November 24, 2020
Jan Lee Santos, MD, MHA, received a Master of Healthcare Administration degree from the UNC Gillings School of Global Public Health’s Department of Health Policy and Management (HPM) in 2017. Now, he’s working with several other Gillings alumni and students to bring COVID-19 testing to the places it’s needed most in North Carolina.
Santos is associate director of training and clinical services at Piedmont Health Services (PHS). There, he works with Gillings School HPM alumni Kayla D. Hill, MHA, and Blair Woodward, MHA, along with current Gillings students Sarah Flexman, Julia Liborio and Kent Kiatthanapaiboon, who are all seeking Bachelor of Science in public health (BSPH) degrees.
This group works with PHS to provide drive-through community testing at no cost to the patient at least two to three times a week in Alamance, Orange, Lee and Moore Counties. The number of people tested depends on the location – events in Sanford, N.C., for example, saw over 250 people per day, whereas an event in Robbins N.C. hosted roughly 30. Testing sites are strategically located at chicken plants, churches, schools, civic centers, nursing homes and elder-care facilities, and the events typically last for between four and five hours. The sites also offer free flu vaccinations.
Before the COVID-19 pandemic began, Santos said his duties primarily kept him at the PHS corporate office in Chapel Hill, N.C., where he engaged in training and staff development, student preceptorship, design and implementation of quality- and process-improvement projects, and data analysis. However, like many others in his field, the pandemic required him to make a rapid pivot.
In addition to his regular duties, he now works closely with the clinical operations team to train and provide staffing at community testing events, create workflows, secure equipment and supplies, and coordinate with various organizations and entities to schedule COVID testing and administration, which involves a lot more travel.
“The pandemic provided an opportunity to join the front lines and work alongside our health center staff to provide COVID-19 testing for the community,” said Santos. “I joined the initial offsite community testing team to provide testing to chicken processing plant employees, and I am now the clinical team lead.”
Launching this initiative placed a large demand on the organization’s time and resources, so PHS partnered with the UNC Division of Infectious Diseases, N.C. Department of Health and Human Services (DHHS), local churches, departments of public health, and N.C. National Guard.
Santos’ innovative solution to staffing challenges was to organize and train volunteers from the UNC School of Medicine, Gillings School and Campbell University to serve in administrative or clinical roles. These volunteers joined new staff hired specifically for clinic and community COVID-19 testing, and existing staff members took on new duties to ensure smooth operation.
Flexman began the summer as a community health intern at PHS – the Gillings School BSPH program requires students to complete an internship – and immediately joined the COVID-19 response effort. She helped coordinate telehealth visits for patients, provided Spanish-English translation and created training documents and video tutorials to mobilize volunteers for mass-testing events and patient follow-up.
She noted that the pandemic called for many organizations in the health system to expand their capacity and work together. These mass testing events required coordination among county health departments, PHS and UNC Health.
“My time with PHS has given me the chance to see multiple aspects of public health and medical care through working with physicians directly to provide telehealth visits, planning and offering feedback for the workflow at testing events, compiling training materials, and just getting to talk with everyone while working,” said Flexman. “It was an incredible experience that helped put many things I’ve learned in the classroom into perspective. I am very thankful for all the individuals at PHS who did everything they could to make it a welcoming and positive learning environment.”
Liborio also got involved with the testing effort through a summer community health internship at PHS. She made follow-up calls to inform people of their results after mass-testing events and worked as a medical scribe. This hands-on experience sparked an interest in exploring how DHHS task orders influenced testing priorities and practices, which led to her honors thesis topic. Liborio will compare the effects of two state task order requirements on what populations are prioritized during each stage of the response. Like many health organizations, PHS worked to follow best practices while scaling up coronavirus testing and rapidly redesigning clinic practices, and Liborio will ensure this experience is analyzed and documented for future use.
“I hope that the results of this effectiveness evaluation will shed light on this struggle, and that it can be used by the state and other community health clinics to improve coordination between each entity and to better serve the populations that are being disproportionately affected by COVID-19,” said Liborio. “I feel extremely grateful to be a part of this effort. I hope my research emphasizes the importance of local emergency response during a pandemic and that it can contribute to improvements to the COVID-19 testing system in North Carolina.”
Kiatthanapaiboon recently began working at PHS as a patient care coordinator. Though still in training, he schedules patients for COVID-19 testing.
“Before working for Piedmont Health, I had never thought about the scheduling of patient appointments, and it made me realize how complicated it can be to navigate their system and electronic health records,” he said. “Interacting directly with patients has made me realize how fortunate I am to be healthy and have proper access to health care.”
These current students have the benefit of learning alongside dedicated Gillings alums. Hill has been an administrative fellow at PHS since 2019 and a passion for connecting the community with health services and resources led her to become involved in COVID-19 testing. She coordinates offsite testing events, analyzes data and distributes daily reports to stakeholders, roles she says her training at the Gillings school prepared her to step into.
“I was able to quickly transition into managing the organization’s COVID data because of my advanced knowledge of Excel,” said Hill. “Coursework in process improvement and people management have also proven helpful.”
Woodward manages the Siler City Community Health Center and helped coordinate the first mass-testing event at a chicken plant in Siler City. Currently, he provides support by helping get people registered for testing and helps onsite if there is a shortage of volunteers. And though he acknowledges that there is plenty of work to do, he appears undaunted by the demands the pandemic has placed on him.
“My family has always been a source and strength and energy during these times,” he said. “I’m also lucky to have such a wonderful team that I work with each day, that truly sees the need for this work to be done.”
Contact the UNC Gillings School of Global Public Health communications team at email@example.com.