Because the Housing Outcome document is a shared document, only 1 person at a time can save information in it. Facility staff have been unable to create a simple macro that closes the document automatically. Instead, screeners who need to save information when a document is already opened elsewhere must use a group e-mail list to alert others to close the document.
Streamlining the communication channel between the screeners and management evolved from the daily call, to e-mailing and program managers discussing topics with their staff, to Dr. Hooshyar facilitating a weekly call for screeners and program managers.
Optimizing the ratio of walk-in to scheduled appointments took time. Prior to the UHHS process, some CHCP housing programs offered scheduled appointments, whereas others had walk-in appointments. The decision to offer in-person scheduled appointments for veterans who preferred scheduled appointments or who commuted from a distance was made. Universal Homeless Housing Screening staff also offered scheduled telephone appointments for veterans who lacked transportation.
At times, admitting program staff was unable to reach veterans eligible for and interested in their program, despite screeners recommending to veterans that they should provide these programs with any changes in their contact information.
Recommendations for designing a screening process for homeless housing include:
- Have periodic retreats instead of weekly conference calls to quicken the pre-implementation process.
- Start with a pilot that includes some potential screeners to test the implementation process. The screeners involved in the pilot would train future screeners to expand the screener pool.
- Invest time in electronic tracking tools despite upfront and maintenance time requirements.
- Offer more walk-in than scheduled screening appointments.
- Embrace the idea that the pro-cess is always under development.
Conclusion
To ameliorate anxiety associated with changing the system, UHHS- associated staff redesigned the housing screening process through openness to stakeholder feedback and building on consensus. The staff also nurtured a culture that could change newly revised processes, depending on quality assurance findings. Without this method, the unknown likely would have propagated continued status quo. Universal Homeless Housing Screening processes improved veteran access to CHCP housing programs through instituting a one-stop housing screening assessment that also reduced the potential number of screenings by ≥ one-third.
Acknowledgments
The authors greatly appreciate the input of the many people involved in the creation of the UHHS process, in particular Daniel Anderson, Heather Arredondo, Tara Ayala, TiieShaiyon Banton, Melody Boyet, Amelia Bradley, Timothy Brown, Carnisha Campbell, Donald Capps, Burnell Carden Jr, Pushpi Chaudhary, Howard Cunningham, Rachael David, Marianna Demko, Derrick Evans, Steven Fisher, Kimberly Fite, Fatina Ford, Christi Godfrey, Gerald Goodwin, Melvin Haley, Tony Hall, Jessica Hennessey, Teresa House-Hatfield, Don Hubbard, Kathryn Jacob, Tonja King, Cecelia Knight, Janine Lenger-Gvist, Vickie Linden, Julia Long, Kristin Manley, Peggy Martin, Treva McDaniel, William McNair, Tammy Miller, Jeffery Milligan, Anhloan Nguyen, Tywanna Nichols, Cheryl Paul, Catherine Orsak, Dustin Perkins, Claudette Phillips, Joan Prescott, John Purkey, Martin Roback, Catriska Robertson, Charles Ross, Shanna Ruppert, Stephanie Saldivar, Linda Saucedo, Inga Sinclair-Henderson, John Smith, Zaire Smith, Cheryl Stringer, Valetta Ward, Carolyn Washington, Tammra Wood, and Skylar Woods-Nunley. They would also like to thank the veterans for their service and feedback.
Author disclosures
Dr. North discloses research support from National Institute on Alcohol Abuse and Alcoholism, National Institute of Diabetes and Digestive and Kidney Diseases, and VA and consultant fees from the University of Missouri-Columbia. Dr. Surís is Local Site Investigator for VA CSP #589 VIPSTAR-Veterans Individual Placement and Support Towards Advancing Recovery (PI Lori Davis, MD). She is co- investigator for VISN 17 grant Association of Myocardial Viability to Symptom Improvement post-CTO PCI (PI-Shuaib Abdullah, MD) and co-investigator for National Institutes on Drug Abuse grant Lidocaine Infusion as a Treatment for Cocaine Relapse and Craving (PI-Bryon Adinoff, MD). In addition, Dr. Surís is co-site-PI for the upcoming VA CSP #590 Lithium for Suicidal Behavior in Mood Disorders.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
