In the Collaborative Health and Human Services program at California State University, Monterey Bay it is required that all students participate in a yearlong community based project. The students work closely with field mentors, their agency of placement, and their capstone instructor to implement and evaluate an applied project that addresses a health or social problem in the community. In addition, students collect data to evaluate the impact of their projects in the community using appropriate evaluation designs. The final thesis report and presentation provide the project’s findings and recommendations. Following is my Community Based Project:
The disparities in hospital readmission rates between lower socioeconomic and higher socioeconomic status older adults are too high. Research shows that patients from high-poverty communities are more likely to be readmitted into the hospital after a recent discharge. In the US, almost 20 % of Medicare patients are re-hospitalized within 30 days, increasing their health care costs. The purpose of this capstone was to explore the degree of communication that occurs between social workers and their patients during the discharge process at Kindred Pacific Coast Care Center. A thirteen-question survey was produced and administered to twelve patients. Results showed that even though patients felt they received adequate time with their social worker, they believed they would benefit from more time to discuss their discharge process, In-home supportive services, and additional information on how to administer their medication. The study concludes that care centered around communication, and connecting patients to resources in their community are not only key components in decreasing the rate of avoidable readmissions, but from a business standpoint, are key components in decreasing costs.
Capstone Report: J-Rousseaux_Final-Capstone-Report
Capstone Presentation: J-Rousseaux_Final Capstone Presentation
The following skills were further developed and strengthened throughout my time at Kindred Pacific Coast Care Center and aided me in the creation of my capstone project.
Professional Development: I strengthened this skill further when I presented my report to the facility. I had to present both positive and negative information, but I was able to present my report in a way that highlighted the strengths of the facility and how to build and improve upon those strengths to accomplish our common goal of decreasing the rate of readmissions and providing quality care. I was able to provide the team with a professional level snapshot of how care is being provided and how we can improve that care. I was also to present examples from facilities and hospitals that illustrated what the possible financial gain may be for the facility if they invested more time and resources in their social services department.
Statistics and Research Methods: I identified a social problem that was affecting the facility and conducted research to see what the immediate impact of this problem currently was and how it was affecting the nation’s health care system on both a micro and macro level. I was able to identify some major causes that may have an impact on unplanned hospital readmissions and identified that communication, or lack their of was a common thread weaving its way through all these potential causes. I created a patient survey to try to uncover potential areas that may need to be strengthened within the social services department and facility as a whole, in regards to communication and a residents perceived level of understanding. Through my research and data analysis I was able to identify key areas of concern within the facility that could potentially help alleviate the rate of unplanned readmissions within the facility.