2019-20 Annual Report – Health Services

Mission

To improve the health and wellness of the university community by providing inclusive, evidence-based, quality health care and wellness promotion.

Summary Narrative

1) Enhance recruitment and retention efforts to increase enrollment

  • Health Services staff manned a resource table at all fall and spring orientation sessions. Handouts on services provided in the clinic, meningococcal disease and ACWY & Men B vaccines, and pregnancy prevention were distributed. In addition, free promotional products were given to all who visited the table.
  • Health Services staff manned a resource table at “Discover Days,” a recruitment event held for prospective UA Little Rock students. Handouts on services offered in the clinic and free promotional products were distributed. 
  • Health Services staff assisted the Office of Admissions during the busy weeks before classes by directing students to appropriate areas for advising, enrollment, and/or financial aid, and helping them log in to BOSS.
  • The Health Services APRN created a video for use in fall virtual orientation sessions. The video introduced all staff members and included information on services provided in the clinic, how to contact Health Services, and how to make an appointment. It also discussed meningococcal disease and the American College Health Association’s recommendation that those living in residence halls be immunized with both the ACWY & Men B meningococcal vaccine. In addition, specific recommendations relating to COVID- 19 were discussed, i.e. wash your hands, wear a mask, and social distance.

Health Services Orientation Video   

Strengthen student-friendly operations and customer service

  • Health Services is dedicated to providing high quality, easily accessible medical care to the campus community. Our providers are committed to evidence-based, patient-centered care which helps contribute to the success and overall well-being of UA Little Rock students. Services offered in the clinic include assessment and treatment of illnesses; physicals; immunizations; family planning, including birth control; and screening and treatment for many other health issues affecting the college-aged population.

“…they have made me feel so comfortable that I can confide in them about my uncertainties and they not only help me find the right answers, but are able to calm down my worries before I leave. Amazing staff!”

  • When the COVID-19 pandemic forced UA Little Rock to go to all on-line classes (leaving very few students on campus), Health Services quickly converted to HIPAA compliant telemedicine visits. These visits provided students with the ease and simplicity of picking up their device, logging in, and video-chatting with a health- care provider, and familiar face, from Health Services. Because responses to this method of medical care were very positive, Health Services will continue offering telemed visits as a routine option.
  • In response to suggestions from the Health Services Patient Satisfaction Survey, two new desktop computers were purchased for the self-check-in stations. Although the front size had been increased on the laptops previously used for self-check-in, students still felt it was too small and difficult to read. In addition, card scanners were purchased so students can now scan their UA Little Rock ID card to check-in versus typing in their name and T#.

Improve diversity and inclusion efforts to provide a safe and inclusive environment for students

  • In observance of LGBT History Month, Health Services collaborated with the Alliance and offered a viewing of the movie, “The Lavender Scare.” This documentary shed a valuable spotlight on the U.S. government’s shameful history of anti-gay discrimination. The film covered President Dwight D. Eisenhower’s vow during the Cold War to rid the government of all gay and lesbian employees under the assumption that they were a “security risk” to the United States. Due to another event on campus, attendance was minimal. 

Align financial and human resources to operate more effectively and efficiently

  • Health Services collaborated with the Department of Nursing to administer 1,020 flu vaccines to the campus community. This collaboration allowed nursing students, under the supervision of nursing faculty, the unique opportunity of experiencing hands-on learning by administering the vaccines.
  • Health Services staff collaborated with Human Resources and the UA System Office to provide annual wellness visits to employees with UMR health insurance. For employees to receive a reduction in their out-of-pocket expenses (deductible and coinsurance) during the coming year, a preventative wellness visit was required. Health Services provided wellness visits to 51 employees and generated $5,800 in revenue for the clinic.
  • The director and assistant director developed and submitted  a business proposal which would help ensure the clinic’s financial stability and compliance with insurance billing regulations. If approved, the new guidelines will take effect fall 2020. 
  • Health Services surveyed all employees with UMR health insurance asking if they would utilize Health Services for the healthcare needs of their dependents ages 13+. Responses were favorable, therefore, a request to offer this service was included in the new business proposal. If approved, Health Services can begin seeing dependents in fall 2020.

