Improving safe discharge options for patients experiencing homelessness
Susan (Suzi) Taylor1, Lisa Wood, Jake Turvey, Mark Petrich1Chief Allied Health Office, Clinical Excellence Division, WA Department of Health, 2Institute for Health Research, University of Notre Dame
Abstract
Background: People experiencing homelessness are overrepresented in hospitals. To reduce demand on public hospital emergency departments (EDs) and improve safer discharge pathways for homeless patients, the WA Department of Health initiated a pilot of the Homeless-Discharge-Facilitation-Fund-Project (HDFFP) at six Perth hospitals.
Objectives: To evaluate the HDFFP pilot including:
•profiling individuals supported
•examining patterns of hospital use (pre/post support)
•strategies used to ensure safer and appropriate discharge
•perceived benefits for patients, hospital staff and wider health system.
Method: An independent evaluation of the pilot was undertaken by the Home2Health team at The University of Notre Dame. Quantitative and qualitative approaches were used.
Results: In the 2021/2022 phase of the pilot, 207 patients experiencing homelessness were supported. Most funding was used to secure short-term accommodation for patients to be discharged to (85% of all expenditure), 7% was used for transportation (such as getting patients to accommodation or outpatient appointments), and 8% for other supports such as, phones, food, and toiletry items. Analysis of hospital use pre and post support demonstrated that post support:
•57% of individuals had fewer ED presentations
•54% had fewer inpatient admissions
•57% had reduced inpatient bed days.
In the hospital staff feedback survey, 91% of staff agreed HDFFP improved discharge planning, 85% said it saves hospital staff time, and 60% said it improved patient post-hospital recovery.
Conclusion: Discretionary funds empower clinicians to make decisions to ensure safer and more appropriate discharge. These funds are an enabler to further support patients into other accommodation and social support options.
Biography
Professor Wood is based at the Institute for Health Research, at The University of Notre Dame leading an innovative suite of multidisciplinary research and evaluation in the areas of homelessness and inclusion health. Her academic work is complemented by three-decades of experience in public health, government and non-government sectors within WA, nationally and internationally.
Susan (Suzi) is an occupational therapist with a PhD in health sciences and has led multiple industry-based research projects. Suzi leads the Homeless Health portfolio in the WA Chief Allied Health Office and is focussed on integrated and equitable health care approaches for people experiencing homelessness.