SHAC treated its long waits; good prognosis

Before Student Health and Counseling enacted a new way to handle student healthcare services in fall 2009, patient wait time was a nightmare, according to SHAC director Mary Beth Collins. 

 “[Now] most patients are in and out [of SHAC] in 30 minutes,” she said.
Previously, students had to see a nurse and then wait to see a doctor, according to Collins.

“Students were spending the day in the waiting room,” she said. “It was horrible.”

Before 2004, SHAC had a standing-order nurse who directed students, except for annual exams and other appointment-based services, according to Collins. The system worked well in the basement of Cramer Hall until the student population began to steadily increase. In 2004, SHAC moved to its current location at 1880 Southwest Sixth Avenue, where nurses are continuously added to the staff to deal with the rising number of patients.

Since 2004, there has been a 17.6 percent growth in the end-of-term student head count, according to David Burgess of PSU’s Office of Institutional Research and Planning. This is a 3.13 percent yearly increase in the number of students attending Portland State.

To help combat the patient wait problem, SHAC brought in Judy Bee, a consultant from Practice Performance Group, located in
La Jolla, Calif. Bee was recommended by the American Medical Association, according to Collins.

During her three days at SHAC, Bee found several things wrong with its system. For example, students wanted to see providers instead of nurses and were spending time retelling their stories to several people under the old system, according to Collins.

SHAC providers include nurse practitioners, physician assistants and physicians. Nurses are qualified to do certain things such as give and read tests for tuberculosis, strep throat, the common cold and pregnancies, according to Collins.

After Bee’s visit, desk personnel were trained to divide students into emergency, urgent and routine patients, depending on the severity of the problem and the availability of providers. In addition, a new triage booth was introduced, which is to be used when front desk personnel are not confident about directing a patient or when the patient is not comfortable with the personnel’s decision, according to Collins.

Front office triage appointments take about five minutes to assess a need. While in the booth, patients cannot be heard by others, said Emily Shulz, a three-year office specialist at SHAC.

However, the new system works better when students phone in ahead of time, as those who walk-in may have to come back for an appointment, according to Becky Karki, a senior biology major and three-year employee of SHAC.

Commenting on the system’s drawbacks, Karki said that students have to be prepared to divulge what is wrong to the front desk staff, a group of people who are trained and work hard to remain discreet. In order to respect patient privacy, purple slips of paper are used to write down confidential information.

After Bee left, the challenge for SHAC became that the number of providers was not high enough to meet patient need. This was because Bee does not usually work with students and did not realize that sometimes students just want to talk, according to Collins.

Collins said she would hire more providers if space allowed.

However, the biggest challenge arises when there are no available appointments, according to Collins. Under the new Aetna insurance plan, an urgent care appointment is $20. Emergency room service is 100 percent covered, with a $150 deductible if the student is not admitted as a patient.

However, there is a possibility of students receiving a fee waiver by contacting SHAC in a situation such as a broken arm, when immediate treatment is necessary but may not require an extended hospital stay, Collins said. 

She would like to see the system moving into a seamless activity where students see their own records and are aware of what tests they need and when they need them. If this is achieved, a physician would function more like a coach, Collins said.

Collins, who retires in June after 29 years of service, looks forward to the future, when students can e-mail or text message SHAC, make their own appointments, access their own records and add additional information to their records, such as blood sugar and blood pressure readings. This would save students from sitting through a 20-minute appointment to give the physician the information.

In addition, Collins would like to see a higher physician-to-student ratio.

In order to experience less wait time at SHAC, schedule an appointment at 503-725-2800.
For more information, visit
www.pdx.edu/shac.