When most of us are discharged from the hospital emergency department with a prescription for “medical rest,” we have a safe, warm bed to go home to for recovery and healing. But, for hundreds of homeless people in Washington’s Snohomish County, until three years ago, the harsh streets were the only place they could return to after being injured, sick with fever or pneumonia, or even assaulted.
That all changed in April 2014, when Providence Health & Services in Northwest Washington began an innovative partnership between Providence Regional Medical Center Everett’s (PRMCE) Emergency Department and the Everett Gospel Mission to set aside eight beds in a special area of the community shelter to provide a quiet and safe place for homeless people who need physician-prescribed bed rest after ED discharge. In addition to providing the homeless a medical rest bed for short-term recovery needs, the program also offers them a chance to rehabilitate their lives through connections with the mission’s services and community resources.
“Inadequate living conditions make many who are homeless in our community more vulnerable and susceptible to illness or injury,” says Julie Zarn, PRMCE regional Director of emergency services. “If they’re not sick enough to be admitted as an inpatient, we can’t keep them in the hospital after they’re treated. These medical rest beds are the difference between repeat admissions to the hospital and a better chance at healing.
“And once the patient is fully rested, they are able to think beyond their immediate survival and plan for their future,” she says. “The mission gives them the choice to stay and participate in programs to re-integrate into the community, gain access to jobs and housing, and get connected with social workers and case managers so they can go on to lead healthy, productive lives.”
Teaming up to address a larger community need
Homelessness emerged as an area of great need in this region of Northwest Washington during Providence’s community health needs assessment. In 2016, there were an estimated 1,118 homeless people in Snohomish County and 471 of them had no shelter. This year, that number of unsheltered people rose by 9 percent to 515.
Being homeless has a significant impact on a person’s health, and PRMCE’s ED often treats these patients when they are injured, sick and cold. When they are not sick enough to be admitted but have been treated, they must be discharged from the hospital.
Providence understands the cycle of simply treating the homeless in the ED and sending them back to the streets is only a Band-Aid approach versus a real solution to improving their overall health and well-being. For many, their conditions worsen and they return to the ED even sicker, possibly requiring hospital admission, and for some, even resulting in death.
The Providence General Foundation has provided a grant of $20,000 per year to help support an ongoing partnership between PRMCE and the Everett Gospel Mission for the medical rest program. Partnerships like this are an important way to fulfill critical needs identified in the community health needs assessment.
Since the program started in late 2014, 120 homeless patients have been discharged from the PRMC ED and prescribed 637 days of medical rest at the mission. Several have recuperated and then stayed on to participate in community programs to find stable homes.