Engagement  TOP

• Outreach – Use outreach workers. Offer diagnostic testing and treatment at outreach sites whenever possible. Remember that unmet basic needs may prevent a person from seeking health care. Promote engagement by including nutritious snacks as part of outreach. Use a “revolving care manager” to help them connect with available health and social services. Work with religious leaders and faith communities (“health ministries”). Maintain a consistent presence in places where homelessness people congregate.
• Clinical team – The clinical team should include professionals and paraprofessionals with strong engagement skills who make themselves available to listen to patients and help them address obstacles to care. This team member should see the patient first. Address psychosocial barriers to health as well as medical issues, employing an intensive case management model.
• Therapeutic relationship – Nonjudgmental and supportive patient interactions with all members of the clinical team are essential to successful engagement. Listen to their concerns and engage with their interests. Realize that seeing the same provider over time facilitates engagement. Take good care of professional staff to promote provider retention and continuity of patient care. Recognize that engagement of homeless patients often takes a long time. Be patient and spend time getting to know your patients. Success should be measured in small increments.