Promote student development, engagement, and leadership

  • Fifteen (15) nursing students spent a day each shadowing the RN and APRNs in Health Services. Shadowing allowed the nursing students to observe interactions between the provider and patient and learn about communication and teamwork. In addition, the students were able to observe various medical procedures conducted during the visit.
  • Students presenting to Health Services were asked about their involvement on campus. Those indicating they were not involved were given a card with a unique website that linked to the UA Little Rock Student Experience Center’s involvement opportunities page. 
  • Campus Well/Student Health 101, an online magazine filled with information to support students’ health and well-being, was distributed via email to all students. The link also was available on the Health Services website. The following question was asked in each issue: “Have you read at least one thing in Student Health 101 that you will apply to everyday life or that caused you to get involved?” Following are some of the answers to that question:
    • I spoke to my roommates about personal space & we learned a lot from it.
    • Being in my last semester of nursing school has me stressed most days, but I am going to take the time to meditate and set aside time for my mental wellness.
    • I have started to get involved in the opioid epidemic by talking to other students who I can see need help.
    • I’ll speak to a campus counselor more often to get help with my problems.
    • I will now think of more ways to get exercise around campus.
  • Arkansas Act 943 directs colleges and universities to develop and implement action plans to help students prevent unplanned pregnancy or delay plans for pregnancy. In fall 2019, in compliance with this act, Health Services partnered with Campus Living to place 4 x 6 cards outlining service offerings on all desks in all rooms of the residence halls.
  • During this reporting period, 216 female students were seen in Health Services for contraceptive care visits. Thirty eight (38) of those were for initial birth control prescriptions. Depo-Provera, a contraceptive injection, was the most provided method with 65 injections being administered. Oral contraceptive pills came in 2nd with 44 prescriptions written. In addition to visits for first time prescriptions,74 students utilized Health Services for the management of their current birth control prescriptions and 104 students were seen for general consultation and advice on choosing a birth control method.
  • Health Services staff participated in Trojan Wars, a multi-department event designed to educate students about safe sex (including STIs, HIV, and unplanned pregnancy prevention).

“Everyone on the Health Services team is a VIP. Thanks for keeping our campus as medically safe & informed as it can be!”

Other

  • Following NCAA guidance, Health Services APRNs conducted heart and lung physicals for 25 new athletes to ensure they didn’t have any pre-existing medical conditions that might worsen by participating in sports. Sickle cell screenings were also required during each visit per NCAA regulations. 
  • Health Services collaborated with the Intensive English Language Program (IELP) and the Office of  International Student Services to ensure all foreign-born students were screened for tuberculosis per Arkansas state law. A total of 79 students from 28 different countries were screened for TB. No active cases were identified.
  • Health Services responded to a request from the Arkansas Department of Education, Division of Higher Education, and the AR Foundation for Medical Care (AFMC) to survey students regarding their access to contraceptives in Arkansas. The pre-printed survey was distributed to patients upon arriving in the clinic and also was available on the Health Services website. The website survey results were routed directly to AFMC. A total of 47 paper surveys were collected in the clinic and then scanned to AFMC. 
  • Health Services presented a program in West Hall entitled “Men’s Sexual Health.” Topics included the importance of safe sex, how STDs are transmitted, and how to make an appointment in Health Services for STD screening. Free condoms were distributed and the game, “high risk, low risk, no risk,” was played. Each student got a chance to spin the wheel and based on the action the wheel landed on, the student had to determine if it was high risk, low risk, or no risk for transmitting an STD. A total of 14 male students participated and completed an anonymous survey. Below are the results of that survey:
    • 56% were sexually active
    • 67% used protection such as condoms
    • 44% knew Health Services offered STD screening
    • 33% knew Health Services could provide STD treatment
  • Health Services staff participated in the Growing Healthy Communities Fair hosted by UA Little Rock’s School of Counseling, Human Performance, and Rehabilitation. Staff provided blood pressure checks, blood glucose tests, and education on high blood pressure and diabetes to members of the University District.
  • Health Services staff participated in the Self-Care Fair hosted by Counseling Services. The APRN partnered with the President of the Student Nurses Association to promote the importance of immunizations and was able to look up students’ immunization records on site. In addition, staff took blood pressure readings and helped raise awareness of services available at UA Little Rock. 
  • Health Services surveyed campus employees via facfocus and staffocus listservs to inquire about their interest in high-dose flu vaccines for those 65 years of age and over. Ten (10) employees responded they were interested and were able to receive a high-dose flu vaccine in Health Services.
  • Registered nurses from Health Services manned a resource table at the HR Benefits Fair. Employees were given information on the upcoming flu shot clinic and how to schedule their annual UMR wellness visit in Health Services.  

