Date of Award

Fall 2024

Project Type

Clinical Doctorate

Department

Nursing

Program or Major

DNP

Degree Name

Other

First Advisor

Dr. Cathleen Colleran

Second Advisor

Dr. Beth Elly

Abstract

Background: Homelessness in the U.S. is a critical issue, with New York City experiencing significant challenges due to an increasing number of families requiring shelter. The Department of Homeless Services (DHS-NYC) faces operational inefficiencies, particularly in the medical clinic at the intake center, leading to prolonged wait times.

Local Problem: Families with children experience long wait times in the DHS-NYC medical clinic, which impacts their overall health and well-being. Reducing these wait times is essential for improving service delivery and families satisfaction.

Purpose:

This quality improvement project aims to reduce wait times for families with children at the medical clinic of the Department of Homeless Services in New York City (DHS-NYC) intake center. By streamlining processes, enhancing bilingual interpretation services, and optimizing staff allocation, the project aims to improve service delivery, increase the number of families seen daily, and enhance overall families satisfaction and health outcomes.

Methods: The project uses the Easy Protocol Process (EPP) and Everett Rogers' Diffusion of Innovations Theory as a framework. It implements a Plan-Do-Study-Act (PDSA) cycle approach to iteratively develop, test, and evaluate interventions. The setting is the NYC DHS intake center, specifically the medical clinic section. The project entails evaluating and modifying the current care delivery process to reduce wait times and increase the number of families seen daily.

Interventions: The clinic workflow was modified, bilingual interpretation services were improved, and the staff was strategically allocated to increase efficiency.

Results: Initial steps included mapping the current process, identifying delays, and implementing changes. Preliminary data shows reduced wait times and increased families served daily.

Conclusions: The interventions have shown promising results in reducing wait times and improving clinic efficiency. Further monitoring and adjustments are needed to sustain these improvements and explore their applicability to other DHS-NYC departments.

Keywords: Wait times, EPP, Quality improvement, Medical Clinic, Homeless services, Process optimization, Bilingual services, Staff allocation, Service delivery DHS-NYC.

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