Homeless Healthcare CORE PCIM Rotation

Lesson Plan
Homelessness Healthcare Core PCIM Rotation @ Woodhull

Caring for patients experiencing homelessness

Summary

1. Subject(s): Homelessness - Clinical and Systemic Factors 

2. Objectives: 

   1. By the end of this rotation, the resident should have basic competency in the skills of: patient-centered interviewing to engage patients in behavior change conversations in a non-judgemental manner, collaborative development of treatment plans, and taking a trauma-informed approach.

   2. Residents will also have basic understanding of common medications ailments affecting patients experiencing homelessness, along with collaborative treatment options.  Residents will learn systemic factors that contribute to homelessness and how systems affect the care of this vulnerable population. 

   3. The resident will rotate through the following outpatient experiences: Woodhull Homelessness Healthcare

Adult Learning Tip: What do you know about these topics?  Have you cared for patients needing these procedures?  What questions have come to mind?  How could you integrate these procedures into your practice?  Use your questions as conversation starters to introduce to your subspecialty faculty as you get to know them over the next few weeks.

3. Time Allotment: A dedicated 2-week section of an X block for a focused learning experience.  

Materials & Resources

Adult Learning Tip: Use the resources below to familiarize yourself with the supplies, steps and techniques involved so you can have a more nuanced learning experience when you are on the rotation.  

Resources:

1. Podcasts

   1. Health Affairs - Podcast: A Disproportionate Share: Meditations on Safety Net Hospitals & How We Pay For Them https://www.healthaffairs.org/do/10.1377/hp20221223.346098/full/

   2. Health Affairs - Podcast: A Disproportionate Share: A Complex Patchwork of Supplemental Payments https://www.healthaffairs.org/do/10.1377/hp20221223.651856/full/

   3. Health Affairs - Podcast: A Disproportionate Share: The Future of Safety Net Hospitals & Payment Policies https://www.healthaffairs.org/do/10.1377/hp20221223.105519/full/

2. Websites

   1. Street Medicine Institute https://www.streetmedicine.org/

   2. National Coalition for the Homeless - Factsheets http://www.nationalhomeless.org/factsheets/ 

3. Journal / Review Articles

   1. Care of the Homeless Patient - Med Clin North America2015 

   2. UpToDate Review on Health care of people experiencing homelessness https://www.uptodate.com/contents/health-care-of-people-experiencing-homelessness-in-the-united-states 

   3. Advance Care Planning for Individuals Experiencing Homelessness

4. News Articles

   1. NY Times Magazine - ‘You Have to Learn to Listen’: How a Doctor Cares for Boston’s Homeless - Lessons from Dr. Jim O’Connell’s long crusade to treat the city’s “rough sleepers.” 

   2. NY Times - What’s Homelessness Really Like? Thirty people answer questions and share their experiences. https://www.nytimes.com/interactive/2023/02/10/headway/homelessness-mental-health-us.html

5. Modules

   1. ACP Caring with Compassion - The knowledge and skills you need to serve at-risk populations (requires ACP membership) https://caringwithcompassion.org/

Assessment

At the end of your rotation, your faculty subspecialty attendings will be asked to complete an evaluation on your performance.  This will reflect your progress on the objectives outlined above.  You will have an opportunity to evaluate our rotation as well - we look forward to specific feedback which will help us grow and improve these experiences going forward!