Category: Federal Forum Posters
Purpose: Although homeless Veterans may receive care through the Veterans Affairs (VA), it is difficult to contact them for follow-up. As a result, homeless Veterans often rely on emergency departments without receiving chronic and preventative care. Our VA medical center has established a day shelter for homeless Veterans, where they may shower, launder clothing, and find employment and housing with assistance from social workers. Healthcare support, however, is not currently available. This quality improvement project aims to implement a weekly clinic run by a post-graduate-year-2 (PGY2) psychiatric pharmacy resident to provide primary care and psychiatric support to those Veterans.
Methods: The Institutional Review Board (IRB) reviewed the project and determined it a non-research quality-improvement project. A half-day weekly walk-in clinic with 30-minute appointment time slots will be established to operate from September 2018 through March 2019. A prospective group will consist of “walk-in” appointments, or those referred by social workers at the day shelter. The pharmacy resident will be supervised by a psychiatric pharmacist. During each appointment, the following services will be provided by the pharmacy resident (if appropriate): medication review, medication or dose adjustment, discontinuation, or initiation, evaluation of drug-drug interactions and adverse drug reactions, identification of non-VA medications, patient referrals, follow-ups scheduled, patient education, psychiatric assessments using tools for depression (PHQ-9) and PTSD Checklist for DSM-5, and discussion of the Whole Health for Life VA initiative.
The retrospective patient group will consist of the same Veterans prior to receiving service from the walk-in clinic. Data collection includes documentation of a mental health diagnosis, date of their last appointment with a healthcare provider, their percentage of adherence based on refill history of chronic medications, and visits to the emergency department or hospitalizations. Prospective and retrospective data will be analyzed to evaluate the impact of the clinic on patient outcomes.
Results: not applicable
Conclusion: not applicable
Elizabeth Haake– Resident, VA Sierra Nevada Health Care System, Reno, NV