TEAC HOMELESS (TEACH) INITIATIVE
TEACH to learn, learn to TEACH
In an effort to help mediate the chronic public health disaster of homelessness, TEAC has developed a domestic initiative dedicated to improving health outcomes for the homeless in Philadelphia. The TEAC Homeless (TEACH) Initiative trains Temple University medical students as health educators, offers on site medical care at North Philadelphia safe havens and provides access to primary care at the Temple University Hospital (TUH) Internal Medicine Continuity Clinic.
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TEACH provides clinical services to the homeless of North Philadelphia in the shelter system through two teams – a microclinic planning team, and a long term clinic team. The microclinics offer quick screening clinics focused around a topic introduced in health literacy sessions the week prior, and offer immediate results and consultation on health issues such as diabetes and high blood pressure. A physician and upper level students also act to provide urgent care should the shelter residents needs a higher level of care, if they have more major health concerns. These microclinics provide a continuity of care that may not be accessible to the residents of the shelters.
A long term clinic team is being developed to plan a higher level transitional clinic to serve the homeless, with the ability to diagnose and treat, as well as screening should it be necessary. Oversight will be provided by a licensed physician, and the goal of the clinic is to bridge the gap between no healthcare, and a primary care physician who can then guide the patient from there on. Specifics of the clinic may change through the 2013-2014 school year as it is being planned, but it is sure to aid the homeless of North Philadelphia in both medical and social welfare needs
Taught by medical students, our health literacy workshops seek to build relationships between student volunteers and homeless participants at each site by facilitating a comfortable environment for discussion. Here residents and students alike can develop an understanding of how to engage in dialogue with one another about preventative health care. Participants are then encouraged to consider how small adjustments in their current lifestyles can help them enjoy healthier lives.
Currently TEACH visits four different sites: Kailo Haven, Progress Haven, Self Inc., and The Woodstock Family Center. At these sites TEACH provides a 12-week health literacy curriculum which includes topics such as hypertension, cold weather care, sexual health, substance use, smoking, HIV/AIDS, nutrition, and diabetes. Additionally TEACH, in continuing its mission of staying adaptable and meeting the needs and desires of the safe haven residents, has developed and provided the resources to further develop integrated health-modules. Covering topics ranging from daily planning to heart-healthy cooking, these modules aim to present a picture of health from many perspectives.
Mobile Medical Home
In an effort to provide a spectrum of essential medical and social services to the homeless in locations where they feel comfortable, TEACH has developed a monthly mobile home model that rotates throughout safe havens in North Philadelphia. Working in conjunction with medical and social work students, Temple University Hospital physicians are on site to provide clinical care and medical assessments—a prerequisite for accessing government assistance. Additional social work support is provided for those navigating the managed care system and/or seeking to establish a primary care physician for ongoing medical care. By providing multiple services in a single safe haven location, it is our hope that we can simultaneously expedite the difficult process of accessing public assistance, while also providing comprehensive, coordinated care for the homeless population in our community.
Primary Clinical Care
TEAC has developed a partnership with the Temple University Hospital (TUH) Internal Medicine Continuity Clinic to provide homeless residents with a more direct route to primary health care. Dedicated TUH Internal Medicine residents are now trained to work with homeless patients and then provide primary care to interested and eligible participants.
Ever conscious that visiting a doctor for the first time in years can be a traumatic event, particularly after living on the street, the TEACH Clinic has attempted to mediate possible trauma in the following ways:
- Maximize the presence of familiar faces.
- Homeless patients will be assigned a primary care physician whom they will always see when visiting the TUH Internal Medicine Continuity Clinic.
- Participating Internal Medicine residents will visit the safe haven in advance of initiating clinic visits to introduce themselves and the clinical experience.
- If desired, homeless patients can request that a medical student from the workshop whom they trust accompany them during their doctor appointments.
- Minimize waiting room time. TUH Internal Medicine will reserve appointments for homeless patients first thing in the morning or directly after lunch so that long waits can be avoided.