Medical receives a makeover
Triage call system, Community Care Center work well
MIT Medical recently unveiled new daytime-only operation hours for its Urgent Care Service and redesigned its inpatient facilities to become the new Community Care Center. New hours came into effect on Dec. 22, 2010.
Urgent Care Transition
A two-pronged transition, MIT Medical’s changes reflect an effort to provide 24-hour care to students while maximizing MIT’s resources effectively. Medical’s Urgent Care Service is now open from 7 a.m. to 11 p.m. every day. At night, Medical offers a call-in triage nurse service at 617-253-4481. When this number is dialed, an automated voice directs the student to call 100 (if on-campus) or 911 if he or she is in an emergency. If the student is calling in for a non-emergency situation, he or she will be directed to a nurse who will run through a set algorithm of questions to determine an appropriate course of action.
There are three end-game options that the nurses generally provide: A treatment that can be done at home, with a follow-up request if certain symptoms occur later on; a “coping” strategy until MIT Medical opens the following morning; or an order to go to the hospital for more serious illnesses. In addition to the triage nurse service, MIT clinicians are on call overnight to answer questions.
If the student is experiencing any mental-health related concerns, MIT Medical advises calling 617-253-4481, and a clinician from the Mental Health and Counseling Service will return the phone call and meet with the student on campus if necessary.
In the event that a friend is intoxicated, students have two potential options. If the friend is responsive, Medical recommends the triage number to get advice on how to help him or her get over the initial sickness. If the friend is unresponsive, students should call 100 from campus phones or 617-253-1212 for campus police.
Urgent Care changed its hours to 7 a.m. to 11 p.m. daily because statistics showed that students rarely visited Medical during late-night hours for any form of illness. In 2009, Urgent Care had 17,027 visits. Of these, only 459, or 2.7 percent, were between midnight and 7 a.m. Compared to a daily average of 45.4 daytime visits (from 7 a.m. to midnight), the average of 1.2 nighttime visits made it clear that Urgent Care was not a primary resource for students during the nighttime hours.
Medical says that though their Urgent Care hours have changed, the mission to provide 24-hour care to students is fulfilled by the daytime service and triage nurse line.
Community Care Center
Complementing MIT Medical’s changes to Urgent Care is the new Community Care Center (CCC), which was created to replace the inpatient unit on the fourth floor of MIT Medical. The Community Care Center has five nurse care managers that help students coordinate their health care across MIT and local hospitals. It is open from 7 a.m. to 7 p.m. on weekdays.
CCC coordinates care through an alert system put in place between MIT Medical and Mt. Auburn Hospital in Cambridge. If a student is sent to Mt. Auburn Hospital, hospitalized through the MIT Medical system, or sent via the MIT-EMS ambulance service, the nurse care managers will immediately get a transcript of the visit and will help coordinate post-hospital care.
The coordination of post-hospital care entails a variety of interactions that would otherwise be perplexing for students. For instance, care managers will find out what happened in the hospital, discharge plans, the type of follow-up medical care required, and whether transportation will be required for any post-hospital procedures. Care managers also help to coordinate services within MIT to ensure that students can keep up with academics in case of any health-related setbacks.
In addition to coordinating post-hospital care, CCC also administers several routine procedures. These include IV administration, wound care, and instruction in self-administered treatment.
The CCC also facilitates “assessment visits.” Assessment visits are provided by MIT Medical’s care managers if a student requires a medical practitioner, but cannot travel to MIT Medical. For instance, if a student had an appendectomy, a nurse could come to ensure that the student was faring well post-operation. This service is at the discretion of the care managers at CCC.
Success of MIT Medical Transition
According to MIT Medical, the transition thus far has been relatively smooth. In its first two months of providing service, CCC saw 379 patients. The triage nurse line has received an average of one call per night, similar to the number of walk-ins seen at night during the 24-hour operation of the Urgent Care Unit. These calls ranged from mental health calls to ailments that only required self-care to illnesses that required a follow-up in Medical. Ultimately, Medical Director William M. Kettyle emphasized that “For our patients, the bottom line is that MIT Medical is here for you 24 hours a day. That will not change.”