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Introduction: Unhoused individuals in Skid Row experience a disproportionate burden of chronic, untreated wounds and acute illness. Without timely intervention, these conditions can progress to severe complications and death. Across Los Angeles County, over 75,000 individuals experience homelessness, with approximately 4,000–5,000 concentrated in Skid Row. Nearly 70% are unsheltered, facing significant barriers to accessing traditional healthcare. In response to these gaps, UCLA’s Student Run Homeless Clinics (SRHC), in partnership with Union Rescue Mission (URM), implemented a weekly, student-led, on-foot ‘wound-care x prayer walk’ outreach model delivering real-time wound care through relationship-centered engagement. Outreach was conducted alongside chaplain teams providing optional supportive engagement through prayer, while medical students, supervised by an attending physician, directly engaged with individuals to assess and treat wounds and acute illness on-site. The needs identified through these encounters informed the development of this quality improvement project.

Objective: To design, implement, and evaluate an innovative, community-partnered street outreach model integrating chaplain support and wound care to improve patient care delivery, medical student education, and community partner capacity.

Methods: This was a mixed-methods QI project. Outreach was conducted weekly by medical students alongside community partners, including chaplain teams providing optional prayer and engagement. Clinical care, including wound assessment, treatment, and triage, was delivered in real time during encounters. Data collection included clinical characteristics (wound type, severity, acute vs. chronic), care delivered and outcomes, patient barriers to care, wound photography, and semi-structured interviews with community partners. Quantitative data were analyzed using descriptive statistics, and qualitative data will be analyzed using thematic analysis.

Preliminary Findings/Results: Over a 12-month period, 190 patients were evaluated and treated. Most presentations included chronic wounds and acute infections, often at advanced stages due to delayed care and limited access to hygiene resources. Patients reported limited mobility, inability to leave belongings or pets, healthcare distrust, prior negative experiences, and difficulty navigating care as key barriers to accessing services. Of those treated, 169 patients (89.0%) were successfully managed in the field, 14 patients (7.4%) received warm-hand offs to Wesley Health Center, and 7 patients (3.7%) required escalation to the emergency department.

Conclusion: This student-led, on-foot outreach model reached patients at critical moments, with 89% managed in the field. Patients frequently presented with advanced wounds and faced significant barriers to care, including mobility limitations, healthcare distrust, and concerns about belongings and pets. Through consistent, street-based engagement with community partners, patients were more willing to accept care and share concerns. Chaplain supported engagement (e.g., prayer) was well received and appeared to facilitate trust and disclosure, including previously unaddressed wounds. These findings suggest that relationship centered, community partnered approaches can improve engagement and access to care in vulnerable populations. This model offers a scalable approach to delivering low-barrier, community-based care while serving as a framework for medical student education and outreach.

Future Directions: Following current initial data collection and analysis, findings from this project will inform future targeted, iterative interventions across three domains: 1) Enhanced outreach and patient care by addressing patient-identified barriers and real-world needs; 2) Medical student education and training through development and evaluation of a street medicine wound-care curriculum to strengthen clinical skills in low-resource settings; and 3) Community partner capacity expansion through partner training and resources to improve care coordination with potential to scale to additional shelters in Skid Row if successful.

Acknowledgements: This project was supported by the UCLA DGSOM Center of Excellence. We thank Union  Rescue Mission (URM) in Skid Row, SRHC chiefs, Chaplain Lisa and Rasheed, Naureen, Jimmy, and Wesley Health Centers, and all community members who participated in outreach.