ABSTRACT

Since its founding in 2013 and its first outreach clinic

rollout almost a year ago, University District Street
Medicine (UDSM) has been establishing itself as a
compassionate, student-run organization dedicated to
meeting the needs of people experiencing
homelessness in and around the University of
Washington Seattle campus. UDSM involves an
interprofessional group of students, faculty, staff,
alumni, community partners and professionals
working together to assess the needs of the local
homeless population and provide supplies, services
and referrals. UDSM is beginning to systematically
gather pertinent data which will guide future
planning, provide information for program evaluation,
and help to further assess target population needs.
With strong academic and community support, UDSM

INITIAL DATA has great potential to grow and develop its capacity
for service, learning and mutual respect that is shared
among all.

Michelle M. Edwards, MD, MPH

REPORT Data Manager, Public Health Consultant

APRIL 2016
University District Street Medicine

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Table of Contents
Introduction 2
Overview 2
Vision and Mission 2
Outreach Clinics 2
Data Management System 3
Summary of Data 4
Combined Initial Data (7/6/2015-3/27/2016) 4
Summer Quarter 2015 (6/22/2015-9/29/2015) 7
Autumn Quarter 2015 (9/30/2015-1/3/2016) 8
Winter Quarter 2016 (1/4/2016-3/27/2016) 11
Spring and Summer Quarters 2016 (3/28/2016-6/19/2016 and 6/20/2016-9/27/2016) 17
Discussion 17
Conclusions and Recommendations to Consider 18
Future Plans 19
Health Sciences Interprofessional Education 19
Undergraduate Internships 19
Master’s Degree Practicums and Capstones 20
Free “Walk-In Clinic” 20
Special Thanks 21
Appendix A: UDSM Outreach Tally Sheet 22
Appendix B: Screen Shot Samples of Master Spreadsheets 23
Appendix C: Supplies and Services Categories 26

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Introduction
Overview
University District Street Medicine (UDSM)​ is a student-run, interdisciplinary, volunteer organization
dedicated to improving health equity among the homeless population within the University District
(U-District). UDSM was founded in 2013 by Krystal Koop, MSW when she was a graduate student in the
School of Social Work at University of Washington (UW). Upon graduation, she was awarded a staff
position and remains as Director. Students involved are primarily from the six UW Health Sciences
Schools: School of Dentistry, School of Medicine, School of Nursing, School of Pharmacy, School of Public
Health, and School of Social Work.

Vision and Mission

UDSM’s vision​ is to facilitate access and improve equitable medical care among the homeless
community in the University District by establishing a free, student-run clinic and to promote
interprofessional learning by fostering an interdisciplinary partnership between the Health Sciences
Schools and the community.

UDSM’s mission​ is to provide a sustainable, justifiable, and unbiased source of quality medical services
that will remain nonprofit, student-run, and focused on reliably meeting the needs of the homeless
community in the University District. We are determined to embrace a wide range of services by
including all Health Sciences Schools and to foster learning across disciplines in a realistic setting. We
look forward to forming community partnerships in order to provide comprehensive service and to form
a relationship and partnership.

Outreach Clinics
UDSM currently operates outreach clinics in the U-District to assess the needs of adults experiencing
homelessness and refer them to basic service agencies and medical providers. This outreach is provided
through face-to-face encounters between volunteer UW Health Sciences graduate/professional students
and homeless clients who seem interested or request such a consultation. During the encounter, which
is usually one-on-one, the volunteer offers some free basic supplies, such as a pair of socks or a granola
bar, and employs motivational interviewing techniques to encourage the client to explore his/her/their
challenges and potential actions, always remaining respectful of the client’s decision-making autonomy.
Occasionally, upon the client’s request, a non-invasive, narrowly focused, physical assessment is
performed such as taking a blood pressure measurement or examining a wound. The volunteer
concludes the encounter by providing referrals, resources, or information on hand as requested by the
client. A licensed health professional is present at every outreach event as a preceptor per regulations.

Outreach clinics take place in three locales. One is at Elizabeth Gregory Day Home (for adult women) in
University Lutheran Church. Another is at the Saint Vincent de Paul Sunday Dinner in Blessed Sacrament
Church. The third, called Street Outreach, is along the streets of the U-District where homeless
individuals and groups are frequently seen. The outreach clinics at the two churches occur monthly
while Street Outreach occurs every two weeks.

