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The purpose of this project was to conduct a feasibility study showing the advantages and costs of placing family nurse practitioners in the rescue mission’s homeless programs one day per week. Homeless people experience greater health complications from chronic diseases and early mortality due to a lack of ongoing treatment. This study noted that homeless people often depend on emergency departments for episodic care, which promotes poor access and ineffective utilization of primary care providers. Family Nurse Practitioners or FNPs would likely provide early diagnosis of, and ongoing treatment for, chronic diseases. Further, a partnership between a rescue mission and an intercity hospital with FNPs on staff may reduce emergency department costs for the hospital, improve access, and promote continuity of care for the homeless.
This study utilized primary data from a community needs assessment conducted by an inter-city safety net hospital, Public Health Department, and evidenced-base literature review. Analysis of the data was done utilizing feasibility studies which described the project, market assessment, technical assessment, financial/economic assessment, and the organizational/managerial feasibility. The study analyzed the conclusions and assumptions that would determine the course of action to pursue, either the adoption of a business plan or rejection of the project.
The conclusion reached was that the cost of care currently being provided by the safety net hospital exceeded the cost of the FNP by $821,205. This figure represents bad debt for the healthcare organization. With the implementation of the FNP to serve the Rescue Mission homeless population, the healthcare organization experiences cost savings and decreased incidence of inappropriate use of the Emergency Department.
In the 21st century, nursing is uniquely positioned to meet future healthcare needs in the United States. Nurses, by virtue of their numbers, evidence-based practice, and adaptability in providing primary care outside the acute-care setting, will create new ways to meet future healthcare challenges (Institute of Medicine [IOM], 2012). One such challenge is caring for the healthcare needs of the homeless. The chronic care delivery model for this population, for example, could be refocused from the emergency department to the community setting. Utilization of FNPs to provide access and preventive treatment for the homeless may improve quality and life expectancy while decreasing healthcare costs.
The purpose of this project was to conduct a feasibility study, to show the advantages and costs of placing a family nurse practitioner in a rescue mission’s homeless programs one day per week. FNPs may provide homeless clients with access and continuity of healthcare that could reduce the cost and improve the quality of healthcare for the homeless at the rescue mission. The provision of health care services, client navigation, assistance for obtaining medications, procedures, and specialty treatment for chronic diseases was evaluated in this project.