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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