SHM Converge Scientific Abstract ePoster Gallery-Use of a Shelter Database to Determine Missed Identification of Homelessness at an Urban Academic Hospital

Pdf Summary

This study examined how often homelessness was correctly documented in the electronic medical record during emergency department (ED) visits and hospital admissions at an urban academic hospital.<br /><br />Researchers used Washington, DC’s Homeless Management Information System (HMIS) to identify adults known to have used shelters or transitional housing between September 1, 2019 and February 29, 2020. They then matched these individuals to electronic medical records and reviewed charts for documentation of housing status during up to two ED visits and two inpatient admissions per patient.<br /><br />Out of 2,523 HMIS entries with matching EMR charts, 702 patients met inclusion criteria. Among 813 ED visits without admission, homelessness was identified in only 37% of visits (303/813). Among 220 hospital admissions, homelessness was identified in 64% (140/220). Thus, homelessness was missed in nearly two-thirds of ED visits and about one-third of admissions. The difference in identification rates between ED visits and admissions was statistically significant.<br /><br />When homelessness was documented, it appeared in different parts of the chart depending on encounter type. In ED visits, it was most often documented by ED physicians, nurses, or case management/social work. In admissions, it was commonly found in the history and physical, discharge notes or summaries, case management/social work notes, and occasionally on the problem list.<br /><br />The authors concluded that homelessness is more likely to be correctly documented during hospital admissions than during ED visits, possibly because admissions allow more time, involve more thorough assessments, and require more detailed discharge planning.

Asset Subtitle

Catherine H. McDowell

Meta Tag

Author List Aditya Maddali, Catherine H. McDowell, Hanna Haile, Jillian S. Catalanotti, Kartik S. Patel, Mario A. Pita, Matthew A. Tovar, Megan Phan, Nathan Errampalli, Richard L. Amdur

Category Research

Concept Homelessness

Concept Hospital EMR

Concept Emergency Department Visits

Concept Inpatient Admission

Concept Identification Rate

Distinguished Non-Finalist

Presenter Organization George Washington University School of Medicine and Health Sciences

Presenting Author Catherine H. McDowell

Track Other

Keywords

homelessness

electronic medical record

emergency department

hospital admissions

documentation accuracy

housing status

urban academic hospital

homeless management information system

case management

social work

Homelessness

Hospital EMR

Emergency Department Visits

Inpatient Admission

Identification Rate