Homelessness Research Poster Project

Kerri Souter

Ferris State University

Continued Increase in the Rate of Homelessness

Shows the Need for Improved Support :

The nation’s homeless population increased by approximately

20,000 people from 2008-2009 (3% increase).

An estimated 656,129 people experience homelessness in the

United States on a given night (This translates to a rate of 21

homeless people/10,000 people in the general population).

According to research (n.d.),“Homeless people spent an average

of four days longer per hospital visit than comparable non-homeless

people. This extra cost, approximately $2,414 per hospitalization, is

attributable to homelessness” (National Alliance to End

Homelessness).

Homelessness

continues to be

a concern

because of the

increased

morbidity and

mortality of this

population and

the overall

burden it has on

the existing

health care

system.

The purpose of this presentation is

to clearly define a research

proposal that focuses on decreasing

the cost burden placed on hospitals

by the homeless population with

the implementation of a homeless

liaison.

The Purpose of this

Presentation:

Why homeless liaisons are needed in the hospital:

Homelessness in the US continues to be a leading social problem

The enormous cost burden this population places on the health care system

Previous research data has shown the need for a change in the way homelessness is being addressed

Requirement of ongoing health services for the acute and chronic conditions that accompany being homeless

The Hospital

Homeless

Liaison

.

• Will be hired and paid for by the participating hospital.

• Will need to have Care Management experience and

be dedicated to the homeless population.

• Will assist with the attainment of basic needs (safety,

person hygiene, adequate nutrition, adequate shelter,

adequate health care, addiction management) and be

able to link the homeless individuals to appropriate

community resources.

• Will be certified in Service Outreach and Recovery

(SOAR) and will assist the homeless individuals fill out

paperwork needed for state support. This process will

start in the hospital and will follow up until process is

complete.

• Will be required to go out into the community to follow

up with this population to track their progress and

encourage compliance with recommendations.

After Discharge Follow Up:

According to a study by Nickasch and Marnocha (2009), “One

hundred percent (n=9) of the homeless individuals went to the local

Salvation Army and Homeless Shelter for a cold breakfast and a

warm meal over the lunch hour each day” (p. 43)

Based on the above study, follow up

appointments should be available at

the same location as local homeless

assistance programs.

Are hospitals who implement a

homeless liaison at less

financial risk compared with

hospitals who do not implement a

homeless liaison?

Research Question:

Process for Success of

this Research Proposal:

A preliminary survey will be completed (by Care Management, Finance/ Billing Departments) to see how many homeless individuals come into the emergency room yearly. The finance department will compare the cost the homeless population is placing on the hospital to the cost of implementation of a homeless liaison for one year.

Obtain approval by the hospital administrators for the implementation of a hospital liaison. This will provide validity for this project.

Solicit funding for this research project from the hospital and from the National Institute of Mental Health for costs above and beyond the cost of the liaison.

Submit proposal to the Institutional Review Board (IRB) for approval and ethical oversight of project

A l o n g i tu d i na l s tu d y w i l l b e p er fo rmed an d w i l l u se d a ta

co l l ec ted f ro m th e h o mel ess p ar t i c i p an ts an d o u tco mes

th a t th e i mp l emen ta t i o n o f a h o mel ess l i a i so n h ad o n th e

co s t b u rd en to th e h o sp i ta l .

A p re an d p o s t su rvey w i l l b e f i l l ed o u t o r an sw ered b y a l l

p a r t i c i p an ts o n th e i mp ac t th e ass i s tan ce p ro g ram h as

p ro vi d ed th em .

Longitudinal Study:

Study Participants &

Length of Study: Data Collection:

All homeless individuals who enter

the hospital system will be asked

to participate in this study. They

will be tracked using a care plan to

identify needs and follow up care

provided.

This study will be conducted over 1

year to assess if the

implementation of a hospital

homeless liaison will decrease the

cost burden placed on the health

care system by this at risk

population.

The finance/billing department

and the homeless liaison (Care

Manager) would be responsible

for the data collection and

reporting.

Possible Approach:

Potential Problems:

•Difficulty tracking this population

•Noncompliance

•Mistrust of health care workers agendas by this population

•Length of time tit takes to complete a longitudinal study

•Cost due to implementation of Nursing Position

By l inking homeless indiv iduals to the hospita l and

community services, hospita l l ia isons could play a

cr i t ical ro le in assist ing with important paperwork,

improving support systems, and promoting heal thier

l i festyles.

This study wi l l help nurses by ident i fying this at

r isk populat ion by creat ing a consistent care plan

that ident i f ies these indiv iduals and their needs.

Implications of this Research

and Importance to Nursing

Practice:

References:

National Alliance to End Homelessness; Cost of Homelessness. (n.d.), Retrieved from http://www.endhomelessness.org

Nieswiadomy, R. (2008). Foundations of Nursing Research (5th ed., pp. 3-414). Upper Saddle River, NJ: Pearson Education, Inc.

Nickasch, B., & Marnocha, S. (2009). Health Care Experiences of the Homeless. Journal of the American Academy of Nurse Practitioners, 21, 39- 46. doi: 10.1111/j.1745- 7599.2008.00371.x

Sermons, M., White, P. (2011). State of Homelessness in America. A Research Report on Homelessness. National Alliance to end Homelessness. Retrieved from www.endhomelessness.org

Service Outreach and Recovery (2011), Retrieved from

http://nrepp.samhsa.gov/ViewIntervention.aspx?id=164