.03 Provides one week of 200-level credit
  for your fourth year electives

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Elective Requirements

• Essentially 40 hrs of credit
• Orientation Session
• 7 clinics
• 1 Educational Activity
• Present to MSI/IIs on-site - skin infections,
  onychomycosis, alcoholism, diabetes, etc.
• Teach MSI/IIs on-site HP notes, presentation,
  assessment
• Facilitate a smoking cessation session
• Attendance at mid-year (January) and end-of-year
  (May) Reflection Sessions
• Can fulfill MSIV Primary Care College requirement

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Lecture Series (all lectures from 12-1pm)

• Topics
• Dispensary 101
• HP Notes
• Homeless Womens Health
• LGBT
• Dermatologic Issues in the Homeless
• Harm Reduction
• And others

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Scheduling

• If youre in the Selective/Elective sign up on
  the website
• Web sign up http//fm.mednet.ucla.edu/clinic-sign
  up.asp
• Clinics calendar http//fm.mednet.ucla.edu/clini
  c-calendar.asp
• Both components will be transferred to our new
  website at http//fm.mednet.ucla.edu/
• If youre not in the Selective/Elective contact
  Scheduling Chief, Cindy Her, cher11_at_ucla.edu
• Cancellation Policy
• Must cancel by Sunday at midnight the week of
  clinic
• If fail to do so?
• 1st offense WARNING
• 2nd offense extra clinic
• 3rd offense 2 extra clinic sessions review of
  possible failure of Selective

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Old Website
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New Website
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What CAN I do as a Medical Student?
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• Take histories
• Perform physical exams
• Present to attendings
• Write a note co-signed by the
  attending
• Dispense medications under
• supervision of the attending
• Administer flu vaccines
• Grab an older student if you need help

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Role of Clinic Chiefs

• Run the clinics
• Set-up, sign-up, case assignment
• Organize and dispense medications referrals
• Liasons with national organizations and
  conferences
• See patients as necessary

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Social History Note

• To be filled out for each first-time patient
  encounter
• How patients got to be where they are today
• Learn how to ask the tough HEADSS questions

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Intake HP and Progress Note
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Seeing Patients
Flu shots available during flu season
Med Supply Drawers
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Flu Vaccine Video
Click here
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Presenting to the Attending
presentations are fun and full of good
teaching points
Great time to practice presentations in a LOW
STRESS environment.
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Wanna be a Chief?

• You can become a Clinic Chief in your 2nd, 3rd,
  or 4th year
• Student-run clinic leadership
• 12 diverse chief positions
• One week of 100-level credit OR one week of
  200-level credit for MSIVs
• New Chiefs usually start in April
• Let us know during the year if youre interested
  in becoming a Chief!

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Chief Positions

• Number can vary from year to year
• Applications due mid-Feb
• Additional week of Elective credit
• Positions
• Administrative
• Supplies (2)
• Education
• Scheduling
• Development
• Winter Shelters (4)
• Samoshel (2)

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Other Plans

• National Conference of Society of Student-Run
  Free Clinics 2012
• Long Beach, CA
• February 4, 2012
• Inter-disciplinary connections School of
  Nursing, Physical Therapy programs, UCLA
  Volunteer Center, Sports Teams, Dental..
• Fundraising events
• Supply collections clothing, hygiene, soaps,
  socks, shoes

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Questions?

• OUR WEBSITE
• http//fm.mednet.ucla.edu/
• (Find it under Training ? Medical Student ?
  Homeless Clinics)
• IMPORTANT CONTACTS
• Mary Marfisee, MD, MPH (Program Director)
• mmarfisee_at_mednet.ucla.edu
• Gideon R. Gorit (Administrative Chief)
• ggorit_at_mednet.ucla.edu
• Alexa Merz (Education Chief)
• amerz_at_mednet.ucla.edu
• Cindy Her (Scheduling Chief)
• cher11_at_ucla.edu