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The St Thomas’ Hospital Emergency Department Homeless Health Initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ED

We carried out a quality improvement (QI) project (QIP), aiming to improve the quality, safety and equity of healthcare provided for homeless patients attending the emergency department (ED). We used QI methodology to identify areas for improvement, and introduced and modified interventions over fou...

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Detalles Bibliográficos
Autores principales: Gallaher, Charles, Herrmann, Simone, Hunter, Laura, Wilkins, Alex
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047490/
https://www.ncbi.nlm.nih.gov/pubmed/32051216
http://dx.doi.org/10.1136/bmjoq-2019-000820
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author Gallaher, Charles
Herrmann, Simone
Hunter, Laura
Wilkins, Alex
author_facet Gallaher, Charles
Herrmann, Simone
Hunter, Laura
Wilkins, Alex
author_sort Gallaher, Charles
collection PubMed
description We carried out a quality improvement (QI) project (QIP), aiming to improve the quality, safety and equity of healthcare provided for homeless patients attending the emergency department (ED). We used QI methodology to identify areas for improvement, and introduced and modified interventions over four Plan, Do, Study, Act cycles. We launched a departmental ‘Homeless Health Initiative’ (HHI), the chief intervention being the provision of ‘Homeless Health Boxes’ in the ED, which contained a ‘Safe Discharge Checklist for Homeless Patients’, maps to specialist homeless general practitioner surgeries and homeless day centres, information on other inclusion health services, copies of a local rough sleepers’ magazine and oral hygiene supplies. Voluntary Homeless Link Nurses and a number of informal ‘Homeless Health Champions’ were appointed. The HHI was embedded in departmental awareness through regular presentations to staff and incorporation into the induction programme for new doctors. Staff satisfaction, in terms of how satisfied staff members were with the care they were able to provide for homeless patients in the ED on a 0–10 scale, improved modestly over the course of the QIP from median 6/10 to median 7/10. The number of staff who were severely dissatisfied with the care they were able to provide for homeless patients improved more markedly: first quartile staff satisfaction improved from 3.875/10 to 6.125/10. Staff compliance with the checklist was poor, with full compliance observed in only 15% of cases by the end of the QIP. An HHI is a cheap and worthwhile QI project, with the potential to significantly improve the quality, safety and equity of healthcare provided for homeless patients, while improving staff satisfaction concurrently. Similar initiatives should be considered in any ED which sees a significant number of homeless patients.
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spelling pubmed-70474902020-03-09 The St Thomas’ Hospital Emergency Department Homeless Health Initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ED Gallaher, Charles Herrmann, Simone Hunter, Laura Wilkins, Alex BMJ Open Qual Quality Improvement Report We carried out a quality improvement (QI) project (QIP), aiming to improve the quality, safety and equity of healthcare provided for homeless patients attending the emergency department (ED). We used QI methodology to identify areas for improvement, and introduced and modified interventions over four Plan, Do, Study, Act cycles. We launched a departmental ‘Homeless Health Initiative’ (HHI), the chief intervention being the provision of ‘Homeless Health Boxes’ in the ED, which contained a ‘Safe Discharge Checklist for Homeless Patients’, maps to specialist homeless general practitioner surgeries and homeless day centres, information on other inclusion health services, copies of a local rough sleepers’ magazine and oral hygiene supplies. Voluntary Homeless Link Nurses and a number of informal ‘Homeless Health Champions’ were appointed. The HHI was embedded in departmental awareness through regular presentations to staff and incorporation into the induction programme for new doctors. Staff satisfaction, in terms of how satisfied staff members were with the care they were able to provide for homeless patients in the ED on a 0–10 scale, improved modestly over the course of the QIP from median 6/10 to median 7/10. The number of staff who were severely dissatisfied with the care they were able to provide for homeless patients improved more markedly: first quartile staff satisfaction improved from 3.875/10 to 6.125/10. Staff compliance with the checklist was poor, with full compliance observed in only 15% of cases by the end of the QIP. An HHI is a cheap and worthwhile QI project, with the potential to significantly improve the quality, safety and equity of healthcare provided for homeless patients, while improving staff satisfaction concurrently. Similar initiatives should be considered in any ED which sees a significant number of homeless patients. BMJ Publishing Group 2020-02-12 /pmc/articles/PMC7047490/ /pubmed/32051216 http://dx.doi.org/10.1136/bmjoq-2019-000820 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Quality Improvement Report
Gallaher, Charles
Herrmann, Simone
Hunter, Laura
Wilkins, Alex
The St Thomas’ Hospital Emergency Department Homeless Health Initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ED
title The St Thomas’ Hospital Emergency Department Homeless Health Initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ED
title_full The St Thomas’ Hospital Emergency Department Homeless Health Initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ED
title_fullStr The St Thomas’ Hospital Emergency Department Homeless Health Initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ED
title_full_unstemmed The St Thomas’ Hospital Emergency Department Homeless Health Initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ED
title_short The St Thomas’ Hospital Emergency Department Homeless Health Initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ED
title_sort st thomas’ hospital emergency department homeless health initiative: improving the quality, safety and equity of healthcare provided for homeless patients attending the ed
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047490/
https://www.ncbi.nlm.nih.gov/pubmed/32051216
http://dx.doi.org/10.1136/bmjoq-2019-000820
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