Intermountain Healthcare

            My internship at Intermountain Healthcare was one of my strongest learning experiences I have had at BYU.  Through daily experience, the changing world of healthcare was explained effectively.  I saw what hospitals are doing to get ready for Obamacare, by preparing their staffs and programs to efficiently maintain the rules of Obamacare.  Without my internship, my knowledge of HCAPHS would be minimal. Now I know staff performance affects each hospital’s reimbursement rate.

            In my internship, my main responsibility was “rounding on” patients, asking questions about their care in the Emergency Department.  Hospitals will only receive full reimbursements from the government by improving their HCAPHS scores. The best way for hospitals to heighten their HCAPHS scores is by improving nurse communication consistency, responsiveness, and pain management.  Nurse communication is the biggest contributor to a hospital’s HCAPHS scores. So, my job, when I went “rounding on” patients would be to ask all important questions.  How is the medicine to take?  What did they expect from the information from their labs or tests?  What was their pain level?  For the most part in talking about their care, all of the patients had the best things to say about the nurses and staff members.

Truly, the nurses that work in the emergency department are some of the brightest nurses I have ever encountered. Several of the patients echoed that belief back to me.  I once saw a nurse helping a patient carry her belongings, including a baby, to the patient’s car.  A nurse’s ability to make a patient not only understand but care about a patient, I believe, makes them gain their health back more quickly.  I had a fantastic time rubbing elbows, and gaining wisdom from the nurses.

Next, the actual staff helped me to see the process of running a hospital.  Each has their part or specific job.  Those who take blood, those who give breathing treatments, those who take x-rays each have a specific task to accomplish that must be done properly to maintain the scores each hospital receives.   And the fact that those individuals all work independently throughout the day or night shift illustrates that a hospital would be a large undertaking for an administrator.   The doctors, though the directing part of the system by ordering labs, treatments and procedures, are only a small part of a much larger service.

It could seem daunting to manage a group as diverse as the staff at a hospital, or, at least highly problematic without a specific protocol of enforcement.  I was able to see this firsthand with the use of a program that all the interns were asked to work with, called AIDET.  AIDET stands for acknowledge, introduce, duration, explain, and thank you.  AIDET is one of the up and coming “best practices” programs that hospitals are starting to use.  Intermountain was one of the first to implement AIDET.  This program illustrates the quality a hospital can achieve with their patients.  It takes consistency to work through problems of duration with patients. The problem that Intermountain has been having is to get all staff members to commit to use AIDET with every patient under their care.  The nurses that were committed to AIDET performed efficiently with enhanced communication.  However, the nurses that didn’t commit to AIDET struggled with their communication skills and had inconsistent results.

My increase of knowledge of the health care system is something I needed not only for my professional life but my personal life as well.  This opportunity to do an internship at Intermountain Healthcare helped me plan for my professional career quite specifically.  If a person’s understanding of a future job can be enhanced through knowledge of how a system works, then the chances of a consistent, enjoyable job is also more likely.  This internship taught me so much about how hospitals operate and the problems hospitals face.  The depth and breadth of diverse problems a hospital can face took time to believe.  At one point I wondered if it were possible to overcome the budget and human communication problems I saw.  Yet, once I began to learn the various protocols that were used in the emergency department I could see that skills could increase if they were followed, especially by using the HCAPHS scoring system.

Further, the guest speakers we had throughout the internship became a highlight of my time by giving me insight into different fields within healthcare. There was one common theme from the guest speakers, and it was how they got to where they are now.  All of them had very different paths getting into healthcare, an assortment of varying degrees and jobs they worked in before coming to Intermountain.  Since I am now considering becoming a hospital administrator, the path of the speakers was of keen interest to me.  Do I go for an MBA or an MPA?  How many years of experience should I strive to get before I enter graduate school?  Each speaker helped me look at decisions I was about to make. The Intermountain internship was a great experience that I would definitely recommend to anyone thinking about looking to work in the healthcare career field.  

Debre Zeit, Ethiopia: Engage Now Africa Internship -Logan

I completed an internship with a nongovernmental organization called Engage Now Africa. The internship was based in Debre Zeit, Ethiopia. Debre Zeit is located about an hour south of the capital of Ethiopia. My duties in the internship included gathering data concerning the humanitarian projects completed in the villages, volunteering and shadowing at the local hospital, and teaching English at a local school. It was a very engaging and interesting internship that helped me develop understanding of foreign health care and aid.

            My wife and I arrived in Ethiopia and were trained by Diana Bingham who is the country director of Engage Now Africa (ENA) in Ethiopia. We were introduced to the local staff and situated into our housing. After a day of training, Diana left to go back to America and we went to work. It was difficult to get started at first due to the Ethiopian staff. We immediately learned that the Ethiopian culture is very laid back in meeting deadlines. We would often plan our day full of activities and only accomplish a handful due to Ethiopian culture. ENA has built schools, sanitary wells, and health posts throughout the villages surrounding Debre Zeit. It was our job to travel to these projects and collect data, testimonials, and pictures that could be utilized to produce results for the donors of ENA. We were able to travel to a lot of projects and collect a lot of data and pictures. It was great to see all the good that has been done due to ENA’s efforts. There were many villages that had gone without a school until ENA came and built the school. After the school was built it was handed over to the government, which would then higher teachers to run the school. Thousands of children are now able to attend school thanks to ENA. Wells were also dug by ENA, which has helped decrease the amount of disease due to unclean water. ENA drills for water and then sets up a pump and caps the well to prevent contamination. ENA also has set up health posts throughout the villages, which brings medical help to the people. Villagers can travel to these health posts and receive basic healthcare that would normally cause death without care.

            My wife and I were also able to teach English at a local school in Debre Zeit. The national language in Ethiopia is Amharic. The villagers rarely speak English but they need to know English in order to be employed in Ethiopia. We were able to teach English at a school. The children were more than willing to learn the language to get ahead in life. We did a lot of exercises and played a lot of English learning games. By the end of the internship the children were able to carry out a basic conversation with someone on the street. Hopefully this spark of learning will motivate them to continue to learn the language and get ahead in life.

            I am a premedical student, so I wanted to get some insight on the health care system in Ethiopia. I was able to arrange with the Debre Zeit hospital a shadowing and volunteering opportunity. Every day I would spend a few hours in the hospital shadowing different doctors. I saw a lot of typhoid, HIV, and malaria. There were also a lot of car accidents, fighting injuries, and abuse. I saw a lot of cases that I would not be able to see in America. I was also able to clean parts of the hospital and make lots of gauze. The doctors are educated and employed by the government. The government pays the doctors very little to work at the hospitals. To make more money the doctors usually work at a private practice and spend little time at the hospital. Due to this issue, the nurses see most of the patients at the hospital. I feel the health care system can be improved in Ethiopia by training the doctors, donating new equipment, and helping reform government health care services.

            This internship helped me get a better perspective of the world. I enjoyed meeting different types of people along the way and learning from their strengths. I learned that there is much good that can be done throughout the world. There are basic needs that every human should have met and I feel like there are many people not getting the necessities. 

If you are interested in Engage Now Africa, here is the link: http://www.engagenowafrica.org/