Employing a Quality Improvement Database to Observe the Gaps in Care at a Student-Run Free Clinic

Abstract

The Student Health Alliance Reaching Indigent Needy Groups (SHARING) clinics are student run free
clinics (SRFCs) at the University of Nebraska Medical Center that serve low income, uninsured adults
in Omaha, Nebraska. Like many other SRFCs, they face multiple barriers to providing high quality care.
To address this, the SHARING Quality Improvement (QI) Database was created. QI has many definitions,
but, overall, it is a method of analyzing clinic performance and the changes made to improve
the clinic. Before this database, there was no way of continuously tracking clinic metrics over time, so
previous QI projects required timely data abstraction that often only evaluated retrospective outcomes
with limited real-time data to track clinical outcomes as changes were implemented thereby
limiting our ability to implement further changes to improve patient health. A review of SRFC literature
reveals a lack of a model or guide on how to assess quality of care in SRFCs and track patient data
over time. This study seeks to fill this gap. Our database consists of a patient list of electronic medical
records that were compiled in the charting system Epic. The patient data is exported into a Microsoft
Excel document each month and clinic metrics are analyzed, thus providing a real-time dashboard of
quality metrics for the clinic. This database will be utilized to inform decisions regarding the reform of
clinic processes. This database model can be used at other SRFCs to monitor quality of care provided
at their clinics and implement QI measures accordingly.