When the outreach clinics began operating in May 2015, data was not routinely collected other than
outreach managers making informal notes to plan what supplies or information they needed for the
next outreach event. Occasionally, the approximate number of clients encountered on the street was
noted, but this was not consistently documented. We gradually became more aware that such

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information could improve our planning and financing efforts. As UDSM became more visible in the
community, and people began to inquire about our activities, we also realized how useful it would be to
describe what we do both qualitatively and quantitatively. Thus, the need for a data management
system was envisioned.

Data Management System

The data management system was developed between November 2015 and March 2016 by Michelle M.
Edwards, MD, MPH, a recent graduate from UW School of Public Health, with collaborative input from
the UDSM leadership team at that time. It was designed to capture what we believe is the most useful
program information within the given constraints of UDSM’s current outreach activities and human
resources. The system was also intended to be fully incorporated into routine operations so that it could
be maintained with little to no additional costs.

The data management system consists of two main parts: (1) a system to collect data at outreach clinics
and (2) a system to store and organize the data.

The central tool of the data collection system is the ​Tally Sheet​ (see Appendix A). It was designed as a
convenient, one-page, paper document on which desired information may be quickly and easily
recorded. Based on outreach managers’ previous notes and input from our leadership team, the
following categories/headings were included on the Tally Sheet: demographics of clients encountered,
supplies distributed and requested, topics/services discussed or referred, services requested, physical
examination, intervention, notes, client feedback, and an opinion poll regarding future plans for a free
medical clinic. The opinion poll may be removed when no longer needed, and other polls or questions
may be added as necessary. During or after each outreach event, the frequencies of each item on the
Tally Sheet are recorded by hand under the appropriate heading using gate-style hash marks. Additional
headings and qualitative notes may also be hand-written as needed. None of the documented data is
linked or associated with any individual homeless client in any way, and no identifying information is
recorded about any clients.

To store and organize the data collected from the outreach clinics, two spreadsheet files were created
using Google Sheets and collectively referred to as the ​Master Spreadsheets​. One file is for the Street
Outreach clinic data. The other file is for the two church-based outreach clinics (Elizabeth Gregory Day
Home and Saint Vincent de Paul Sunday Dinner). Each file contains six spreadsheets, each housing a
different category of data (see Appendix B). After each outreach event, the frequencies and qualitative
notes from the Tally Sheet are entered into the Master Spreadsheets. Summation formulas in the
spreadsheets automatically calculate event and quarterly totals for the quantitative data. The categories
and headings on the Tally Sheet correspond to those used in the Master Spreadsheets and may be
revised in the future as necessary. See Appendix C for the current list of supplies and services categories.

The outreach managers for the Elizabeth Gregory Day Home clinic and the Saint Vincent de Paul Sunday
Dinner clinic were easily able to incorporate use of the Tally Sheet and Master Spreadsheets into their
regular duties. The dynamics of Street Outreach interactions, however, made it challenging for
managers of this clinic to assume data collection duties. We therefore created a new volunteer role for
Street Outreach called a ​scribe​. The scribe’s duty is to attend the Street Outreach event, document what
was encountered on the Tally Sheet, and transfer the data into the Master Spreadsheets in a timely

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manner. The scribe does not directly interact with homeless clients but rather listens respectfully and
attentively to capture event data. We recruit scribes from UW’s undergraduate student population, and
they complete the same orientation as the other volunteers, HIPAA training, and scribe training which
includes Tally Sheet/Master Spreadsheet protocols and how to perform their role during encounters.

Summary of Data
The following is a summary of the data collected from ​July 6, 2015 through March 27, 2016​. Data from
the combined quarters of this period is presented first, followed by data summaries from each separate
academic quarter.

Combined Initial Data (7/6/2015-3/27/2016)

Demographic data​ is presented in Table 1. The total number of ​client encounters documented was 270​.
The majority (201, 74.4%) were conducted by Street Outreach (SO) with an average of 25 encounters
per outreach event (range 11 – 50), followed by the Saint Vincent de Paul Sunday Dinner (SVDP) clinic
(total 47 [17.4%], average per event 16, range 10-21 per event). The Elizabeth Gregory Day Home (EGH)
clinic documented the fewest with a total of 22 (8.15%) and an average of 4 encounters per event (range
3 – 6 per event). Most clients were noted to be males (173, 64.1%) although gender was not
documented in 40 (14.8%) of the encounters. Most clients were estimated to be between 25 and 40
years old (82, 30.4%) although age was not documented in a third of the encounters.

