1/Join us for "Research to Measure What Matters in Primary Care for Persons Experiencing Homelessness: What's the Point, Really?"
@HarvardChanSPH Initiative on Health & Homelessness
Register online for our event Wed 11/10, 1pm EST
Let me offer a brief 🧵:
@HarvardChanSPH Initiative on Health & Homelessness
Register online for our event Wed 11/10, 1pm EST
Let me offer a brief 🧵:
2/I began focusing on homeless patients' views of care after working in Boston's shelters.
"Wow!" I thought "much of what we do we doesn't look good with traditional ways of measuring quality of care!"
My co-presenter Dr. Roncarati has >15 yrs with the @BHCHP Street Team
"Wow!" I thought "much of what we do we doesn't look good with traditional ways of measuring quality of care!"
My co-presenter Dr. Roncarati has >15 yrs with the @BHCHP Street Team
3/Standard quality of care metrics (visit counts, blood pressure checks) seem good
but what if what we homeless health clinicians *really focus on* is:
"Spending hours to build trust with a person who has been traumatized by repeated bad experiences in health care?"?
but what if what we homeless health clinicians *really focus on* is:
"Spending hours to build trust with a person who has been traumatized by repeated bad experiences in health care?"?
4/The "customary metrics" for primary care may conflict with what homeless patients need. If I spend 40 minutes building trust with someone with active addiction that could be scored as
a) inefficient
b) failure to check boxes for hypertension and diabetes management
What gives?
a) inefficient
b) failure to check boxes for hypertension and diabetes management
What gives?
5/So we put a decade into developing patient-centered measures that reflect the highest aspirations of patients who have been homeless & expert clinicians - chunks of that are published: pubmed.ncbi.nlm.nih.gov/33827104/
But there are tough questions
But there are tough questions
6/What makes a homeless-tailored primary care care model unique?
Does this apply on the streets?
And here is the biggie?
Is the *health care focus a DISTRACTION* from the essential truth that people --need--- HOUSING?
Does this apply on the streets?
And here is the biggie?
Is the *health care focus a DISTRACTION* from the essential truth that people --need--- HOUSING?
7/Our discussant Dr. Jill Roncarati is a health services researcher & PA with experience on the @BHCHP street team- her research shows that after the most vulnerable are housed, it's not a simple story: pubmed.ncbi.nlm.nih.gov/33710091/
8/And that's the challenge. One can argue that homeless health care research is really just "how to rearrange the deck chairs on the Titanic".. instead of dealing with the Titanic (HOUSING).
Or perhaps, the health care issues are crucial no matter what! JOIN US /fin
Or perhaps, the health care issues are crucial no matter what! JOIN US /fin
9/ @dianeyentel @hardlynormal @homeless_new @homeless_hero @KellyMDoran @DeborahPadgett5 @CarlynZwaren @MKushel @AllysonVarley @DrAudreyJones @AJ_Gordon @slsatel @VACtrHomeless @BHCHP
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