Development of a sustainable student-run clinic serving the homeless of the inner city

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2020

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Johnston, Deanne

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Abstract

Student-run clinics (SRCs) are environments where students take the lead in operating the clinic and provide healthcare to a community under the direct supervision of healthcare professionals. SRCs are not only of educational benefit to the students but also improve the healthcare services to underserved communities such as the homeless. Trinity Health Services (THS) is an interprofessional SRC based at a church providing free healthcare to the inner-city homeless of Johannesburg. This study aimed to describe the establishment and to investigate the various factors affecting the sustainability of THS. A convergent parallel mixed method study design was used to relate the qualitative and quantitative data collected. There were four components contributing to the proposed model of sustainability. The first component described how and why the clinic was established. The establishment, closure and re-establishment of THS (2004 – 2016) documented the partnership between the university and church in providing healthcare services to the homeless. The second component sought to understand the clinic from the perceptions of stakeholder groups: student and professional volunteers, student management committee and homeless community, using a grounded theory approach. Three broad themes, serving, learning and management emerged, forming the basis of the stakeholder framework. The retrospective record review, component three, documented 240 patient visits from January - December 2016. Patients frequently presented with conditions related to the respiratory (21.7%) and digestive (12.4%) systems. The most commonly dispensed medications were analgesics (38.8%), antibiotics (13.8%) and antihistamines (10.4%). Lastly, the cost analysis component quantified the cost of establishing (ZAR 214 157.08) and operating (ZAR 346 185.54) THS as well as the cost of treatment per patient (ZAR 69.05). The proposed sustainability model consists of three levels. The foundation, level one, represents the management structure of THS incorporating the student management committee supported by the church, university and advisory committee. The second level consists of three pillars of sustainability. The central and largest pillar, volunteering to serve, is flanked by learning and services and supervision. These pillars are housed under the third level, a homeless-centred healthcare service pillars are housed under the third level, a homeless-centred healthcare service. The proposed model involves collaboration from all stakeholders in providing a healthcare service meeting the needs of the homeless

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Original published work submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy, 2020

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