New York City Health and Hospitals Corporation

Lincoln Medical and Mental Health Center
 
Improving Access to Care for Hispanic and Black Adolescents in the South Bronx:
A Low-Cost Service Model
 
Lincoln Medical and Mental Health Center prides itself on offering a wide array of health and wellness services specifically tailored to the health care needs of teens in the South Bronx. Yet, a retrospective analysis concluded that a low number of teens were actually visiting the Center, and of those with actual scheduled appointments, there was a high “no-show” rate.

Recognizing the need to make it easier for teens to access and utilize the services available to them, Lincoln redesigned and implemented a new convenient same-day service model as part of its hospital-based pediatric clinic. The goal of this model of care was to provide timely access to quality health care for teenagers, to assist with the physical, intellectual, emotional and social challenges of the transition to adulthood, and to encourage positive communication between teenagers and their families. In addition, this model attempts to increase the number of visits and reduce no-show appointment rates.

All components of the standard visit, including registration, triage, interdisciplinary team (nurse, physician, social worker, psychologist, and health educator) assessments, immunization, testing, treatment and follow-up appointments are performed in the same exam room. This one-stop clinic visit enables adolescents to receive confidential services in a friendly, sensitive and structured environment. The implementation of a new “Confidential Adolescent Account” allows Lincoln to build trust and better professional relationships with its young patients, and provide health care regardless of patients’ financial or parental insurance status.

Post-redesign analyses revealed the total number of visits per clinic session and calendar year increased by nearly 300 percent. Additionally, Lincoln observed an excellent rate of return visits for the second and third doses of HPV vaccinations. Lincoln was recognized for having the highest number of HPV vaccines administered to adolescents within the New York City Health and Hospitals Corporation since program inception (December 2006). The ‘No show visit’ rate decreased and the return visits increased to 62 percent for the 12-month period after the implementation of this service model in 2005. A 24-hour toll free number (1-866-ZIP TEEN) was established for teens and their parents (in English and Spanish).


For more information about this program, please contact:

Tatiana P. Greenfield, MD, PhD
tatiana.greenfield@nychhc.org