School of Medicine and Health Sciences Poster Presentations
Document Type
Poster
Abstract Category
Quality Improvement
Keywords
Homeless health, patient navigator, QI
Publication Date
Spring 5-1-2019
Abstract
Background: Washington D.C. has extensive resources to serve the homeless population; however, connecting these patients with resources upon discharge from GW hospital remains a challenge. After key informant interviews with local physicians who care for the homeless community, we decided to explore the use of medical students to bridge the gap between patient discharge and follow-up with local resources. Objectives: This project aimed to identify community-wide resources to connect patients with comprehensive follow-up care, train internal medicine residents to identify and use specific ICD-10 codes for homelessness, measure the effectiveness of homeless patient identification upon admission, assess the feasibility of using medical students as resource navigators, and determine the use of resources by patients 30 days post discharge. Methods: A literature review and resource mapping exercise were completed to identify the most accurate screening questions for homelessness in a busy clinical setting and to develop a community-wide resource guide for patients. Academic presentation was completed for GW internal medicine residents to introduce the topic, describe protocol, and answer any questions. Data collection comprised of daily patient interviews and retrospective chart analysis, including review of admission dates, clinician coding practices and screening of housing status, discharge dates, and resource guide usage. Results: Charts analyzed for a total of 8 weeks showed an increase in the proper documentation of homelessness but there is still room for improvement as housing status was often documented in other areas of the chart. It became apparent that identification would be one of the biggest barriers to seeing these patients. This project also provided insight into the barriers a medical student may face when trying to provide resources, including chart review time, presence of housing status documentation, knowledge of DC resources, etc. Furthermore, while many patients could be identified on chart review, it was difficult to speak with each patient to have the opportunity to provide resources. Conclusion: While a medical student could be used as a resource navigator, there appear to be more efficient methods. GW Hospital needs to continue improving housing status documentation so resources can be automatically provided upon discharge. Also, while interviewing patients, it was apparent that simply handing out the resource guide was not sufficient. Discussing options and learning about each patient was the most valuable. There is significant potential for integrating medical students into the discharge process and I look forward to continuing work towards that goal.
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Open Access
1
Medical Student Patient Navigators: Connecting Hospitalized Homeless Patients to Outpatient Care
Background: Washington D.C. has extensive resources to serve the homeless population; however, connecting these patients with resources upon discharge from GW hospital remains a challenge. After key informant interviews with local physicians who care for the homeless community, we decided to explore the use of medical students to bridge the gap between patient discharge and follow-up with local resources. Objectives: This project aimed to identify community-wide resources to connect patients with comprehensive follow-up care, train internal medicine residents to identify and use specific ICD-10 codes for homelessness, measure the effectiveness of homeless patient identification upon admission, assess the feasibility of using medical students as resource navigators, and determine the use of resources by patients 30 days post discharge. Methods: A literature review and resource mapping exercise were completed to identify the most accurate screening questions for homelessness in a busy clinical setting and to develop a community-wide resource guide for patients. Academic presentation was completed for GW internal medicine residents to introduce the topic, describe protocol, and answer any questions. Data collection comprised of daily patient interviews and retrospective chart analysis, including review of admission dates, clinician coding practices and screening of housing status, discharge dates, and resource guide usage. Results: Charts analyzed for a total of 8 weeks showed an increase in the proper documentation of homelessness but there is still room for improvement as housing status was often documented in other areas of the chart. It became apparent that identification would be one of the biggest barriers to seeing these patients. This project also provided insight into the barriers a medical student may face when trying to provide resources, including chart review time, presence of housing status documentation, knowledge of DC resources, etc. Furthermore, while many patients could be identified on chart review, it was difficult to speak with each patient to have the opportunity to provide resources. Conclusion: While a medical student could be used as a resource navigator, there appear to be more efficient methods. GW Hospital needs to continue improving housing status documentation so resources can be automatically provided upon discharge. Also, while interviewing patients, it was apparent that simply handing out the resource guide was not sufficient. Discussing options and learning about each patient was the most valuable. There is significant potential for integrating medical students into the discharge process and I look forward to continuing work towards that goal.
Comments
Presented at Research Days 2019.