Care Beyond the Clinic

UNC student volunteers and the families they serve recently gathered at the Museum of Life and Science in Durham to celebrate completion of the first year of Beyond Clinic Walls for Kids, an interdisciplinary student group that identifies – and seeks to meet – the medical and social needs of pediatric patients and their families outside the clinic setting.

Care Beyond the Clinic click to enlarge Skyler Alexander enjoys her experience at the Museum of Life and Science in Durham at the celebration of the end of the first year of Beyond Clinic Walls for Kids. Photo by Kim Moenich.

For many pediatric patients, the social and medical challenges they face persist long after they leave their appointment at the UNC Children’s Outpatient Center. Beyond Clinic Walls (BCW) for Kids, an interdisciplinary UNC volunteer organization comprising students from various health professions, formed last year to serve these patients in their daily lives, outside the clinic setting.

“Health-care facilities can’t provide all the care some patients and families need,” says Blaire Hanvey, second-year UNC medical student and 2014-2015 director of BCW for Kids. “Our goal is to identify the needs of patients referred to us by UNC Children’s Outpatient Center and connect their families to the local resources that can meet those needs.”

BCW for Kids recently completed its inaugural year, and to celebrate, volunteers and families recently gathered at the Museum of Life and Science in Durham. The event highlighted the strong relationships student volunteers developed with the families they supported during the academic year.

“It was a special event for everyone,” says Katie Weinel, BCW for Kids operations director and a second-year UNC medical student. “Each of the student volunteers, individually and as part of a team, built relationships with the families they served, so being able to celebrate the first year of the program was very meaningful."

The health challenges of the children span the spectrum, including obesity, ADHD, and microcephaly, among others. During the 2014-2015 academic year, volunteers were able to make improvements small and large in the daily lives of these families. They helped a home become more heat efficient for a Hillsborough family living in difficult conditions and put up a gate at the home of a Raleigh family whose child was prone to running toward the street. Some work was more complicated, such as advocating on behalf of an Orange County child in need of an individualized education plan at his school.

Hanvey stresses that the work of volunteers is not simply busy work – it has a tangible impact on the care patients receive.

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Two weeks ago, Beyond Clinic Walls for Kids student volunteers and family volunteers gathered for lunch and a day of fun at the Museum of Life and Science. Photo by Kim Moenich.

“At the end of each visit, our students write a home visit note and upload it into the electronic health record system, so they’re getting practice documenting visits,” she says. “These notes make it to the Children’s Hospital and help clinic providers change and adapt their practice to better understand the needs of the client at home. Physicians can’t see that in a whitewashed clinic office. We become their eyes and ears in their clients’ homes.”

UNC undergraduate Amanda Ferraro first learned about BCW for Kids last fall, when Weinel attended one of her classes and shared information about the group with UNC students. Ferraro, who plans to apply to medical school, immediately knew she wanted to volunteer.

“I’d never realized how closely intertwined health and health education are,” she says. “I learned that health care really extends beyond the hospital or clinic setting.”

In addition to providing a service to families in need, BCW for Kids volunteers are given educational opportunities by working alongside health profession students from eight different departments on the teams that make the monthly home visits.

“It’s a great opportunity to work on an interdisciplinary team before you graduate and enter a professional setting,” says Weinel, who plans to specialize in psychiatry. “Also, as medical students, we don’t set foot in the clinic until our third year, so BCW for Kids is a great way to interact with a patient.”

First-year medical student Kyle Richardville made a strong connection with the family he served and plans to visit them as long as he’s in Chapel Hill. He found his BCW for Kids experience rewarding for several reasons.

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Beyond Clinic Walls for Kids student volunteers talk with Precious Alston, a UNC Children’s Outpatient Center patient. Photo by Kim Moenich.

“By working with an interdisciplinary team, I was able to learn how much of a team sport health care is,” says Richardville, who chose the UNC School of Medicine because of its patient-centered focus and its emphasis on treating the whole person, not just the disease. “And we were able see the conditions patients lived in, which helped us understand why patients may not be taking medication or following the care plans physicians prescribe.”

Kim Moenich, a student in the School of Nursing, plans to attend CRNA school after she graduates, and eventually work with Doctors Without Borders. Moenich ran a multicounty mental health facility in eastern North Carolina for several years before deciding to pursue a career in nursing. She served as a liaison for two BCW for Kids teams and believes that the experiences of working with families of low socioeconomic status benefits medical students.

“A lot of medical students haven’t had these types of experiences,” she says. “Through the group, they learn that the medicine they’ll practice in the ED or an ambulatory facility will be different from what their idea of medicine was. Through a program like this, you see people on a human level and you understand that what you see in front of you in a clinic setting does not tell the entire story. There’s so much more involved with these patients.”

Beyond Clinic Walls (BCW) for Kids has two purposes: to serve community members who have complex health or life situations and to give UNC students an opportunity to learn about the challenges and joys of raising a child with complex needs. From October through April, a small group of students visits their client monthly. During these meetings, teams assess their child’s needs and address concerns related to the child’s health care, comfort, and safety.  In the course of the program, students may suggest community resources or other connections that support the family’s interests and well-being.  Students also use the family's input to work on a special project that improves some aspect of the child’s life. For more information, visit the BCW for Kids page at the link above.