Table 1. Demographics of UDSM Outreach Clinic Encounters July 6, 2015 through March 27, 2016
SVD Percen
Demographic SO EGH P Total t
Documented Encounters 201 22 47 270 100%
Age <18 5 0 1 6 2.2%
Age 18-24 31 1 3 35 13.0%
Age 25-40 63 2 17 82 30.4%
Age 41-64 23 4 21 48 17.8%
Age 65+ 4 0 5 9 3.3%
Age Unknown 75 15 - 90 33.3%
Male 133 0 40 173 64.1%
Female 28 22 7 57 21.1%
Transgender Male - - - - -
Transgender Female - - - - -
Gender Not
Documented 40 - - 40 14.8%
Veteran 5 - - 5 1.9%
Pregnant 2 - - 2 0.74%

UDSM= University District Street Medicine; SO=Street Outreach; EGH=Elizabeth Gregory Day Home;
SVDP=Saint Vincent de Paul Sunday Dinner

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Table 2 shows the ​physical exams and emergency interventions​ documented during encounters. The
two documented 9-1-1 calls were each associated with a suicidal intervention.

Table 2. Physical Exams and Emergency Interventions July 6, 2015 through March 27, 2016
Examination/Intervention SO EGH SVDP Totals
Feet 1 4 - 5
Skin/Wound 4 1 5 10
Mouth/Tooth/Teeth 5 1 0 6
Blood Pressure 1 1 40 42
Lung Sounds 0 2 0 2
Suicidal Intervention 0 1 1 2
Called 911 0 1 1 2
Clinic Totals 11 11 47 69
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

Table 3 presents ​topics and service categories​ that concern many homeless adults and the frequencies
with which they were ​discussed or referred for care​ by UDSM volunteers.

Table 3. Topics and Services Discussed or Referred July 6, 2015 through March 27, 2016
Topics/Services SO EGH SVDP Totals
Housing 5 2 5 12
Employment 2 - 2 4
Food 10 - - 10
Transportation 2 1 - 3
Other Basic Needs 1 1 1 3
Addiction 1 2 - 3
Mental Health - 4 - 4
Medical 8 15 - 23
Dental 12 2 6 20
Podiatry 1 3 - 4
Vision 2 1 5 8
Health Insurance 8 1 4 13
Legal Aid - 1 1 2
Clinic Totals 52 33 24 109
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

The top 10 supplies distributed​ are presented in Table 4 with the amount and proportion distributed by
each clinic. Please see the sections describing the data for each quarter for the rest of the supplies
distributed.

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Table 4. Top 10 Supplies Distributed July 6, 2015-March 27, 2016
Item SO SO% EGH EGH% SVDP SVDP% Item Totals
Socks (pair) 163 50% 142 43% 23 7% 328
Tampons 70 22% 228 72% 20 6% 318
Feminine pads 30 14% 181 83% 8 4% 219
Snacks 136 83% 28 17% 0 0% 164
Hats 28 52% 18 33% 8 15% 54
Other drinks 10 29% 24 71% 0 0% 34
Hand/foot warmers 28 100% 0 0% 0 0% 28
Soaps 0 0% 24 100% 0 0% 24
Reusable water bottle 17 85% 2 10% 1 5% 20
Grooming kits 7 47% 8 53% 0 0% 15
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

The list of ​supplies requested by clients​ was very long and diverse. Table 5 shows the most frequently
requested items and what proportion came from each clinic. Please see the sections describing the
quarterly data for the rest of the supplies requested.

Table 5. Supplies Most Frequently Requested July 6, 2015-March 27, 2016

Item SO SO% EGH EGH% SVDP SVDP% Item Totals
Backpacks 2 22% 0 0% 7 78% 9
Gloves (pair) 2 29% 1 14% 4 57% 7
Medical Tape 1 14% 0 0% 6 86% 7
Hats 0 0% 1 17% 5 83% 6
Underwear 5 83% 0 0% 1 17% 6
Socks (pair) 4 80% 1 20% 0 0% 5
Gauze pads 2 40% 0 0% 3 60% 5
Wound cleaning equipment 1 20% 0 0% 4 80% 5
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

The list of ​services requested​ was also very long. Table 6 presents the top 10 most frequently requested
services with proportions per clinic. Please see the sections describing the quarterly data for the
complete lists of the services requested.

