International Medical Graduate Health System Acculturation
Greater New York Hospital Association
Recognizing that International Medical Graduates (IMGs) face challenges above and beyond those of their American peers in acculturating to the US health care system, the Greater New York Hospital Association (GNYHA) called upon the Capstone team to assist them with the creation of a training curriculum intended to address the needs of IMGs arriving in a medical system that is foreign to them. In preparation for a 2006 program launch date, the Capstone team provided feedback to GNYHA from field research conducted on current IMG needs as well as information garnered through intensive research on program evaluation, best practices from programs around the country, program-specific topic areas and a general literature review on IMG issues. This research and analysis informed the content of a one-day training program as well as the means for evaluating its success. Available to the class of IMGs arriving in Brooklyn this June, the program will focus on topics vital to IMG acculturation essentially acting to bridge the gap between American and International Medical Graduates familiarity with the US health system.
Building a Foundation for Organizational and Programmatic Evaluation
Lesbian, Gay, Bisexual and Transgender Community Center
The Capstone team was asked by the Lesbian, Gay, Bisexual and Transgender Community Center (the Center) to implement a system to measure organizational and programmatic performance. The team began by conducting an evaluation-related needs assessment of the four programmatic departments at the Center: Cultural Programs; Mental Health and Social Services; Public Policy and Government Relations; and Organizational Development, Planning and Research. Simultaneously, the team researched best practices in the field of outcome measurement, as well as the evaluation practices of other nonprofit organizations with comparable structures and/or serving similar populations. The team then developed the framework of a logic-model based evaluation system for the Center. This framework includes organizational, departmental and programmatic logic models, as well as measurable indicators for desired outcomes. As its final step, the team created a set of recommendations to guide the Center in building upon the framework and in sustaining an organization-wide evaluation initiative over time.
Staff Training Curriculum: Substance Use/Abuse Prevention Among Youth in Congregate Care
New York Foundling Vincent J. Fontana Center for Child Protection
The New York Foundling aims to help children, youth, and adults in need through advocacy, preventive, and in-care services. Within the NY Foundling, the Fontana Center provides training, research and public awareness for the treatment and prevention of child abuse. The New York Foundling continues to investigate contributing variables for at-risk youth in congregate care that affect both their current and future development. This includes gaining knowledge of demographic and etiological factors that may affect youths drug and alcohol use, particularly those in foster care. With these objectives in mind, the NY Foundling implemented a 2005 study to investigate substance use among its population. To supplement the studys findings, the Capstone team conducted an extensive literature review to determine best practices for substance use/abuse prevention. The team developed an informative training curriculum for the Foundling staff about substance use/abuse among its target population. Additionally, the team recommended peer education as an effective method for substance use/abuse prevention for at-risk youth.
Medical Technology-Based Communication Tools for Persons with Limited English Proficiency (LEP)
Bellevue Hospital Center Department of Emergency Medicine
Bellevue Hospital Emergency Department (ED) requested a Wagner Capstone team to research available technologies to improve communication with LEP patients. Of the approximately 100,000 patients treated at Bellevue every year, more than 80 percent are from the Citys medically underserved population, which primarily consists of immigrants who do not speak English as their first language. Bellevue ED plans to implement a technology-based multicultural communication center to help LEP patients participate effectively in their plan of care. Ultimately, the system could help reduce existing disparities in immigrant health. The Capstone team identified vendors that provide technology-based interpretation services by submitting a Request For Information (RFI) to 40 vendors nationwide and conducting interviews with national and international healthcare and non-healthcare institutions dealing with multi-lingual clientele. The team scored and ranked the responses to the RFI and used its findings from the interviews to analyze strengths and weaknesses of suitable vendors.
Improving Detection and Management of Depression in Primary Care
Gouverneur Healthcare Services
Depression is a serious medical illness that is pervasive throughout our population. It is evident that if depression is left undetected and/or untreated, an increasing disease burden will manifest, resulting in serious adverse health outcomes. The Capstone team was asked to explore effective ways of improving depression screening, diagnosis and treatment in primary care at Gouverneur, with specific attention to the non-English speaking, ethnically diverse patients - 45 percent Latinos and 35 percent Asians. The team conducted secondary research to identify prevalence, cultural and language barriers, and clinical practices and tendencies given the patient mix. Interviews and focus groups were also conducted with various members of the medical team at Gouverneur and other well-informed healthcare professionals. The Capstone team familiarized themselves with several best practices models to understand how other organizations succeed at fostering an environment fully supportive of depression screening in primary care. Building on their research, they offered systemic recommendations to improve the diagnostic depression care and treatment in primary care at Gouverneur.
Building a Foundation for Organizational and Programmatic Evaluation
Prison Moratorium Project
The Capstone team studied the historical context and implementation of the Impact Schools Initiative (led by the NYPD and Department of Education) in New York City and how effective it has/has not been in dealing with the issue of school safety. The team also researched alternative models of school safety to assess their compatibility (or incompatibility) with the Impact Schools initiative. The team has provided their client organization with a research report and an annotated bibliography of research literature to use for further studies. In the research report, the team recommended ways the citys school safety policies could be improved and questions for future study.