Health care (maintenance) for the homeless: Integrating preventative care into a HCH clinic

Like many HCH sites, the Mission Neighborhood Resource Center (MNRC) in San Francisco serves a dynamic and highly mobile patient population. As a result, no-show rates are high and preventative care often takes a backseat to acute complaints for both patients and providers. However, over the last 2 years, MNRC has doubled rates of routine screening, dramatically improving health care maintenance across a broad range of clinical indicators. This workshop will showcase our practice transformation from serving as an urgent care clinic to becoming a true medical home, while preserving the flexibility and open access that our patients experiencing homelessness need. We will share multiple ideas for interventions, including the development of standardized care protocols and data tracking systems, the empowerment of nurses and MAs to proactively address preventative care at every visit, and creative approaches such as the use of a raffle to motivate patients to complete recommended screenings. Through lecture and examples from our clinic, we will review best practices for diabetic health care maintenance, women's health, counseling on weight and smoking cessation, and cancer screening. Participants will be encouraged to brainstorm ways to bring preventative care into their practice.