Please use this identifier to cite or link to this item: http://hdl.handle.net/10125/69035

IMPLEMENTATION OF A STANDARDIZED WORKFLOW FOR THE DISCHARGE OF PATIENTS WHO ARE HOMELESS AT A TERTIARY MEDICAL CENTER

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Title:IMPLEMENTATION OF A STANDARDIZED WORKFLOW FOR THE DISCHARGE OF PATIENTS WHO ARE HOMELESS AT A TERTIARY MEDICAL CENTER
Authors:Shannon, Flannery A.
Contributors:Tse, Alice M. (advisor)
Nursing (department)
Keywords:Nursing
biopsychosocial
discharge
healthcare
homeless
show 2 morehouseless
standard of care
show less
Date Issued:2020
Publisher:University of Hawai'i at Manoa
Abstract:Background: Individuals who are homeless are at risk for poor health outcomes. This population often triages their baseline needs over their medical conditions. As a result, minor conditions evolve into critical health events requiring acute medical care and readmissions. This is followed by increased rates of acute medical care usage and mortality in homeless patients. Hawaii has one of the highest rates of homelessness in the country, with 60% treated primarily at a tertiary medical center (TMC) in urban Honolulu. Resulting in an excessive and partially preventable expense for both the TMC and the state’s Medicaid program. Due to this pattern and recent legislation passed in California addressing this issue, the Healthcare Association of Hawaii (HAH) has collaborated with community partners to develop a standard of care for the discharge of homeless patients to the community. Aim: The goal of this project was to integrate HAH’s community standards of care into a standardized approach for the discharge of homeless patients from an emergency department observational unit at the TMC. This was accomplished through a collaborative effort to develop an EMR template (workflow) that met HAH’s guidelines and improved staffs’ efficacy in identifying and addressing biopsychosocial deficits impacting the health stabilization of homeless patients returning to the community. Method: Project volunteers’ attendance to the workflow training were recorded. The number of homeless patients admitted to the unit, their identified biopsychosocial needs and the volunteers’ ability to meet these needs were recorded. Results: Fifty-seven percent of volunteers were trained to utilize the workflow. One hundred percent of homeless patient encounters utilized a workflow, identified at least four biopsychosocial deficits, and addressed every deficit identified. Discussion: It is inconclusive if the training was necessary for the use of the workflow. Volunteers were efficient in completing workflows and addressing identified needs. As evidenced by this project, this population exhibited high rates of deficits requiring attention for proper healthcare maintenance post-discharge.
Pages/Duration:48 pages
URI:http://hdl.handle.net/10125/69035
Rights:All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
Appears in Collections: D.N.P. - Nursing Practice


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