Biederman and Colleague Submit CTSI Application

Kudos to Donna Biederman, associate professor; and her collaborator Sally Wilson, executive director of Project Access of Durham County; for the submission of their Duke Clinical & Translational Science Institute (CTSI) application entitled "Durham Homeless Care Transitions Evaluation Project." This proposal requests funding for a one-year period with a start date of July 1, 2019.

Persons experiencing homelessness have worse health outcomes and higher acute care utilization as compared to their domiciled counterparts. Medical respite programs provide a safe and clean place for individuals experiencing homelessness to recover from illness, injury, and medical procedures and during prolonged treatments such as chemotherapy or IV antibiotic administration. Our team developed  and implemented a successful medical respite pilot program and received a prestigious award to develop the Durham Homeless Care Transitions (DHCT) program, an evidence-based 9-month intensive case management program for homeless patients exiting an institutional setting (e.g., hospital, mental health setting, jail) and includes a medical respite component based on individual patient needs. DHCT aims to decrease homeless patient ED utilization and inpatient bed days though connection to primary care. Other expected program outcomes include improved housing and connection to: 1) community resources; 2) income; 3) friends and / or family; and 4) mental health and / or substance abuse treatment if needed. From 7/1/16 to 3/15/19, DHCT enrolled 88 patients; of these, 50 also received medical respite care. At this time, a robust program evaluation is warranted to highlight DHCT mid-program outcomes, and affiliate and patient perceptions, to demonstrate program value in efforts to promote DHCT sustainability.