The Problem: New York Health and Hospitals Corporation (NYCHHC) had an overwhelming influx of patients under investigation (PUIs) for COVID-19. Although they were able to test all outpatient PUIs, thousands of patients needed to be called for their test results.
Our Approach: A group of six student leaders were assigned to lead this project and collaborate with NYCHHC headquarters. The project leaders recruited students interested in remote volunteering to call patients with their test results. The leaders developed a sample script, Smart Phrase for Epic, and other informational materials to train students on how to make these calls. All participants were also required to join a training and Q&A teleconference with a supervising attending at NYCHHC prior to making calls. Students would call patients using *67 to mask their personal phone numbers. Each student would confirm the identity of the patient, then inform the patient of their COVID-19 test result. All patients would be screened for current symptoms, regardless of result. They were generally instructed to take precautions by staying in self-quarantine for 72 hours after becoming afebrile or 7 days after symptoms started, whichever was longer. If a patient appeared to be significantly symptomatic (e.g. shortness of breath significant enough to have difficulty speaking on the phone), the student was instructed to call the supervising attending and merge the calls. The supervising attending would then provide additional phone triage and escalate as necessary. All calls were documented in Epic using a standardized Smart Phrase. If interpreter use was required, students used the pre-existing commercial interpreter line and documented the interpreter license number in the documentation. Notes were co-signed to the supervising attending.
The general process for soliciting volunteers was as follows:
- Administrative Request. A centralized request form is submitted by the clinical team (i.e. faculty or administrator) with a description of the task, the estimated number of hours, and the estimated number of students requested.
- Vetting. The request is received by the Office of Student Affairs, which reviews the request and decides whether it is appropriate for student volunteering based on a number of factors, including usefulness, risks to students, and clinical expertise required. Those opportunities that are deemed inappropriate are sent back to requester.
- Triage. The Office of Student Affairs determines the level of clinical expertise needed to staff the request - e.g., whether MS2s or MS3s with clinical rotation experience are needed, vs. MS1s. The request is then forwarded to Clinical Support Liaison on the student level.
- Student Assignment. Based on the type of work requested, the Clinical Support Liaison assigns the task to one of several Task Forces responsible for coordinating all clinical requests related to a certain domain (e.g. Workplace Safety, Remote Clinical Work, etc.).
- Recruitment. Each Task Force leader recruits volunteers and ensures position requests are filled.
- Participants: Negative result calls were assigned to MS1 and MS2 students. Positive result calls were assigned to MS3 and MS4 students.
This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial license.