Project Renewal: Homeless Patients, High Quality Healthcare February 2013 Quality Improvement Grantee Spotlight
To successfully treat more than 8,600 homeless patients a year, you have to be dedicated and diligent. HRSA-supported health center Project Renewal finds that it also pays to hold yourself to the same quality standards as providers who practice in a less challenging environment.
- Deploy an interoperable electronic health record? Check.
- Qualify for the Federal Meaningful Use incentive program? Done.
- Integrate the principles of the National Quality Strategy? In process.
- Achieve the goals of Healthy People 2020? All on board.
Controlling hypertension is never easy, but when your patients tend to seek care irregularly, move frequently, have a high prevalence of both chronic and acute conditions and distrust the medical system, it seems almost impossible.
But that’s exactly what Project Renewal has done. In 2011, 51 percent of hypertensive patients had their blood pressure under control; a 2012 chart review shows the number has climbed to 60 percent, thanks to close monitoring of medication compliance with an assist from local pharmacy students working with the program.
Go to the Mountain
Knowing that the many homeless patients will not come to Project Renewal, Project Renewal goes to the homeless patients.
Three mobile clinics (CARE – A – VANS), certified by the National Committee for Quality Assurance as Level 1 Patient Centered Medical Homes, regularly and at all hours go to homeless shelters, emergency housing and even New York City parks where homeless people are known to congregate.
They start small, first just walking around and becoming familiar to the homeless people. Over time, their presence in the community earns a level of trust and they begin to offer health services.
Because hypertension is so common and such a health threat, Project Renewal focuses on its prevention and treatment by providing health checks that include blood pressure and cholesterol testing at the first opportunity.
To help ensure patients follow treatment plans and remain in care, Project Renewal connects patients with other resources, verifies their eligibility for Medicaid and uses the electronic health record to schedule follow up appointments, order medications and exchange patient health information across providers.
Patients who later seek care at another Project Renewal mobile or freestanding clinic find providers who have instant access to their full health records and are fully prepared to respond in a patient-focused way that is consistent across providers.