Table 6. Top 10 Most Frequently Requested Services July 6, 2015-March 27, 2016
Service SO SO% EGH EGH% SVDP SVDP% Item Totals
Blood pressure 2 4% 1 2% 51 94% 54
Dental info/care 11 46% 5 21% 8 33% 24
Medical care 6 35% 9 53% 2 12% 17
Optometry 1 8% 4 31% 8 62% 13
Bus tickets 5 42% 0 0% 7 58% 12
Primary care 0 0% 1 9% 10 91% 11

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Health insurance 4 36% 7 64% 0 0% 11
Housing 8 89% 1 11% 0 0% 9
Healthcare navigation 2 22% 6 67% 1 11% 9
Chronic illness management 0 0% 6 100% 0 0% 6
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

Summer Quarter 2015 (6/22/2015-9/29/2015)

Although Summer Quarter began on June 22​nd​, the first recorded outreach data was dated July 6​th​.

Table 7. Summer Quarter 2015 Dates of Outreach Clinic Events

Street Outreach Elizabeth Gregory Day Home Saint Vincent de Paul Sunday Dinner
7/6/2015 9/10/2015 9/27/2015
7/24/2015
8/21/2015
9/14/2015

The ​number of client encounters​ was not documented during this quarter, but some of the supplies
distributed were tallied (see Table 8 below), and some of the supplies and services requested were
recorded (listed qualitatively below).

Table 8. Summer Quarter 2015 Supplies Distributed per Clinic

EG SVD Item
Item SO H P Totals
Tampons 30 88 5 123
Socks (pair) 29 30 5 64
Feminine Pads 20 41 - 61
Other drinks 3 24 - 27
Snacks 10 1 - 11
Reusable Water
Bottles 10 1 - 11
Coffee 6 1 - 7
Toothbrush kit 1 - - 1
First Aid Kits 1 - - 1
Medical Tape - - 1 1
Ice Packs - - 1 1
Ace Wraps - - 1 1
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Clinic Totals 0 186 13 309

SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

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During Summer Quarter 2015, the ​supply requests​ were as follows:

► Clothes​: socks, jackets, shower sandals

► Accessories​: blankets, backpacks, bags, tarps, pillows, sleeping bags, mat/ground pads,
hand/foot warmers, flashlights, batteries
► Personal care items​: toothbrushes, toothpaste, floss, shaving razors, toilet paper, toothbrush kit,
hand sanitizer, nail clippers, condoms
► Medical items​: vitamins, sunscreen, iron tablets, first aid kit, medical tape, ice pack, ace wrap,
thermometer, cough drops, Orajel, Ensure drink, other medications
► Food/drink​: hot chocolate, special food (celiac)

Multiple requests were documented for socks, blankets, toothbrushes, vitamins, and sunscreen;
however, the frequencies were not tallied.

The following ​services requested by clients​ were also noted: housing, transportation, food/meals,
driver’s license/ID, job training, running water, restroom access, free internet, and garbage/trash
disposal.

Autumn Quarter 2015 (9/30/2015-1/3/2016)

Outreach managers recorded more data than the previous quarter, but our data management system
was not yet implemented.

Table 9. Autumn Quarter 2015 Dates of Outreach Clinic Events

Street Outreach Elizabeth Gregory Day Home Saint Vincent de Paul Sunday Dinner
10/2/2015 11/19/2015 10/24/2015
10/30/2015 12/17/2015 11/22/2015
11/9/2015
11 or 12/??/2015
12/21/2015
12/28/2015

The ​number of encounters​ documented for the combined outreach clinics during Autumn Quarter 2015
totaled 93. Eight (8.6%) of these were tallied at EGH, and 85 (91.4%) were tallied during SO. The number
of encounters was not tallied at SVDP. Since EGH serves only women, all eight of the clients encountered
were noted as female. The ​approximate ages​ of some clients were documented although not
consistently (see Table 10 below).

