Erie Family Health Centers, Chicago, IL
I decided to become a doctor after taking a human physiology class my junior year in high school. At Williams, I decided to study biology and fell in love with the subject, but quickly found myself disillusioned by medicine. I heard too many stories of stressed out and jaded medical students and found that it was impossible to imagine myself practicing one day. I couldn’t imagine working in a hospital for too many years before truly burning out and private practice seemed contrary to everything I believed medicine should be. I’ve always been concerned with decreasing access, especially in rural areas, so I was unable to wrap my head around the idea of working as a specialist with extremely expensive visits that were difficult to get.
At the beginning of my sophomore fall, I stumbled into the public health concentration and that was my new obsession. It filled all of the holes in medicine for me. It was empathetic and compassionate, contrary to the way medicine felt disconnected and coldly scientific to me. I started to look for public health internships for the summer, and found Erie.
Erie is a truly remarkable organization and I am honored to have had the opportunity to work with them. Erie is a series of thirteen federally qualified health centers (FQHCs) spread out across North and West Chicago which works tirelessly to decrease lingual, legal and financial barriers to healthcare. For example, they serve a large Hispanic population so every single one of their providers are required to learn and conduct visits in Spanish by the end of their first year of employment. They also have round-the-clock translating services for most other languages. They have a limited amount of money, but manage to provide top-notch care for their patients.
This summer, I was working for their compliance team. I had three main projects throughout the internship. First, I helped the team prepare for the FTCA (Federal Torts Claim Act) survey in late August. FTCA is in charge of handling medical malpractice claims for FQHCs. So, if someone sues Erie, they are actually suing the federal government. Unlike most hospitals, the federal government doesn’t have a limit to the amount that they pay out in a medical malpractice suit so if a savvy lawyer is not scared off by the fact that they’re suing the U.S. government, they can make a lot of money for their client. In order to prevent this, FTCA often comes through to do surveys of their FQHCs in order to identify areas of risk and fix them. It was Erie’s first time going through this survey so there was a lot of prep work. I sorted through all of their policies to see what was outdated, and organized relevant policies. This was not the most exciting project of my summer, but it taught me how important it is to stay compliant and current on clinical policies and procedures.
My second project was improving the hand hygiene compliance program. Hand hygiene is a huge topic in healthcare. Infection is the largest cause of death in hospitals and incorrect hand hygiene is one of the easiest ways to spread infection. Erie is currently using a human-based observation model to gauge their compliance which was rolled out in April. Each site had one or two hand hygiene champions who would observe their fellow employees for two hours each month and report back to the compliance team. By the time I got to Erie, the champions were already starting to burn out. Community health centers are always incredibly busy places and it was difficult for the champions to find time to observe. Additionally, most of the employees had realized the identities of the champions and were especially careful to wash their hands around them, tainting the observations. I worked with the compliance team to research new marketing techniques for the program, training tools and electronic systems for observation. I learned how a seemingly small thing like washing your hands can be so important in improving your patient’s health outcomes. I also took over communicating with the champions which taught me how to manage a large group of people with extremely busy schedules.
My final and largest project was synthesizing year-end reviews of incident reports for lab errors, vaccination errors and medical errors. I deciphered about 150 incident reports written in clinical jargon and wrote out simplified and anonymous versions. Then I classified the incidents by type and cause of error to identify areas of risk. Even across the types of errors, I found many similarities. For example, many of the lab errors could be solved by greater transition of institutional knowledge. Many specimens were ruined due to processing or storage errors. As is the nature of all FQHCs, turnover is high at Erie. Processing and storage techniques seemed to be mostly taught during the first few weeks of employment which could easily be forgotten. This was my favorite project because I was working independently. Additionally, I felt like Erie really cared about my findings. After I presented them to my supervisor, she had me present to a committee of medical directors and to the quality improvement committee. While nothing was solved during our initial meeting, they took some concrete steps to further investigate the trends I had discovered and try out the recommendations I gave.
In addition to a variety of projects, my supervisor also connected me with almost every MPH at the company so I could hear more about their journeys from college to community health which solidified my interest in a MPH. Finally, I was able to shadow Jean, Director of Nursing and Population Health, on one of her clinic days. I was really nervous to shadow a clinician. I was scared that it would seem too overwhelming or difficult, but I loved it. It was very hectic, but in the best possible way. I was never bored. Jean worked effortlessly through each patient, always stopping in the hallway to make sure I understood exactly why she was switching medications or treatments. She remembered all of her returning patients and I could tell that they loved her. Spending the day with her reinvigorated my love of medicine. I realized that medicine could be considerate and caring. It was by far the best day of my summer and I cannot wait to spend more time in a clinic like that.
I would like to profusely thank both the ’68 Center for Career Exploration and Mr. and Mrs. Svoboda for giving me this chance to work for Erie this summer. It was truly transformative. The employees at Erie are some of the most empathetic and compassionate people I have been given the opportunity to work among. I had never truly considered community health as a career path before this summer, but now it seems like the only real option for me. This year, I hope to bring back my new presentation, organization and observation skills to Williams. I also hope to continue to develop my passion for community health through my public health classes on my journey to an eventual MD/MPH.