Background: The Mobile Clinic Project (MCP) has served the unhoused community at weekly streetside clinics in Hollywood for 25 years. Through this review, we found that a large proportion of our clients had signs and symptoms of heart failure. Thus, we proposed a novel project utilizing point-of-care ultrasound (POCUS) as a tool to screen patients for heart failure. A $50,0000 grant was awarded to the team for project implementation.

Objectives:

1. Standardize HF screening through POCUS protocols for attendings and medical students
2. Identify novel risk factors unique to our clients to trigger heart failure screening in the absence of classic signs of heart failure.

Design:

This project will take place at MCP, which operates a weekly clinic in Hollywood. Patients will be screened for classic signs and symptoms of heart failure to identify those at risk and subsequently undergo a POCUS for heart failure screening. Depending on the screening results and in conjunction with the patient’s preference, we will refer our positive screening patients to follow-up care.

Impact/Effectiveness:

This is a stepping stone to faster and more accessible care. We bring a tool to inform our patients about their health and utilize it as a resource for further advocacy. Furthermore, we can better understand risk factors and exposures that may put them at higher risk of heart failure.

Lessons Learned:

I reinforced my knowledge about inaccessibility to care, especially to those who have unstable housing or are uninsured. Although many resources exist in the community, many of those resources don’t have adequate tools to provide additional or specialized care, even for chronic conditions such as heart failure.

Summary:

The integration of this project could pave the way for other streetside clinics to implement POCUS into their care models and possibly new indicators for heart failure screening.