Catholic Health East
Best Practice Narrative
RHC: Pittsburgh Mercy Health System
1400 Locust Street
Pittsburgh, PA 15219 |
Category:
New Delivery Models
Contact: James S. Withers, M.D.
Title: Medical Director, OSN
E-mail: Jwithers@mercy.pmhs.org
Fax: (412) 232-3726
Phone: (412) 232-5739 |
Description of the Best Practice: Operation Safety Net
Operation Safety Net is an innovative street medical outreach
program for the unsheltered homeless of Pittsburgh. OSN brings
medical, emotional support and coordinated care to the unsheltered
homeless population. By working "from the street up", barriers
and prejudice are systematically broken down and a caring
relationship is developed. The medical care provided includes
attending wounds, psychiatric illness, upper respiratory illnesses,
and follow-up to chronic diseases such as diabetes, hypertension
and cancer. A wide range of medical problems treated are in
advanced stages due to neglect. Prevention measures on the streets
include prenatal care, Tuberculosis and AIDS testing, foot care
and protection from the environment. Since OSN began in 1992,
there have been no deaths due to freezing, despite a substantial
number of below zero days every winter.
Implementation
James S. Withers, M.D, founded operation Safety Net in 1992.
In an initial six-month study of 114 homeless individuals living
on the streets of Pittsburgh, Dr. Withers found many veterans
and minorities without regular physicians; few who used the
free clinics and all who were extremely wary of traditional
medical systems. As a result, their medical needs were not
being addressed, and they were dying in the streets. Now
operating at fourteen clinical teams, the teams travel by
foot and make "street rounds" to the unsheltered homeless
in the city streets, alleys, river banks and abandoned
buildings as well as deliver care in a dedicated medical van.
Time Frame
Since 1992 OSN has grown from the initial team to over
fourteen clinical teams consisting of volunteer physicians,
registered nurses and other health professionals along with
formerly homeless outreach staff.
Financial Profile
OSN is dependent upon the generosity of local and private
foundation supporters. Gifts of sleeping bags, socks, hats
and gloves as well as monetary support are needed and very
welcomed. Operation Safety Net is a tax-exempt charity
program. OSN operates with a total annual budget of $250,000.
Outcome
The OSN model has significant implications for homeless
health care access, medical education and volunteer
opportunities. OSN has developed a typology of outcomes and
behaviors as a means of tracking the status of clients,
both clinically and in terms of their own independence and
self-esteem. To facilitate care coordination, a computerized
database known as SAFENET was developed. This database
tracks all interactions between the street teams and the
homeless and is a useful tool for case management. Physician
training is an integral part of OSN with resident rotations
established as part of the curriculum. OSN has received
attention by the media and health care leadership
organizations including 20 local and national awards.
Best Practice Narrative is limited to a one page summary.
Supporting data is limited to one page.
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