By: Camille R. Murray
Interprofessional education is crucial in healthcare as it equips providers with the necessary skills and knowledge to collaborate across disciplines for better patient care. Atlanta Interprofessional Student Hotspotting (AISH) is an example of an applied interprofessional education program that provides students with an opportunity to work with complex patients who require intervention across multiple social and medical domains.
AISH is student-run and leverages the skillsets of students from pharmacy, medical, nursing, business, public health, and mental health counseling programs to provide patient support and address the complex social determinants of health. Housing, food access, and transportation are some of the primary areas where the patients we work with require support. AISH has been operational since 2017 and is based out of Grady Memorial Hospital, Atlanta’s public, safety-net hospital. Students work in institutionally and interprofessionally diverse teams to provide patient support via a nine-month partnership. While students do not provide direct patient care, they act in roles similar to community health workers or even family members who might connect patients to resources, empower them to self-advocate in healthcare settings, and support them in other ways through their health journeys. AISH’s goal is to achieve the Triple Aim objectives: improve patient care, improve the health of populations, and reduce the per capita cost of healthcare.1
Although there is limited data on the effectiveness of hotspotting programs, the evaluation of Camden Coalition Healthcare Providers (the group that spearheaded the concept of “hotspotting”) focused solely on the effect of the program on patient outcomes.2 We sought to fill this gap by conducting an evaluation of skill-building among student hotspotters in AISH via a partnership with students in the BSHES 530: Program Evaluation course. In 1-on-1 interviews with AISH student hotspotters from the 2022-23 cohort, we observed broader themes of developing and applying skills in the 4 Interprofessional Education Collaborative (IPEC) Core Competencies3 and gaining skills or knowledge that was not covered the students formal program curricula.
One student described how the process of connecting patients to existing resources equipped them with practical resource-gathering skills that were not covered in their program’s curriculum.
| “I think the biggest skill that I’ve gained from AISH, amongst the others, but the biggest one was resource gathering…it wasn’t really included in my formal training, the gathering of resources, but working with AISH, that was a major component of it. Because that’s kind of what we were doing for our patients. We’re gathering resources and distributing them.” |
Two other students expanded on the skills built and reflected on how their experiences in AISH have helped them see the importance of understanding and navigating social systems. One student explained that participating in AISH has fostered humility and an appreciation of the complexity of social systems. They emphasized the need for interprofessional collaboration by highlighting the limitations of individual knowledge and expertise, even among those with advanced education.
| “I think the biggest thing is just how hard it is to navigate social systems. To be honest, I think it’s something you very often read about, and you’re just like, “Oh, there’s all these resources, you know. We have pamphlets, and lists of things that, you know, patients can turn to.” But I think acknowledging….even being very well-educated and being in an advanced degree program…we struggle. And we have a lot of questions…“does this person qualify for this? How do they apply for this? How do they go through this?”…just really getting some humility from that process and learning that the systems are hard, and…it’s while we are helping patients directly it’s kind of like an academic exercise…we’re trying to just figure out, you know, how can we go through this? So I think the humility of that process, I think, has probably been the most impactful.” |
Another student highlighted how AISH has helped them see that healthcare extends far beyond just providing patient care. The student describes how time constraints and complexity of the social determinants of health necessitate interdisciplinary approaches to care which recognize that the challenges that patients face often require a broader range of expertise than they alone are able to provide.
| “…through AISH, like you learn about how much more there is beyond just like a person like showing up to your office and like not taking their minds like it’s a lot of like structural things. And like, it’s a lot more than a doctor can really like handle in like a meeting in like a short appointment time. Um so I’m saying that I want to be more involved than just like providing patient care like I wanna do more as a physician than, just like practice and like I know that that will be like interdisciplinary.” |
Finally, two students recounted how their involvement with AISH has helped them to participate more effectively on interprofessional teams. The first student described how AISH has helped them to gain a deeper understanding of the perspectives of different professionals, a critical component when working on interprofessional teams.
| “I think the other thing is that it’s just kind of helped in terms of thinking about mindsets, or just like different frameworks that different professionals operate in, you know, like, for example, it seems obvious, you know, public health students are usually thinking on a more systems-basis versus nursing are often thinking about, you know, how is this going to be implemented with the patient.” |
A second student discussed how participating in AISH helped them address reservations that they previously had about working with doctors. This highlights the importance of building relationships and understanding between different professionals on interprofessional teams.
| I think my working with AISH has helped me overcome maybe an internal bias that I had against working with physicians. So we work- I’m a nurse, so I’ll be a nurse, and I’m with physicians, people who will be a physician, and they’re just like me, and they’re just people, and they’re very eager to help the patient just like I am and not some of the things that I expected. |
Collectively, these passages suggest that AISH has had a positive impact on students’ ability to work collaboratively and navigate the complex social systems that underpin healthcare. By providing opportunities for students to learn from and collaborate with professionals from different fields, AISH has helped promote a more collaborative approach to healthcare by breaking down barriers and prepare students to be more effective and compassionate healthcare providers.
About the Author: Camille R. Murray, MPH, CHES® is a Former MPH student at Rollins School of Public Health (BSEH) and Co-Lead of Atlanta Student Hotspotting
References:
1.Berwick D, T Nolan & J Whittington. The Triple Aim: Care, health, and cost. Health Aff (Millwood). 2008;27(3):759-69.
2. Finkelstein A, A Zhou, S Taubman, et al. Health care hotspotting—a randomized, controlled trial. N Engl J Med. 2020;382(2):152-162.
3. Interprofessional Education Collaborative. Core competencies for interprofessional collaborative practice: 2016 update. 2016. https://www.ipecollaborative.org/assets/2016-Update.pdf
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Picture source: Atlanta Interprofessional Student Hotspotting