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CIR’s Patient Care Funds:
Finding New Ways to Meet Patient Needs

What precisely is a Patient Care Fund?

Some CIR-affiliated hospitals have them, some don’t. They vary widely in what they fund, and how much money they have. They are hard-won, created through contract bargaining between residents and their hospitals.  In most cases, residents agreed to forgo some percentage of negotiated raises in order to create this fund which directs money to patient needs that residents determine are going unmet in their hospitals. So they are a way for residents, who often feel on the bottom of the medical hierarchy in their hospital, to have some say in improving the care that they deliver.    

This past year’s crop of PCF projects, as always, are a product of the creativity of the residents who came up with the ideas, and the dedication of those who served on the committee to determine which projects win the funding.

Aiding Refugee and Asylum Seekers in Mass.

 

Residents on the Mass. Patient Care Fund Committee choose which projects to fund.

“At Cambridge Hospital, we often take care of people who fall through the cracks,” said Dr. Robert Marlin, a CIR leader and resident when he thought of the idea of opening a coordinated care program for immigrant patients who are refugees, asylum seekers, torture survivors and trafficking victims from other countries. These patients come from all over the world, he said, and because most of them don’t have health insurance, they were afraid to seek medical care.  “The PCF has always revolved around meeting the needs of the underserved,” Dr. Marlin said, so he submitted a request to open the coordinated care program.

As of September 2006, the new program is educating patients on disease prevention and management, and supplying food, meal vouchers, OTC drugs, emergency prescription medication and travel subsidies. Through a multidisciplinary and coordinated care program, a diverse variety of medical, mental health, social, dental and legal services have been arranged for the patients.

“I knew that the PCF would be able to fund innovative projects that no one had ever thought of before.  Without it, we would not have been able to meet the needs of these patients.” Dr. Marlin said. He also holds a PhD in Medical Anthropology.

 “Our Patient Care Fund Committee really encourages innovative requests from the greater Cambridge Hospital community, says Cambridge CIR delegate Matt Ehrlich, a PGY 3 Psychiatry resident. “We’ve funded everything from yoga classes for patient stress-reduction, to groceries for victims of domestic violence, and waiting room fish tanks.”

Helping Pediatric Patients in NYC

There are few things scarier than a hospital stay for pediatric patients. To ease their anxiety and help them deal with time alone, Dr. Ravi Mangal Patel, a PGY 2 at New York City’s Bellevue Hospital thought that the department could be more child-friendly. After consulting with the Child Life Staff at the hospital, Dr. Patel submitted a request for two fun centers. These mobile entertainment devices are equipped with movies and video games that can ease the burden of illness for children, many of whom are hospitalized for extended periods of time. He also requested PediaPals and ZooPals exam tables with themed wall decal kits, which the Patient Care Trust Fund approved and purchased.  Next up: a digital camera and color laser printer which were just ordered for patient use in Bellevue’s Computer Art Program. “It’s great that CIR, via the PCTF, is giving residents ways to directly improve patient care in the unions,” Dr. Patel said.

Florida Patients Work Out for Health, Physical Therapy

A CIR resident assists a patient in the newly founded Functional Assessment Clinic in Miami with workout equipment thanks to CIR's PCF.

Thanks to CIR residents at Jackson Memorial Hospital, patients at Miami’s Jefferson Reaves Wellness Center have a host of new work out equipment, and the individual attention they need to make the most of it. Dr. Joseph Etienne, a CIR leader and Family Medicine resident, determined that many of his senior patients were lacking the physical therapy and exercise that they needed to improve their health, so he applied for PCF funding.

The $15,000 in exercise equipment came through that fund, and the clinic opened on June 28, 2006. “The importance of the clinic is to improve and overcome patients’ limitations.  Our senior patients need to be able to exercise, under the careful supervision of physical therapists.  This is vitally important for their recovery, and day-to-day functioning. We were overjoyed when the funding came through, and look forward to working with our patients here, and seeing their progress over time,” Dr. Etienne said.

In Los Angeles, CIR Members Streamline the Process

As the oldest, and largest CIR PCF in the country, with $2.2 million countywide, and $1.21 million available annually, the Los Angeles County + University of Southern California (LAC+USC) fund just streamlined their process to make it more accessible to all departments, however large or small. With 50 departments and programs, submitting and justifying requests to the committee and the hospital administration for approval had become a daunting task.

Over time, certain departments have requested large ticket items, due to their high-tech, high-cost needs. “So this year, we instituted a list of new guidelines for PCF requests – our basic message was, ‘Let’s be fair, let’s be civil, let’s share,’ said Dr. Chi Lee, CIR President at LAC + USC, and a PGY 4 in Emergency Medicine.

Dr. Lee reports that this year’s PCF came in under budget, and that there were, “high-fives and pats of support, and that every department that submitted requests got all that they wanted.” It was, she said, “Incredible.”