Assessing the Adequacy of the Federal Employee Compensation Act: A Study of Federal Civilian Employees Deployed to Iraq and Afghanistan
Congressional Research Service
Increasing numbers of federal civilian employees (FCEs) are being deployed to help aid reconstruction and intelligence operations in Iraq and Afghanistan. Working side by side with troops, FCEs engage in work that can put them at similar risk for injury and mortality as uniformed military. However, in case of injury or death, the medical and workers compensation benefits FCEs receive through the Federal Employee Compensation Act (FECA) are distinctly different from the benefits military personnel receive through the Department of Defense and the Department of Veterans Affairs. Despite some preliminary investigation by the US Government Accountability Office, the adequacy of the medical benefits and compensation received by deployed FCEs remained unclear. The Capstone team analyzed the insurance claims data from all injured and fallen FCEs to assess the adequacy of FECA, which is one of the oldest workers compensation systems in the country and was designed for domestic federal employees.
Developing Educational Tools to Increase Breast, Cervical, and Colon Cancer Awareness in the Queens and Harlem Communities
New York City Department of Health and Mental Hygiene, Cancer Prevention and Control Program
Over 13,000 New Yorkers die of cancer annually. In 2004, NYC's Department of Health and Mental Hygiene (DOHMH) launched a citywide health policy initiative called Take Care New York, listing cancer screening as a top 10 agenda item. Specifically, breast, cervical, and colon cancers can be effectively detected through early screening mechanisms. Although the city has made some progress increasing these screening rates, some neighborhoods lag behind, including parts of Queens and Harlem. To help facilitate the DOHMH's goal, the Capstone team conducted research in target neighborhoods via surveys and focus groups to develop effective educational tools that are culturally appropriate and encourage diverse populations to participate in the recommended early cancer screening regimen. Based on the research collected, the team developed prototypes of two promotional tools and devised recommendations for implementing relevant public health education interventions.
Finding Solutions: Providing Effective Ambulatory Care Training
New York University Langone Medical Center
NYU School of Medicine (NYUSoM) seeks to improve its medical school training curriculum to reflect the change in health care delivery from inpatient to outpatient care. As part of this effort, NYUSoM charged the Capstone team to improve the ambulatory (outpatient) clerkship experience for NYUSoM medical students and faculties. The team conducted a literature review of ambulatory care models and researched nationwide best practices, analyzed survey results of medical students, and developed a survey for various NYU affiliated physician groups. Physician surveys identified existing barriers to teaching and suggestions for physician teaching incentives, while interviews with physician faculty and practice directors specified recruitment challenges and financial impact of students in clinical settings The team's report offered recommendations to create an effective teaching environment for ambulatory clerkships, viable incentives to encourage physicians to teach medical students, and a system to manage teaching and recruiting for clerkship rotations.
Assessment of Veterans Administration New York Harbor Healthcare System Missed Opportunities
VA New York Harbor Healthcare System
The VA New York Harbor Healthcare (VA NYHHS) system encompasses the veterans' healthcare system for the boroughs of Queens, Manhattan, Brooklyn and Staten Island. The organization consists of campuses throughout the boroughs and provides care to over 52,000 veterans a year. The VA NYHHS uses the VA national standard known as the "missed opportunity" measure to improve services in their outpatient clinics. The system is struggling with a large number of appointments that are not kept or cancelled. The Capstone team assessed the high missed opportunity rates, and created plans for improvement. The team explored six performance measure clinics to identify areas that are leading to missed opportunities, including surveys and interviews with patients, administrators, service chiefs, clerical and centralized scheduling staff, as well as clinic observation. The team evaluated the findings to determine the cause of the poor missed opportunity rates, and made recommendations for reminder system policies.