“My sincere thanks to Health Services for the free hand sanitizer at the Benefits Fair today. That was a great idea!”

  • Health Services staff spoke to 244 PEAW students about physical fitness strategies. Over half of the attendees completed a survey asking what they learned from the presentation. Following are some of the comments from the survey:
    • Both physical health and mental health are very important.
    • I learned that I need to do more strength training instead of just cardio.
    • If you are trying to lose weight and get in shape, exercising and a healthy diet both are important.
    • I learned that I should watch what I eat more carefully because of how much work is required to burn off the excess calories.
    • That not eating isn’t the way to lose fat.
    • Fad diets are far more harmful for your health than eating proportionately within the food triangle.
    • How to portion out my food.
  • Health Services worked with staff from West Hall to present “drunken” Mario Kart. Students first played while wearing “drunk goggles” and then without the goggles to demonstrate the negative effects of alcohol and how it impairs one’s ability to drive. A total of 20 students participated and completed an anonymous survey at the end of the program. Following are the results from the survey:
    • 88% had ridden in a car driven by someone (including themselves) who was “high” from alcohol or other drug use.
    • 75% used alcohol or other drugs to relax, feel better about themselves, or fit in
    • 44% used alcohol or drugs when they were alone.
    • 13% had been told by family or friends that they  should cut down on their drinking or other drug use.
    • 25% had gotten in trouble while using alcohol or other drugs.
  • In response to the growing need for education, awareness, and training around opioids and opioid safety, the assistant director worked with Little Rock MEMS to provide an on-campus Narcan training program for Health Services staff. All healthcare providers and the assistant director attended.
  • Health Services staff attended an in-service training session presented by the Department of Public Safety on the Clery Act and UA Little Rock’s crime reporting procedures.
  • The assistant director and APRN completed 4 coronavirus training modules within the Department of Human Resources on-line SafeColleges Training program. 
  1. Coronavirus: Transitioning to a Remote Workforce
  2. Coronavirus: Managing Stress & Anxiety
  3. Coronavirus Awareness
  4. Coronavirus: Cleaning and Disinfecting your Workplace
  • The APRN completed a COVID-19 Contract Tracing course offered by Johns Hopkins University.

At A Glance

Revenue Generated: $125,190. This is a 9.55% decrease from FY 18/19. Considering, however, that COVID-19 essentially closed the clinic doors for a quarter of the year, a decrease was inevitable. 

Total Clinic Visits: 5,016

“My provider took special care to make sure my other health needs were attended to beyond just what I made the appointment for.”

  • A patient satisfaction survey was sent monthly to all patients who had visited Health Services during the previous month. Feedback was used to review processes and make adjustments as needed.  
  • One question on the Patient Satisfaction Survey asked, “During your visit with the provider, what health strategies did you learn that will help with your overall wellness?” Following are some of the responses to that question:
    • We talked about creating a diary to monitor my blood pressure readings following a change in medication.This was very useful. 
    • How to perform a breast self-exam.
    • I received wound care suggestions that improved my healing and pain within 2 days!
    • I learned how the flu vaccine is effective, even if I get the flu!
    • To eat more fruits and vegetables and get adequate rest.
    • To practice safe sex.
    • I learned about the side effects of different types of birth control.
    • To drink more water 
    • To watch my caffeine intake and improve my relaxation habits.
    • To watch the expiration date on my inhaler.
    • I learned that some medicines may make symptoms worse if I Juul, so I quit smoking!
    • To exercise.
    • I learned I should wash my hands more often or use hand sanitizer.

