Saban Community Clinic is a Federally Qualified Health Clinic (FQHC), that serves the greater Hollywood area with three clinics. Through the E6 program, which is geared toward serving homeless clients, Saban providers are able to provide basic medical care to these clients at their respective encampments. In 2017, roughly 1360 homeless clients were seen throughout all three clinics. So far in 2018, Saban providers have been able to see 58 homeless clients. While these patients receive excellent medical care in these sessions, many of them do not have primary care providers. This quality improvement projects goal is to assess some of the common characteristics in this population, and to find what specific barriers they face in receiving primary medical care. The goal of this project is to help Saban providers be more informed regarding this patient population, and to serve as a starting point for more through tracking of patients, and more efficient care.
Methods: A retrospective chart analysis of 32 homeless clients of the E6 program at The Center at Blessed Sacrament were evaluated. Specific information concerning length of homelessness, problem list/diagnosis, ethnicity, age, etc were gathered during research. In addition 7 survey’s from the case
Common diagnosis’s of the E6 patients reviewed were, average length of homelessness was 5.48 years, caucasian was the most common ethnicity of clients, average age was 41.2 years of age. Survey results illustrated that previously cited barriers such as fear of stigma and lack of trust of medical providers were ranked lower as barriers to homeless clients, however barriers like transportation and mental health were higher rated. Common diagnosis in this population include Mental Health, Chronic Pain, and IV drug use. The data gathered is not statistically significant due to the small patient population, despite this general recommendations and trends can be viewed. Data attainment was difficulty due to variation in visit/encounter documentation and low survey completion.
Demographic data collected form the chart review reveal that most of the E6 patients have IV drug use diagnoses, mental health diagnoses and often times chronic pain. This data is corresponds to much of the data regarding this health care population The homeless population have large populations of young adults and those over 50, in addition more of this population have been homeless for less than 5 years. This indicates that the population has two large subsets the young who are at higher risk of substance abuse and STI’s and the elderly who have higher incidence of chronic diseases like HTN and DM2, along with chronic pain. The greatest barrier affecting this population continues to be unctonroled or poorly managed mental health concerns, illustrated by the survey
From the results of the survey and the analysis of the collected the E6 clientele need greater access to mental health providers. Saban has two locations that have behavior wellness centers that provide psychological counseling, if efforts are made to routinely plug these patients into psychiatric care at these facilities, then primary care can be conducted in same visits. Expansion of Saban’s commitment to the E6 clients is also needed. Currently two providers assist the programs case managers which currently is sufficient to manage client care, however additional personnel would be invaluable to allow for, better client tracking, organizing weekly/biweekly provider visits, organizing patient charts/encounter notes. These additions will allow for Saban to advance its care for this vulnerable population.