Executive Summary

The two counties that make up Kansas City–Wyandotte County, Kansas, and Jackson County,

Missouri–experience an approximated 15% uninsured rate (University of Wisconsin Population

Health Institute, 2021). Reasons for not having health insurance are often related to cost.

Amongst the uninsured, 73.7% do not have health insurance as a result of its cost-prohibitive

nature, and 41.5% had not seen a healthcare provider in over a year (Tolbert & Orgera, 2020).

Not having health insurance has been shown to decrease preventative services, exacerbate

chronic health conditions, and cause worse overall health (McWilliams, 2009). Unfortunately,

being uninsured has also been linked to premature death due to preventable causes

(Woolhandler, 2017). To address the disparity in healthcare access amongst the uninsured in

Kansas City, the JayDoc Clinic was created by the University of Kansas School of Medicine.

This location acts as a safety net clinic for individuals needing non-emergency urgent care at no

cost to the patient. The JayDoc Clinic has been serving the Kansas City community for over

seventeen years; however, it has never undergone a formal evaluation (University of Kansas

Medical Center, 2021). As a result, the objectives of the proposed evaluation are centered around

two groups, patients and volunteers. Evaluation objectives related to patients are to assess

whether patients are satisfied with the JayDoc Clinic and determine additional services they

would like to see implemented. Evaluation objectives for clinic volunteers are to determine if

volunteers at this clinic are satisfied with their experience and have any recommendations for the



Healthcare access remains a significant factor affecting the health of individuals living in

the United States. Frequently healthcare is avoided due to its cost-prohibitive nature. This places

individuals at increased risk for poor health outcomes. Preventive life-saving health screenings,

such as cervical and breast examinations, are often missed or skipped (Institute of Medicine,

2002). Without cost affordable options and locations, individuals are less likely to receive timely

care, resulting in worse health outcomes and potentially premature death (Office of Disease

Prevention and Promotion, 2014).

The greater Kansas City area is composed of two different counties that experience

unique needs; however, there is overlap regarding health insurance. Both Wyandotte and Jackson

Counties have a higher proportion of individuals who do not possess health insurance than in

their respective states. In 2018, the number of uninsured individuals amongst both counties was

approximately 15% (University of Wisconsin Population Health Institute, 2021). Furthermore,

from the most recent community health assessment, healthcare access was among the top five

problems facing individuals in Wyandotte County (Collie-Akers, et al., 2018).

To address the needs of the uninsured and underserved in the greater Kansas City area, a

safety net of clinics has been formed. These locations provide free or low-cost essential health

care services to individuals who do not have insurance or the ability to afford healthcare. In order

to continue to see patients, these locations must remain financially stable. To accomplish this,

clinics must constantly seek to manage costs while also increasing access, improving health

outcomes, and reducing hospitalization rates. Therefore, this evaluation of the JayDoc Clinic

aims to assess patients’ and volunteers’ satisfaction, what additional services may be beneficial

for a larger target population, and how the clinic may be improved to increase productivity.

Background and Significance:

Accessing healthcare remains a significant challenge that many individuals face in the United

States. In 2018, 8.5% of U.S. citizens, or 27.5 million individuals, did not have health insurance

at any point during the year, which increased from 7.9% or 25.6 million in 2017 (Census, 2019).

Unfortunately, individuals who do not have health insurance often avoid seeing physicians due to

the inability to pay, which may potentially worsen their health outcomes. In 2009, a study

demonstrated that nearly 45,000 deaths per year were attributed to lack of healthcare (Wilper et

al., 2009). To combat the disparity, the University of Kansas Medical Center (KUMC)

established the JayDoc Clinic. This free clinic located in Kansas City, Kansas, provides medical

evaluations and treatment for uninsured and underserved populations in a non-urgent care

setting. Free clinics, such as the JayDoc Clinic, serve an integral role in healthcare. These clinics

help bridge the gap in healthcare coverage and lessen the load on emergency departments by

providing care to patients who otherwise may not be able to be seen by a provider in a nonemergency setting (Birrs et al., 2016). Since its launch in 2003, the JayDoc Clinic has served

over 1,000 patients each year (University of Kansas Medical Center, 2021.). The goals and

mission of the JayDoc Clinic are to:

1. Provide quality healthcare to the uninsured populations of Kansas City,

2. Provide referrals to other community clinics, and

3. Improve student healthcare providers’ skills and competencies.

Problem/Need Statement:

The JayDoc Clinic strives to provide uninsured and underserved populations with free healthcare

services comparable to the national standard of care. However, patients’ satisfaction with the

clinic and input regarding additional health services are unknown. Currently, the JayDoc Clinic

does not report data on participant satisfaction or patients’ suggestions on additional health care

services that they would like to see implemented. Moreover, the JayDoc Clinic also does not

report on or collect information regarding volunteer satisfaction with the clinic or areas of future

improvement. This information is of utmost importance as individual experiences and input

remain essential tools for improving the JayDoc Clinic. Overall, evaluation can help the clinic

continue to effectively combat health disparities for those who do not possess health insurance

while also ensuring that volunteers and staff are satisfied with their experience.

Evaluation Questions:

1. Are JayDoc patients satisfied with the quality of care they receive?

2. What additional services would patients like to see implemented?

3. What do volunteers feel are areas of future improvement?

4. Are JayDoc volunteers satisfied with their volunteering experience?

Aim/Goal Statement: The purpose of this evaluation is to identify areas of improvement for the

JayDoc Clinic from both the patient and staff perspectives. Understanding the JayDoc Clinic’s

successes and areas of future improvement will allow the clinic to provide enhanced quality of

care for uninsured and underserved populations while ensuring that volunteers are also satisfied

with their experience.

Theoretical Foundation

For the evaluation of the JayDoc Clinic, the socio-ecological model will be utilized as the

theoretical foundation. The socio-ecological model posits that the model’s components and the

interdependence of these factors work to affect individuals’ health. The levels of the socioecological model include interpersonal (individual), organizational, community, and policy. The

overall goal of the JayDoc Clinic evaluation is to improve the clinic for patients and volunteers.

By focusing on this outcome, the evaluation process is targeting the community and

organizational factors of the socio-ecological model, which allows for the promotion of better

health for individuals within the community that utilize the JayDoc Clinic.

Figure 1: Socio-ecological Model (Okoye, 2020)

Evaluation Plan

As a result of the JayDoc Clinic’s goal to serve the uninsured and underserved, and due to this

location previously never being formally evaluated, this evaluation seeks to improve the clinic

structure and services for both patients and volunteers. Those who will directly benefit from the

evaluation of the JayDoc Clinic include the University of Kansas School of Medicine, the

JayDoc Clinic advisory board, JayDoc patients, and JayDoc volunteers. The goals of this

evaluation are to provide:

1. An evidence-based evaluation of current patients’ satisfaction

2. An evidence-based outline of current volunteers’ satisfaction

3. An evidence-based outline of recommendations for areas of future improvement

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