Demographics of Survey Participants

Assessment 1

Type of assessment (learning outcome or operational)

Operational

Goal

Help students learn about and join registered student organizations

Activity or experience being assessed

Students who stated they were not currently involved in campus activities or organizations were given a card that included a Health Services specific link (ualr.at/trojanorgs) to the UA Little Rock Student Experience Center’s involvement opportunities web page. By visiting this page, students could learn about campus involvement opportunities.

Assessment artifacts

Two sources of data were collected to assess this endeavor: 1) a question on the HS Patient Satisfaction Survey – Did information provided by Health Services lead you to consider joining or actually joining a student organization or club, and 2) the number of individual hits from the HS specific link.

Time period assessment was done

 7/1/2019-6/30/2020

Results

Results from the Patient Satisfaction Survey indicated only 11 students responded “yes,” receiving the card did lead them to consider joining or actually joining a student organization or group. There were a total of hits to the site as a result of us providing them cards.

Continuous improvement process

Due to the very low rate of engagement from students, Health Services will discontinue distributing the card during appointments.

WHEN: Immediately

Stateholder involvement / Communication plan

HS staff will be informed of this change.

Assessment 2

Type of assessment (learning outcome or operational)

SLO Personal Wellness 3B

Goal

Determine if programs offered through the Campus Wellness Center effective at increasing students’ knowledge of health-related issues that impact college-aged individuals, i.e. how risky behaviors affect overall health.

Activity or experience being assessed

At least 5 programs/events were to be offered throughout the year which focused on physical well-being and risky behaviors.

Assessment artifacts

Pre- and post-tests

Time period assessment was done

9/15/2019 and on-going

Results

The Campus Wellness Coordinator and extra labor employee in charge of planning and implementing these programs left in December 2019. Three (3) student events focusing on physical well-being and risky behaviors were presented before their departure, however, pre- and post-tests were not offered. This assessment was not completed.

Assessment 3

Type of assessment (learning outcome or operational)

Operational

Goal

Determine the viability of Health Services to offer healthcare visits for dependents (ages 13+) of employees with UMR

Activity or experience being assessed

Human Resources emailed employees with UMR insurance about their interest in utilizing Health Services for their dependents’ (ages 13+) medical care. The established threshold for moving forward with proposing this new service was 2% of employees surveyed responding positively. At the time of the survey, there were 1,107 employees enrolled in the UMR health plan. 2% = 22. 

Assessment artifacts

Electronic survey

Time period assessment was done

9/1 – 10/1/2019

Results

Over 2% of the employees responded favorably.

Continuous improvement process

Health Services submitted a new business proposal for the clinic which includes a plan for offering services to UMR dependents (ages 13+) beginning fall 2020. If the business proposal is approved by Cabinet, Health Services will begin offering medical services to UMR dependents.

WHEN: 10/1/2020

Stateholder involvement / Communication plan

Employees with UMR, their dependents, Health Services staff. Health Services will script an email that HR can send to all employees with UMR announcing this new service.

Assessment 4

Type of assessment (learning outcome or operational)

SLO Personal Wellness 3B

Goal

For students who seek care through Health Services to learn strategies to better manage their physical well-being.

Activity or experience being assessed

A Patient Satisfaction Survey was emailed to all patients seen in HS during the previous month from their visit. Their answers to the question “During your visit with the provider, what did you learn that will help with your overall health?” were recorded. 

Assessment artifacts

Survey

Time period assessment was done

August 20, 2019 and ongoing

Results

Results indicated that providers were delivering appropriate wellness education. Patients reported learning a wide-variety of health strategies that would help in their overall well-being. Common strategies included sexual wellness/safe sex, birth control methods, exercise, healthy eating, staying hydrated, and the importance of vaccines.

Continuous improvement process

This data will continue to be evaluated to determine if all relevant wellness-related topics are being covered as needed.

WHEN:

Stateholder involvement / Communication plan

Responses were shared with the Assistant Director of Health Services, the individual provider who saw the patient, and some comments were included in this report.