Table 10. Approximate ages of homeless clients documented during Autumn Quarter 2015
age age age Tota
Outreach Clinic age 18-24 age 25-40 41-65 65+ unknown l

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SO 11 19 5 - 50 85
EGH 1 - 1 - 6 8
SVDP (not documented) - - - - - -
Totals in each age 12 19
group (12.9%) (20.4%) 6 (6.5%) - 56 (60.2%) 93
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner
The only ​physical exams​ documented were two encounters in which clients’ feet were examined at
EGH.

Services discussed or referred​ during encounters were noted only at EGH. The topics of these
discussions were housing, other basic needs, mental health services, and podiatry services.

Documentation of ​supplies distributed​ increased this quarter (see Table 11 below).

Table 11. Autumn Quarter 2015 Supplies Distributed per Clinic

Item SO EGH SVDP Item Totals
Tampons 40 100 5 145
Socks (pair) 38 54 6 98
Feminine Pads 10 40 2 52
Hats 24 6 - 30
Reusable Water Bottles 6 1 - 7
Grooming Kits 7 - - 7
Snacks 7 - - 7
Gloves 6 - - 6
Scarves 2 4 - 6
Tarps 6 - - 6
Other Drinks 5 - - 5
First Aid Kits 3 - - 3
Jackets 2 - - 2
Backpacks 2 - - 2
Umbrellas 1 - - 1
Bags - - 1 1
Pillows 1 - - 1
Mat/Ground Pads 1 - - 1
Hand/Foot Warmers 1 - - 1
Toothbrush Kits 1 - - 1
Clinic Totals 163 205 14 382
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

During this quarter, outreach managers began to tally the frequencies of ​supplies and services
requested​ (see Tables 12 and 13 below).

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Table 12. Autumn Quarter 2015 Supplies Requested per Clinic
Item SO EGH SVDP Request Totals
Hats - 1 5 6
Gloves (pair) - 1 4 5
Backpacks 2 - 3 5
Blankets 2 - - 2
Hand/Foot warmers 2 - - 2
Chapstick - - 2 2
Scarves - 1 - 1
Jackets - 1 - 1
Long Johns (set) 1 - - 1
Shirts 1 - - 1
Underwear 1 - - 1
Bags - - 1 1
Sleeping Bags 1 - - 1
Flashlights 1 - - 1
Headlamps 1 - - 1
Tampons - 1 - 1
Feminine Pads - 1 - 1
Pantiliners 1 - - 1
Lotion - - 1 1
Water 1 - - 1
First Aid Kits 1 - - 1
Antibiotic Ointment 1 - - 1
Gauze Pads - - 1 1
Medical Tape - - 1 1
Antacids 1 - - 1
Shoe Insoles 1 - - 1
Clinic Totals 18 6 18 42
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

Table 13. Autumn Quarter 2015 Services Requested per Clinic

Service SO EGH SVDP Request Totals
Blood Pressure 1 - 11 12
Dental Info/Care 2 1 1 4
Employment - 1 2 3
Primary Care - - 3 3
Optometry - - 2 2
Health Insurance 1 1 - 2

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Housing - 1 - 1
Free Telephone Access - 1 - 1
Free Cell Phone - 1 - 1
Addiction Treatment Clinic - 1 - 1
Drug Cessation Info 1 - - 1
Examine Lung Sounds - - 1 1
CPR Classes 1 - - 1
First Aid Training 1 - - 1
Union Gospel Mission Van 1 - - 1
Diet Info for Specific Health Condition - 1 - 1
Chronic Illness Management Info - 1 - 1
Wound Care Info/Training - - 1 1
Crutch/Cane Management Info 1 - - 1
Harm Reduction Info 1 - - 1
Local Resources List 1 - - 1
Clinic Totals 11 9 21 41
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner;
CPR=cardiopulmonary resuscitation

Qualitative notes​ were documented by the outreach manager at the 12/17/2015 EGH Clinic event. The
following medical problems came up during encounters: foot pain, strokes, type 2 diabetes, and
depression.

Winter Quarter 2016 (1/4/2016-3/27/2016)

Beginning January 15​th​, we started using the new data system, troubleshooting issues, and making
adjustments to the data collection process throughout the quarter.

