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Helping Hospitalized Patients Vote

November 06, 2020
by Amy Anderson

Becoming hospitalized disrupts day-to-day life—from everyday routines and responsibilities to special occasions, including Election Day.

Exercising one’s right to vote is an important part of democracy, and for Americans who are unexpectedly hospitalized, it can make that privilege seem impossible. What happens when an individual is admitted and cannot make it to a polling station? Do they forgo participating in an election?

What many do not realize is that those who are hospitalized can vote by emergency absentee ballot.

A team set out to spread awareness of this crucial information across both Yale New Haven Health System’s York and Saint Raphael’s campuses in an initiative titled “Get Out the Vote.” The project was a joint initiative started by two medical students, Alexandra Bourdillon, YSM class of 2022, and Anthony Mitchel Wride, YSM class of 2024.

Bourdillon and Wride learned of Patient Voting, a non-partisan organization whose mission is to increase voter turnout amongst registered voters, and they wanted to bring the program to Yale. The two researched state and hospital regulations before reaching out to residency program directors Mark Siegel, MD, and Stephen Huot, MD, PhD, in late September. Siegel and Huot connected them to chief residents.

“Chief Residents in Internal Medicine and Surgery provided hospitalized patients with information about how a family member could assist them in obtaining and filing an emergency absentee ballot,” said Stephen Huot, MD.

Bourdillon and Wride soon teamed up with Michelle C. Salazar, MD, general surgery resident and Norin Ansari, MD, MPH, fellow in medical oncology and hematology, to offer this voting option to patients. Salazar and Ansari took on the role of championing this effort in their departments and following up with residents regarding their patients.

“I wanted to make sure our Smilow patients on NP-11 and NP-12 were included in this wonderful initiative by Alex and Mitch—even helping a handful of patients cast their ballots is a worthwhile endeavor,” said Norin Ansari, MD, MPH.

The application for an emergency absentee ballot is a two-step process. It has to be filed with a town clerk within a six-day period prior to an election, and brought to a clerk’s office by a designee. The designee exchanges the application in-person for an absentee ballot. Given the influx of absentee voting this year, in part due to the COVID-19 pandemic, this was challenging.

“We had to ensure that town clerks were informed ahead of time of our initiative and in some cases met a lot of resistance or questioning that escalated and needed approval by the State Secretary's office. In some cases, the process required physically walking up to the town clerk and waiting in line to speak with an official who was able to clarify additional documentation and/or restrictions about the process,” explained Bourdillon.

The team distributed forms and coordinated with teams in 15 units across the two campuses beginning on Thursday, October 29. After interested patients were identified, the team informed patients of the process to cast their ballot from the hospital. The team supported patients by identifying family members who could serve as designees, and, in some instances, offered to help bring forms to designees whose schedules or circumstances made it difficult to obtain the application in a timely process.

“It was incredible to see how quickly and seamlessly they worked together to support our inpatients with exercising their rights as absentee voters. Housestaff and nursing quickly mobilized to help distribute absentee forms to eligible patients, in a way which limited unnecessary exposure to patients given pandemic considerations,” said Elizabeth Prsic, MD, who also helped spread the word to her team at Smilow Cancer Hospital.

Over the course of six days, the team approached hundreds of patients. 300 forms were printed and donated by TYCO, a local print and promotion shop.

“Logistically, it was substantial work to organize everything, but it was very rewarding when patients realized that this was an opportunity to exercise their right to vote. Many were facing the reality that would be very challenging if they were hospitalized. It was very uplifting to see that from patients and their families,” said Bourdillon.

Bourdillon and Wride spent hours following up with patients and family members via telephone explaining the process and coordinating pick-up times for family members to obtain the applications.

“We felt really good about being able to make sure patients have that ‘normal’ and do things that are important to them outside of sickness and illness—by restoring that sense of normality with civic engagement,” said Wride.

Altogether, the reach that the initiative had would not have been possible without the collective efforts from many individuals. Energized medical and PA students—including Cindy Du, Callie Ginapp, May Shum, and Suzanne Xu—played key roles in preparing packets and assisting patients in filling out the application forms during various clerkship rotations. Highly committed surgery and internal medicine residents orchestrated the engagement of patients and distribution of forms. Overall, it was a team effort that included everyone—from nurses to PAs—who wanted to do their best to help patients vote.

“As physicians, our profession has evolved throughout time. We no longer should only focus on the illness at hand—although, that’s what we usually do. Our role advocating for patients is becoming increasingly important, and this effort shows that we can advocate for our patients’ well-being and rights, from a place of neutrality,” said Salazar.

The collaborative effort proved to be a successful initiative that may continue for future elections—both presidential and local.

Submitted by Amy Anderson on November 06, 2020