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Objective
Students will assist in outreaching to the recently discharged patients from all services including COVID-19 care from the Penn State Hershey Medical Center to help mitigate and reduce re-admissions during the pandemic. Medical students will act as patient navigators under the supervision of nurse care managers to reach out to patients to provide health education, re-emphasize post-discharge instructions, and answer or direct a patient to appropriate resources if they have any questions or concerns.
Deliverable
Medical students will follow patients throughout their post-discharge course to reduce readmissions by increasing the number of touch points a patient receives while at home to answer questions or concerns, as well as to provide health education and emphasize discharge instructions.
Execution Plan
- Initially, 15 medical students will remotely contact patients who have been discharged from FCM and DGIM services including COVID-19 care at Penn State Hershey Medical Center.
- Students will initiate contact, with further touchpoints scheduled and discussed with patients.
- Students will assess and address social determinants of health, health literacy, and possible barriers to care and provide health education, re-emphasize post-discharge instructions, and answer or direct a patient to appropriate resources if they have any questions or concerns.