Table 14. Winter Quarter 2016 Dates of Outreach Clinic Events

Street Outreach Elizabeth Gregory Day Home Saint Vincent de Paul Sunday Dinner
1/4/2016 1/26/2016 1/31/2016
1/15/2016 2/23/2016 2/28/2016
2/1/2016 3/22/2016 3/27/2016
2/19/2016
3/7/2016
3/18/2016

The ​number of encounters​ documented this quarter for the combined outreach clinics totaled 177. This
quarter we also began to tally client demographics more regularly, including ​approximate ages, gender,
veteran status, and pregnancy status​ (see Tables 15 and 16 below).

Table 15. Approximate Ages of Homeless Clients Documented During Winter Quarter 2016

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 age<18 age Tota
Outreach Clinic age 18-24 age 25-40 age 41-65 age 65+ unknown l
SO 5 20 44 18 4 25 116
EGH - - 2 3 - 9 14
SVDP 1 3 17 21 5 - 47
Age Group 6(3.4% 23 63 42 9
Totals ) (13.0%) (35.6%) (23.7%) (5.1%) 34 (19.2%) 177
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner
Table 16. Other Demographics of Homeless Clients Documented During Winter Quarter 2016 (N=177).
Gender Not
Outreach Clinic Male Female TM TF Documented Veteran Pregnant
SO 88 18 - - 10 5 1
EGH - 14 - - - - -
SVDP 40 7 - - - - -
Totals 128 (72.3%) 39 (22.0%) 0 (0%) 0 (0%) 10 (5.6%) 5 (2.8%) 1 (0.56%)
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner;
TM=Transgender Male; TF=Transgender Female.

Physical exams and emergency interventions​ were tallied (see Table 17 below).

Table 17. Winter Quarter 2016 Physical Exams and Emergency Interventions per Clinic (N=67)
Examination/Intervention SO EGH SVDP Totals
Feet 1 2 - 3 (4.5%)
Skin/Wound 4 1 5 10 (14.9%)
Mouth/Tooth/Teeth 5 1 - 6 (9.0%)
Blood Pressure 1 1 40 42 (62.7%)
Lung Sounds - 2 - 2 (3.0%)
Suicidal Intervention - 1 1 2 (3.0%)
Called 911 - 1 1 2 (3.0%)
Clinic Totals 11 (16.4%) 9 (13.4%) 47 (70.1%) 67
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

Topics and services discussed or referred​ during encounters were tallied (see Table 18 below).

Table 18. Winter Quarter 2016 Topics and Services Discussed or Referred per Clinic (N=105)
Topics/Services SO EGH SVDP Totals
Housing 5 1 5 11 (10.5%)
Employment 2 - 2 4 (3.8%)
Food 10 - - 10 (9.5%)
Transportation 2 1 - 3 (2.9%)
Other Basic Needs 1 - 1 2 (1.9%)

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Addiction 1 2 - 3 (2.9%)
Mental Health - 3 - 3 (2.9%)
Medical 8 15 - 23 (21.9%)
Dental 12 2 6 20 (19.0%)
Podiatry 1 2 - 3 (2.9%)
Vision 2 1 5 8 (7.6%)
Health Insurance 8 1 4 13 (12.4%)
Legal Aid - 1 1 2 (1.9%)
Clinic Totals 52 (49.5%) 29 (27.6%) 24 (22.9%) 105
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

Supplies distributed, supplies requested, and services requested​ were tallied regularly this quarter (see
Tables 19, 20, and 21 below).

Table 19. Winter Quarter 2016 Supplies Distributed per Clinic

Item SO EGH SVDP Item Totals
Socks (pair) 96 58 12 166
Snacks 119 27 - 146
Feminine pads - 100 6 106
Tampons - 40 10 50
Hand/foot warmers 27 - - 27
Hats 4 12 8 24
Soaps - 24 - 24
Shirts 2 12 - 14
Band-Aids 4 - 9 13
Chapstick - 4 8 12
Water 12 - - 12
Jackets 5 5 - 10
Grooming kits - 8 - 8
Gloves (pair) 1 - 6 7
Scarves 5 2 - 7
Fruits 7 - - 7
Condoms 6 - - 6
Backpacks 3 - - 3
Toiletry kits - 3 - 3
Nail clippers - - 3 3
Tissues 2 1 - 3
Gauze pads 1 - 2 3
Underwear - 2 - 2
Reusable water bottle 1 - 1 2

