By: Ohio Public Health Partnership
This time last year, Medical students were completing their rotations in local health centers in Ohio. The relationship between the local department and the students was a mutually beneficial one. The students received experience in the field that helped them corroborate their academic knowledge to real-life experience. While the health department received support in health centers around the state that needed it most. The onset of the COVID-19 pandemic threatened this ongoing relationship. It left most student rotations through the local health department (LHD) health centers and federally qualified health centers (FQHCs) discontinued. In the time when public health institutions in Ohio needed support most, everything seemed to be at stake. Despite the fact that this seemed like an opportune learning experience, as the first national health crisis in over 100 years, the formerly school-led programs like many around the nation, couldn’t bounce back in the midst of the crisis. This left many students who showed that interest in meaningful engagement to help on the frontlines, left wondering what could be done.
The Ohio Department of Health (ODH) found a way to save this partnership. ODH collaborated with several public health professional associations, academic institutions, and health centers to coordinate volunteer Public Health Assist Teams. These teams made up of medical student volunteers were able to provide COVID-19 response support to Ohio’s local public health agencies and community partners.
The Association of Ohio Health Commissioners (AOHC) surveyed local health departments (LHD) and identified priority areas of support the Assist Teams could help contribute to. The results of that initial survey found the following areas to be of great importance to LHDs: patient follow up & contact tracing, triage and response to community-based calls/inquiries regarding COVID-19, communication, messaging for the community through media, and social media support. With the unpredictable nature of the public health crisis, additional areas of support are still being identified as the program develops.
HOW IT WORKS
The Assist Teams are comprised of volunteer public health professionals (current and retired), students, and/or faculty. The teams work individually or in small coalitions to provide support. The majority of assistance is virtual. ODH leads the initiative and provides overall coordination, roster maintenance, entity request management, and facilitating orientation and training. Roles and responsibilities are established for each of the key partners, which include: local public health departments, requestors of service, Assist Team Leaders, partnering academic institutions, professional associations; and the National Guard.
PARTNERSHIP BRIGHT SPOTS
1) Ohio Association of Community Health Centers (OACHC)
With the overlap of public health and primary care needs, the Ohio Association of Community Health Centers (OACHC) is working with ODH to enlist the participation of FQHCs to meet these needs. OACHC is utilizing their Ohio Primary Care Workforce Initiative (OPCWI), whose mission is to teach, inspire and put to work the next generation of primary care providers by exposing students to rich clinical experiences in a network of modernized primary care settings. This initiative’s work has been mutually beneficial for both parties.
2) Ohio University (OU) Heritage College of Osteopathic Medicine
Student volunteers with ODH have the option of choosing to engage in credit-bearing courses. OU developed a “Public Health/COVID19 Rotation Online & Practical Experience” to support the Public Health Assist Team. This rotation has been able to provide the students with an overview of public health and COVID-19 pandemic health management issues by combining online learning with practical experiences. This course successfully provided a general introduction to COVID-19, pathogenesis, epidemiology, preparedness, testing/screening, handwashing/disinfection, personal protective equipment, and quarantine procedures. The skills this course was able to endow students with is crucial given the present condition of the world.
3) Case Western Reserve University, Cleveland, Ohio
The Public Health Assist Team facilitated the development of a closer working relationship with LHDs in a better-coordinated, partnering response. Dr. Heidi Gullett, Medical Director at the Cuyahoga County Board of Health, demonstrated how this worked for a Neighborhood Family Practice in Cleveland in this recent article: Cuyahoga County ‘disease detectives’, CWRU medical students track coronavirus in one of Ohio’s hotspots
ADAPTING TO THE CHANGES
Ohio public health leaders and staff have found that it is crucial to be thinking strategically about their time. Demands to meet with and respond to local and state policymakers and key stakeholders are high. The need for a breadth of written guidance and protocols is constantly changing and requires immediate attention. State-wide communication and coordination are critical. To meet the need, the public health associations are identifying additional areas of support for public health practice during this time. The Association of Ohio Health Commissioners (AOHC) has facilitated all-member virtual meetings to share concerns and prepare written statements regarding all aspects of the COVID19 response in Ohio. Securing additional workforce through volunteers or retirees has been difficult. They have found themselves cultivating staff resilience in what is essentially a 24/7 operation that could extend over 16 months, something unprecedented. They are meeting daily challenges while looking strategically for the future.
One major lesson learned from these experiences is the need for data. While, Timely and credible data has always been critical, but the pandemic has exposed serious gaps in the Ohio public health data systems. Processes between healthcare, hospitals, and public health to assure the best data available need to be updated and improved. Public and stakeholder awareness of public health is obviously incredibly high right now – sometimes positive, and sometimes not. These lessons learned from COVID-19 will help improve coordination between public health, healthcare, and hospitals to assure an integrated population-focused health approach in the future. COVID19 has shed light on the importance of public health, and offers examples of how we can move forward to a sustainable, relevant, and fully functioning public health system in our future.
More waves of this pandemic and even more frequent pandemics may be the case going forward, which changes everything in terms of the structure, workforce, and capacity needs of the field. Public health must be nimble and needs necessary funding to develop a workforce sufficient in scope and magnitude that is sustainable and resilient in order to meet these new demands. Like ODH has shown in their crisis response, being open to pivoting one’s strategy to meet the needs of the time, as well as being flexible enough in solving critical problems is a skill every organization needs to practice during this time.