Hotspotting is a health care method aimed at reducing costs while improving patient health and experience. It works by identifying “super-utilizers” (those with frequent hospital visits or admissions), and provides hands-on, individualized interventions for patients with complex social and health care needs. 

To examine how hotspotting works and strengthen the understanding of how interdisciplinary care is important to patient outcomes, Siena developed its first ever complex care team this academic year, comprised of six students: two each from nursing, health studies and social work. 

The idea was introduced to Siena by Jenna Thate, Ph.D., associate professor of nursing and department chair. 

“Hotspotting is an accompaniment model that aims to address social determinants of health, promote collaboration among disciplines, and ultimately prevent unnecessary trips to the hospital,” said Thate. “It also helps students hone their teamwork skills and understand that our country’s health care system is very complex and can be hard for people to navigate.”  

Hotspotting (or complex care) is based on an educational curriculum originally developed by the Camden [NJ] Coalition of Healthcare Providers in 2014. Siena is now one of only four colleges in the Northeast hub administered by Thomas Jefferson University in Philadelphia; the others are Harvard University and Johns Hopkins University. 

Zoey Hall ’22 and Liz Wolaver ‘22 represented Siena’s nursing discipline; Nicole Potenza ’23 and Jacob Schoff ’23 represented social work; and Brady Olsen ’22 and Amy Peguillan ’22 represented health studies. Recruited for their classroom performance and leadership qualities, they served area homeless and at-risk veterans through the non-profit Albany Housing Coalition.

Elisa Martin, Ph.D., associate professor of social work and department chair, and Daniel White Ph.D., director of health professions/health studies, helped Thate co-direct the team and noted that the high-impact experience was done on top of the students’ regular for-credit studies. 

“These are students who are very invested in their own learning,” said Martin. “Siena’s team is also one of the few in the country made up entirely of undergrads; most of the other teams have mostly graduate students.”

White said the students’ clients had “extra barriers” to accessing health care; the team was able to help them through the process of obtaining care and staying healthy. 

“They could see first-hand the social determinants of health, and put names and faces to these issues,” he said.

The team of six kicked off their work back in September and met weekly for update sessions until their April 9 wrap up. They presented their findings at the College’s Academic Showcase. 

“Being a member of the Siena complex care team was an eye-opening experience,” said Peguillan. “The opportunity allowed me to gain insight into my future health care career. By helping patients navigate their chronic illnesses and health care goals, I learned that caring for a patient’s life goes beyond treating their physical needs.”

Olsen said the program allowed him to be part of an interdisciplinary team of committed students. 

“This was a great opportunity for me to apply what I have learned in the classroom to a real-world setting,” he said. “As a college student, helping clients by creating and implementing a treatment plan was a great experience. Watching their goals come to fruition was truly special and something I will take with me into the future as a health care professional.” 

Potenza agreed that being part of the team was a terrific learning experience.

“Not only did I get to improve my skills when it came to teamwork, but I also had the privilege of working with the large veteran population and providing them with the care they need and deserve,” she said, while Schoff added that being on the team helped him “make the leap towards the practical application of knowledge and skills I've been prepared with.”

“As it was my first field experience, it was nice to learn how to navigate a patient-client relationship with the help of a team by your side. My client was also very appreciative and thankful for the services the team provided, which made the experience very rewarding.”

Wolaver said, “For me as a nursing student the project was incredibly fulfilling, witnessing the great impact my team had on our individual veteran. When someone has nothing, helping them to accomplish simple tasks greatly impacts their quality of life by relieving stress.” 

Siena is developing a new hotspotting team for the 2022-23 academic year and may expand the program in the future. Interested students should email