Title : Interprofessional collaboration of nursing, social work and psychology staff improve vulnerable patient care
Rationale/Background: To increase access to and quality of care for homeless veterans, a structure including Interprofessional Collaboration (IPC) regional teams (Social Work, Nursing, Psychology) and Housing Resource Groups (HRGs) was developed to provide coordinated assistance in the communities where veterans reside.
Methods. 1) Evaluation of homeless veteran attendance. A measure of weekly HRGs attendance (2010-2015) was tabulated for veterans across three regions. The measure was constructed from Social Security numbers recorded from each veteran visit. Approximately 50% of tabulations include repeat visits (approximately half of all veterans came a second time for assistance). 2) Evaluation of impact on providers. The impact of the change in the program on providers was measured over time, using a repeated measures approach and one established survey tool (AITCS, Orchard, 2010), designed to measure how well teams work collaboratively. All participants at the regional plenary meetings were surveyed on December 2011, January 2013, and January 2015, using a convenience, inclusive sampling technique and paper-and-pencil surveys during all-day annual retreats. Participation was voluntary and surveys were de-identified. The response rate at each data collection point always exceeded 90%.
Outcomes: The redesign was perceived by participants as effective in coordinating service delivery. Specifically, measurement of two key outcomes demonstrated that for those receiving services across a dauntingly large geographic area, housing and services were accessed and used with demonstrably greater efficiencies. Veteran visits became characterized as one-stop where multiple needs were met. Outcome measures of the combined practice models indicated increased access to care for homeless veterans, and provider self-report of increased collaboration, coordination, and communication of stakeholders.
Conclusion: Study outcomes indicate that this project redesign was effective in improving access to services for homeless veterans and improved interprofessional collaboration of staff. The HRGs and redesign to regional teams continues as of this writing.