Clinic Clues - June 2018

St. Mary’s Health Clinics provides necessary and accessible health services
to the medically
uninsured and under-served.
A brief note to thank you for your commitment to our ministry, we appreciate you and love working with you.
Thank you volunteers!
We hope you enjoyed the celebration at Como Zoo this spring!
Gratitude and Good Bye:
Good bye and thank you to
Janis Ollwerther, RN
Janis was an RN Care Coordinator, working for SMHC for almost 23 years. She began her career as a volunteer and then moved to a staff position. We wish her all the best as she is on to new adventures in retirement! Thank you Janis for your many years with St. Mary's Health Clinics, you will be missed.

Good bye and thank you to the following volunteers:
Elaine McGlinch - RN at Eastside Clinic. Elaine began volunteering in 2006 and has donated 918.95 hours of volunteer service to SMHC.
Marilyn Fetsch - RN at Eastside Clinic. Marilyn began volunteering in 2005 and has donated 730.05 hours of volunteer service to SMHC.
Patty Murray - Interpreter. Patty began volunteering in March 2018 while on Sabbatical. She has accumulated 54.49 volunteer hours in 3 months.
Juan Canales - Interpreter. Juan was able to volunteer for 2 months, donating 22.25 hours of his time to SMHC.
Hallie Anderson - admitting at Shakopee . Hallie began volunteering in October 2017 and accumulated 56.35 hours, she is now off to Medical School.
THANK YOU all for your dedication and service to St. Mary's.

Welcome new volunteers!
Provider: Connie Erdmann - Eastside Clinic
Admitting: Mariam Khella - St. Matt's Clinic
Driver: Allyson Maddock - Shakopee Clinic
Interpreter: Diana Ettel - Eastside Clinic
News from the office
From Stephanie Breckenridge
SMHC RN Volunteer/Doctoral Candidate
Thank you SMHC staff and volunteers for your hard work on the Greater Twin Cities United Way grant’s mental health pilot project to improve depression screening and referral in the diabetic patient population, completed between 1/2017 and 9/2017!
The purpose of our pilot project was to standardize screening for depression and to systematize the referral and follow-up processes in order to i mprove diabetic patients’ PHQ-9 scores within six months of a positive depression screen. A positive depression screen was identified as a PHQ-9 score of greater than or equal to 9, or patient communication of psychosocial distress that was out of sync with his or her PHQ-9 score. Findings from the pilot project are as follows:
  • 72% of diabetic patients were screened for depression at least once during the pilot project timeline
  • 47% of patients who were referred to therapy completed at least 3 sessions within 4 months of treatment initiation
  • 35% of patients with positive depression screens completed 3-month PHQ-9 re-screens
  • 6% of patients with positive depression screens achieved clinical remission by 6 months after treatment initiation, which is in line with the Minnesota Department of Health’s benchmark for patients enrolled in programs such as Medical Assistance
  • 50% of behavioral health patient satisfaction survey respondents commented that interactions with their psychotherapists were particularly helpful in their treatment
  • Survey respondents noted the benefit of working with a bilingual, bicultural therapist
The main findings from the pilot project include that follow-up for positive depression screens improved after implementation of a standardized screening, treatment, and referral process; and that care coordination by the social worker (Cathy Luiken) and community health worker (Katie Fuentes-Rivera) was critical to treatment success, especially when they were physically present in the clinic at the time of the initial positive depression screen. Additional learning included:
  • trauma prevalence: 11% of patients were referred to Victim’s Assistance
  • treatment preferences: equal preference for antidepressant medication and psychotherapy
  • clinic staff awareness of subclinical depression: slightly more positive depression screens for expression of psychosocial distress versus an elevated PHQ-9 score
  • effect of the national political climate during the pilot project timeline: significantly increased anxiety in the patient population
We appreciate all of your assistance in this project, as well as your continued work on the mental health initiative. We couldn’t do it without you!

Stephanie Breckenridge

From Rachel Fernandez - Lead Diabetes Coordinator
From the Diabetic Education Enhancement Program (DEEP) team

On May 24th we held an educational event for our volunteer nurses where they were provided with some in-depth information regarding diabetes and hypertension care at SMHC. An updated version of the Diabetes and, soon, the Hypertension algorithm can be found in the Physician Reference Manual at each clinic.

Click here for Diabetic Power Point Presentation.

Overview of Cuídate
Similar to DEEP, SMHC’s Cuídate program will serve hypertensive patients by assisting with education, medication management and support of lifestyle changes including diet and exercise by way of consultations and on-going patient support.
Participants of Cuídate will include patients who have 2 elevated blood pressure readings recorded at 2 separate visits, as well as patients with an existing diagnosis of hypertension.
They will receive:
  • Education about managing and maintaining a healthy blood pressure, and the risks of hypertension
  • Clinic services and medication therapy, as necessary
  • On-going monitoring and support by SMHC staff
  • RN clinic volunteers are responsible for measuring BP readings at clinic
  • RN Care Coordinators are responsible for identifying Cuídate participants based on clinical readings
  • Identified Cuídate participants will get a big sticker on their charts

Memo to come in the following weeks with more information.

From Chris Hanson - Volunteer Coordinator
  • Beginning this month, all SMHC staff scheduled at clinic, will stay until the end of clinic to assist you, the volunteer team, with clean-up and other end of clinic tasks. We are grateful for the time you have volunteered and want to help you get out of clinic in a timely manner.
  • Please watch your email for a Google Document link. We will have a library of information for volunteers to access news and updates from the office.
  • THANK YOU for all you do for St. Mary's Health Clinics!

Chris Hanson

From Julia McCarthy - Programs Operations Manager
Interpreters are essential in our work with patients. They allow the provider and the patient to overcome language barriers and communicate clearly.

Four Tips on Working with Interpreters:
  • DO speak directly to the patient, as if there interpreter was not in the room. For example, ask “how are you feeling today?” while looking at the patient, rather than “how is he feeling today?” while looking at the interpreter.

  • DON’T ask the interpreter to do medical work without a nurse or doctor present. For example, don’t ask the interpreter to explain how a patient should take her medication.

  • DO remember to pause often as you are speaking to a patient. This gives the interpreter a chance to remember everything you’ve said and repeat it in the patient’s language.

  • DON’T have a side conversation with the interpreter while you are working with a patient. Remember that the interpreter’s job is to repeat everything you say in the patient’s language.

From Carol O'Connor - SAGE Coordinator
Thanks to everyone for all your hard work regarding SAGE, the State Cancer Prevention Program.
The following shows the impact of your work since March 2017:

  • 453 encounters for breast and cervical screenings
  • $16,119.00 revenue brought in so far

Interested in the State Sage Program? Please click here for additional information.
1890 Randolph Avenue
 St. Paul, Minnesota