SHM Converge Scientific Abstract ePoster Gallery-"I'm Worried, Stressed Out, Trying to Survive": A Qualitative Analysis Exploring Discharge Planning for Patients Experiencing Homelessness

"I'm Worried, Stressed Out, Trying to Survive": A Qualitative Analysis Exploring Discharge Planning for Patients Experiencing Homelessness

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This qualitative study explored how hospitalized patients experiencing homelessness define a “safe” discharge plan. Conducted in 2023–2024 at a large urban safety-net hospital in the Pacific Northwest, the study used semi-structured interviews with adult general medicine patients who were homeless. Patients with severe cognitive or mental health disorders that prevented consent were excluded.<br /><br />Three main themes emerged:<br /><br />1. Basic needs: Participants emphasized day-to-day survival, especially shelter, warmth, protection from violence, and treatment for major injuries or illness. Many described extreme hardship, such as exposure to cold, inability to maintain hygiene, and worsening wounds or infections while living outdoors.<br /><br />2. Barriers to stability: Patients identified several obstacles that made safe discharge difficult, including physical limitations, harsh environmental conditions, financial instability, a history of incarceration, and loss of property. These factors often made it hard to access shelters, protect belongings, or find any stable place to recover.<br /><br />3. Role of healthcare systems: Participants recognized that hospitals and staff often wanted to help but were constrained by policy, limited funding, communication barriers, and insufficient resources. Some expressed frustration that standard discharge processes did not match their real-world needs.<br /><br />The study argues that discharge planning for patients experiencing homelessness should be individualized and grounded in basic survival needs, rather than relying only on standardized procedures like medication reconciliation. A safe discharge, from the patient perspective, means more than a paperwork-complete transition—it requires addressing the practical realities of living without stable housing.

Asset Subtitle

Anna Fuss

Meta Tag

Author List Anna Fuss, Maralyssa Bann

Category Research

Concept Homelessness

Concept Discharge Planning

Concept Safe Discharge

Concept Patient-Centered Care

Concept Shelter

Distinguished Non-Finalist

Presenter Organization University of Washington

Presenting Author Anna Fuss

Track Transitions of Care

Keywords

homelessness

hospital discharge

safe discharge

qualitative study

patient perspectives

basic needs

shelter

urban safety-net hospital

healthcare barriers

discharge planning

Homelessness

Discharge Planning

Safe Discharge

Patient-Centered Care

Shelter