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Toothbrushes - 2 - 2
Toothpaste - 2 - 2
Toothbrush kit 2 - - 2
Hand sanitizer 2 - - 2
Other drinks 2 - - 2
Antibiotic ointment 2 - - 2
Blankets - 1 - 1
Pillows 1 - - 1
Floss - 1 - 1
Medical Tape - - 1 1
Ace wrap - - 1 1
Sore throat candy 1 - - 1
Clinic Totals 305 304 67 676
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

Table 20. Winter Quarter 2016 Supplies Requested per Clinic.

Item SO EGH SVDP Request Totals
Underwear 4 - 1 5
Medical Tape 1 - 4 5
Wound cleaning equipment 1 - 4 5
Shoes 4 - - 4
Gauze pads 2 - 2 4
Backpacks - - 3 3
"Sterno" (small food heater) 2 - 1 3
Hand sanitizer 3 - - 3
Water 3 - - 3
Antibiotic ointment - - 3 3
Gloves (pair) 2 - - 2
Batteries 1 1 - 2
Reusable water bottle 2 - - 2
Shaving razors - - 2 2
Tampons - - 2 2
Chapstick - - 2 2
Band-Aids - - 2 2
Shoe insoles - 1 1 2
Roller (for PT) - 1 1 2
Reading glasses - - 2 2
Jackets 1 - - 1
Spoons/forks/knives for eating with 1 - - 1
Bike fuses/other parts 1 - - 1
Tent 1 - - 1
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Toothbrushes - - 1 1
Toilet paper - - 1 1
Lotion - - 1 1
Snacks 1 - - 1
Other drinks 1 - - 1
Infant formula 1 - - 1
Ace wrap 1 - - 1
Crutches 1 - - 1
Wheelchair 1 - - 1
Corn Cushions - 1 - 1
Clinic Totals of Supplies Requested 35 4 33 72
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner;
PT=physical therapy

Table 21. Winter Quarter 2016 Services Requested per Clinic Separated by Service Category
Category Service Requested SO EGH SVDP Request Totals
BASIC: Bus tickets 4 - 7 11
Housing 3 - - 3
Employment - - 2 2
Job training - - 1 1
Education - 1 - 1
Other Transportation 1 - - 1
Free telephone access 1 - - 1
Addiction: Addiction treatment clinic/Detox services 1 1 - 2
Mental Health: Counseling/therapy - 1 - 1
Psychiatrist - 1 - 1
Psychiatric Hospital - 1 - 1
Medical: Blood pressure 1 1 40 42
Medical care 6 9 2 17
Primary care - 1 7 8
Chronic illness management info - 4 - 4
Diet info for specific health conditions - - 3 3
Lung sounds - 2 - 2
Physical Therapy 1 1 - 2
Acute illness management info - 2 - 2
Wound care services - - 1 1
Dermatology care - - 1 1
Exercise info for specific health conditions - 1 - 1
Wound care/dressing change info - - 1 1
Dental: Dental info/care 5 3 7 15

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 Routine dental care 2 2 1 5
Urgent dental care 2 - - 2
Podiatry: Podiatrist - 2 - 2
Vision: Optometry 1 4 6 11
Health Systems: Health insurance 3 6 - 9
Healthcare navigation 1 6 1 8
Other: Legal assistance - 1 1 2
Clinic Totals of Services Requested 32 50 81 163
SO=Street Outreach; EGH=Elizabeth Gregory Day Home; SVDP=Saint Vincent de Paul Sunday Dinner

Qualitative notes and some feedback​ were documented. The apparent categories and main points
found in the notes and feedback are listed below:

