Emergency Department Linkage to Care for Patients Experiencing Homelessness

NCT ID: NCT07209072

Last Updated: 2026-01-28

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 390 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-12-05
• Study Completion Date: 2027-12-31

Brief Summary

In an effort to improve access to primary care at time of discharge, patients who are homeless will be given either enhanced follow up through a street medicine team or routine follow up in clinic.

Detailed Description

Patients who experience homelessness frequently utilize the ED, but lack follow up primary care. In an effort to augment access to post-ED primary care, the investigators propose a quasi-experimental equivalent time sample study in which patients fitting certain diagnostic and inclusion criteria are allocated to either a) a referral to the Comprehensive Care Clinic at Denver Health, or b) a referral to Colorado Coalition for the Homeless (CCH) Stout Street medicine clinic. The street medicine clinic aims to lower barriers to access by locating patients on the street and providing primary care rather than asking patients to present to clinic. All patients will still receive the hospital appointment line number at time of discharge. 1 month and 3 months after index visit, the investigators will examine follow up rates at both clinics as well as secondary outcomes including ED visits, hospitalizations, and mortality through chart review of Denver Health and CCH electronic health records and CORHIO.

Conditions

Homelessness

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: SINGLE

Study Groups

Standard of Care

Patients will receive a referral to a rapid follow up clinic at time of discharge

Group Type: NO_INTERVENTION

No interventions assigned to this group

Street medicine

Patients will receive a referral to street medicine at time of discharge

Group Type: EXPERIMENTAL

Street medicine follow up

Intervention Type: BEHAVIORAL

This intervention will use electronic health record builds to automatically send a referral to a street medicine clinic, who will attempt to contact the patient within 2 weeks.

Interventions

Street medicine follow up

This intervention will use electronic health record builds to automatically send a referral to a street medicine clinic, who will attempt to contact the patient within 2 weeks.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

1. adult (≥18 years of age) DHMC ED patient,

2. currently unsheltered, defined as living on the streets, in a vehicle, or in another place not fit for human habitation,

3. anticipating ED discharge, with

4. a diagnosis listed below that requires short-term follow up:

• COPD or asthma exacerbation
• Bacterial or viral pneumonia
• CHF with volume overload
• SSTI
• Dehydration requiring IV fluids
• Hyperglycemia secondary to DM
• Frostbite
• First- and second-degree burns
• Bacterial ENT infections
• Diabetic foot infection
• Traumatic head injury
• Pregnancy
• Opioid overdose

5. a stable location (i.e., an intersection, landmark, or encampment where they can be located by the street medicine team) within Denver County for at least 2 weeks.

Exclusion Criteria

1. have altered mentation (e.g., intoxication, or secondary to medical, psychiatric, or behavioral conditions) that are unable to communicate their location, contact information, or agree to follow up.

2. are prisoners,

3. previously enrolled.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Denver Health and Hospital Authority

OTHER

Sponsor Role: lead

Responsible Party

KJoseph

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Jason Haukoos, MD MSc

Role: STUDY_DIRECTOR

Denver Health Medical Center

Locations

Denver Health Medical Center

Denver, Colorado, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Kathleen M Joseph, MD MPH

Role: CONTACT

kathleen.joseph@dhha.org

13175194468

Carolynn Lyle, PAC MPH

Role: CONTACT

carol.lyle@dhha.org

Facility Contacts

Kathleen Joseph, MD MPH

Role: primary

kathleen.joseph@dhha.org

3036020396

Carolynn Lyle, PA-C MPH

Role: backup

carol.lyle@dhha.org

Provided Documents

Document Type: Study Protocol, Statistical Analysis Plan, and Informed Consent Form

View Document

Other Identifiers

F32HS030344

Identifier Type: AHRQ

Identifier Source: secondary_id

View Link

COMIRB 24-1764

Identifier Type: -

Identifier Source: org_study_id