Implementing a hospital-based case management intervention for people experiencing homelessness: the navigator...

Area of Science:

• Healthcare management
• Public health interventions
• Social determinants of health

Background:

• People experiencing homelessness (PEH) face significant health disparities and hospitalization challenges.
• Hospitalization presents a critical opportunity to address social needs and improve care transitions for PEH.
• The Navigator Program is a hospital-based critical time intervention designed to support PEH during and after hospitalization.

Purpose of the Study:

• To explore the supports and challenges in implementing the Navigator Program.
• To identify effective strategies for hospital-based interventions for PEH.
• To understand facilitators and barriers to program implementation.

Main Methods:

• Qualitative study involving 35 interviews with program staff, healthcare professionals, and community providers.
• 130 hours of non-participant observation.
• Analysis using the Framework Method and Consolidated Framework for Implementation Research.

Main Results:

• Program success was linked to a recognized need for the intervention and a flexible implementation approach.
• Securing stakeholder buy-in through formal and informal methods was crucial.
• A hospital-based model fostered collaboration between healthcare and social service providers, enhancing care coordination.

Conclusions:

• Effective implementation of programs addressing complex health and social issues is vital for success.
• The Navigator Program offers practical strategies for implementing similar interventions in hospitals.
• Lessons learned can inform healthcare systems in Canada and globally with similar structures.