Street Medicine Consult Service at UPMC Shadyside

Grant Application

Anna Marie White, MD, Department of Family and Community Medicine, Center for Street Medicine, University of Pittsburgh School of Medicine, and Street Medicine at Pitt, and Max Hurwitz, DO, Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, and Street Medicine at Pitt

Proposed Innovation

Currently, there is no formal process to identify people experiencing homelessness (PEH) and connect them to services at UPMC emergency departments (ED) or hospitals. This leads to fragmented care, poor clinical outcomes, extended hospital stays, and high readmission rates.

This project seeks to expand a Street Medicine Consult Service at UPMC Shadyside for PEH who visit the ED or are hospitalized. The primary goal is to provide comprehensive and compassionate care throughout their hospital stay and ensure a coordinated discharge plan for a safe transition to community support.

Improvements in Action

In 2023, 223 patients admitted to UPMC Shadyside were identified as experiencing homelessness. About 3 to 5 people experiencing homelessness visit the UPMC Shadyside ED each day.

Homelessness screening will be incorporated into Street Medicine Consult Service at UPMC Shadyside. A team — consisting initially of a social worker and doctors and eventually expanding to include community health workers and nurses — will engage patients early in their stay. The team will focus on building trust, connecting patients to resources, and ensuring a safer, more supportive discharge. The team will extend care beyond the hospital, reaching patients in camps, shelters, respite facilities, and housing to ensure seamless support.

Intended Outcomes

This project prioritizes compassionate care for UPMC’s most marginalized neighbors through an improved quality of life and access to essential medical services. By proactively identifying PEH and connecting them with resources, the Street Medicine Consult Service aims to improve health outcomes, reduce readmissions, and shorten hospital stays. These efforts are expected to result in significant cost savings for UPMC Shadyside. Once proven effective, this model can be scaled and implemented across other UPMC hospitals, providing transformative system-wide impact.