Northwestern Memorial Hospital (NMH) is a nationally ranked academic medical center in downtown Chicago, which provides a complete range of adult inpatient and outpatient services in an educational and research-based environment. NMH is located in an area considered to be an epicenter of a large and underserved homeless patient population. Emergency departments often serve as safe havens for vulnerable patient populations to seek shelter, food and safety in the overnight hours. Therefore, NMH’s emergency department serves as the main, and at many times only, entry point to healthcare for the most medically underserved populations in Chicago.
With funding from the Washington Square Health Foundation, NMH has initiated a two-year pilot plan to create an innovative model for adding essential overnight social work coverage to the emergency department. The social workers are dedicated to working with the population referred to by the emergency department as “super utilizers,” helping to bridge the gap between the overnight needs and the multitude of community resources that are only available during standard business hours (i.e. 8 a.m. – 5 p.m.).
The plan has three primary objectives: decrease length of patient stay, decrease repeated emergency department visits and improve the quality of care for all patients.
“The word of mouth is getting around the street that you could come to Northwestern Medicine, and we can connect you with the resources that you need,” said Dr. Robert Turelli, emergency medicine physician at NMH, describing increased awareness of the availability of non-medical assistance. “In the past, patients did not have an awareness that simply requesting to speak with a social worker, despite not having an emergent medical complaint, would still allow them to speak with and engage with our social work team. Previously, patients whose main medical complaint was ‘homelessness or seeking shelter’ were either referred to our warming center, where they were provided with a temporary warm place to seek refuge for the night (if the center was not filled to capacity), or would wait long hours in the waiting room to eventually be seen by a medical provider. These prolonged wait times and non-emergent medical evaluations were contributing to overcrowding as well as many of these patients leaving before they were able to access valuable community resources that our social work team has the ability to leverage for those seeking housing resources, food and warm clothing.
“In addition, patients with no access to primary care are given referrals and access to a primary care system through our Northwestern Transitional Care Clinic as well as crucial referrals to detox centers for those struggling with substance dependence and addiction,” he said. Now, each night, the emergency department is “filled to capacity” with individuals saying they’ve come to see the social worker for shelter, because they’re starving or cold with frostbite.
Support from the Washington Square Health Foundation has allowed Northwestern Medicine to be a champion for those vulnerable individuals who are in such great need, ensuring that these patients are receiving the compassionate care and dedication from our dynamic social work team that has the ability to positively influence the trajectory of their medical care.