Supporting Emergency Department Patients Experiencing Homelessness

Area of Science:

• Public Health
• Emergency Medicine
• Social Determinants of Health

Background:

• Homelessness presents a significant and growing public health crisis in the United States.
• Emergency departments (EDs) are critical access points for individuals experiencing homelessness, who often have complex medical and social needs.

Purpose of the Study:

• To outline strategies for emergency physicians to address the immediate medical concerns and social drivers of health for patients experiencing homelessness.
• To highlight practice adaptations within the ED and complementary initiatives outside the ED to support this vulnerable population.

Main Methods:

• Review of practice adaptations within the emergency department, including early engagement, trauma-informed care, addressing nonmedical needs, safe dispositions, and documentation.
• Description of external programs such as street medicine and government initiatives.
• Emphasis on utilizing existing programs and incentives for sustainable solutions.

Main Results:

• EDs can initiate care coordination to meet the hierarchy of needs for patients experiencing homelessness.
• Key practice adaptations include trauma-informed care, addressing nonmedical needs, and establishing safe discharge plans.
• Integrating street medicine and government initiatives can provide comprehensive support.

Conclusions:

• Emergency physicians play a vital role in addressing the multifaceted needs of patients experiencing homelessness.
• Coordinated care within the ED, coupled with external resources, can improve health outcomes and facilitate transitions to appropriate care settings.
• Sustainable solutions leverage existing community programs and incentives to support long-term well-being.