► Supplies​: Bagels (perishable) must be distributed; a client requested propane to cook food
(UDSM cannot provide); Tent City 3 gave us a copy of their wish list; a few clients left the socks
they just received on the street
► Discussed with clients​: Client desires experimental treatment for arthritis; need for Pap smear;
homeless in U-District may believe/perceive this area to have more resources than other places;
when cops “kick [the homeless] out of streets,” they have no legal place to sit and stay, so they
have to keep wandering around
► Care issues​: “What age minors can [UDSM volunteers] approach?”; learned to ask all EGH staff
about client history before calling 911 for active suicidal ideation; learned that there is no
easy/fast way to get Apple Health clients into inpatient drug treatment because they must be
seen at an outpatient behavioral health facility for an assessment and the facility notifies client
of open bed (can take weeks to months); Union Gospel Mission and Salvation Army have
intensive inpatient programs (6-12 months) that take direct calls for admission requests during
select morning hours; one homeless client threatened another when the latter wanted to leave
that area, and UDSM volunteers got the former a bus ride to Capitol Hill (out of U-District) with a
note about a VA resource center; a few clients we met lied about their background stories;
many clients seem knowledgeable about resources and shelters
► Medical problems discussed​: pain, knee pain, foot pain, chronic back pain, arthritis, brain
cancer, delusions, blackouts (not alcohol related), HPV, incontinence, pneumonia, skin infection,
tooth gap
► Client feedback​: 3 said we answered their questions; request to include an email for UDSM on
future information flyers
► Volunteer feedback​: find a way to share outreach resources with all student volunteers; saved a
copy of the January 9​th​ 2016 Tent City 3 Wish List which is one page, organized into categories,
and has contact info for the nonprofit organization SHARE which seems to be a partner that is
helping them; Homeless clients often open up to our volunteers when we wear UDSM badges
and explain where we are from; using humor is sometimes a good way to approach them

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We began to collect responses to the ​opinion poll​ this quarter regarding future plans for a UDSM free
walk-in clinic (see Table 22 below). At the time this poll was developed, we supposed that the new clinic
would be located at the UW Medical Center-Roosevelt. The majority of clients polled (92%) stated that
they would likely use the clinic. The four most popular types of services were dental care (37.5%), vision
care (21.9%), acute care (12.5%), and physical therapy (12.5%).

Table 22. Winter Quarter 2016 Opinion Poll of Homeless Clients Regarding a UDSM Free Walk-in Clinic
Survey SO EGH SVDP Survey Totals
If UDSM opened a free clinic at UW Roosevelt,
would you be likely to go there? (N=25)
Yes: 13 - 10 23 (92%)
No: - 2 2 (8%)
Why or why not?: Already have other sources of care
What services do you think you would use? (N=32)
Dental Clinic: 8 - 4 12 (37.5%)
Foot Clinic: 1 - - 1 (3.1%)
Physical Therapy Clinic: 4 - - 4 (12.5%)
Vaccine Clinic: - - - 0 (0%)
Symptom/Injury/Sick Visit (Acute Care Clinic): 4 - - 4 (12.5%)
Vision Care Clinic: 1 - 6 7 (21.9%)
STD Clinic: 1 - 1 2 (6.3%)
Pediatric Care Clinic: 1 - 1 2 (6.3%)
UDSM=University District Street Medicine; SO=Street Outreach; EGH=Elizabeth Gregory Day Home;
SVDP=Saint Vincent de Paul Sunday Dinner; STD=sexually transmitted diseases

Spring and Summer Quarters 2016 (3/28/2016-6/19/2016 and 6/20/2016-9/27/2016)

Data for these quarters are not yet available.

Discussion
This report summarizes all available programmatic data since the initial launch of the UDSM outreach
clinics. Some of the data was collected before the current data management system was established. As
previously mentioned, documentation was not always routine or consistent. Data was gathered
qualitatively on some occasions and quantitatively at other times. Furthermore, outreach clinics are
intended to be client-centered with the purpose of serving and benefitting the client rather than our
organization. Therefore, the UDSM volunteers use their best judgement, and sometimes their best
estimate, in deciding when and how to record data during outreach events. Thus, we must acknowledge
that the data collected and summarized here underestimates the true frequencies.

There are a few nuances to keep in mind when considering this data. In regards to tallying supplies,
some may be counted individually without noting how many clients received them. For example, when

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one box of 20 tampons is given to a client, the outreach manager or scribe may tally this as 20 tampons
distributed rather than “1” distribution of tampons. This could easily make tampons appear to be one of
the most frequently distributed item as they often come in 20, 40, or even 88 or more per box. Another
point to consider is that the supplies distributed may reflect the giving choices of those who donate the
supplies rather than clients’ needs or requests. Likewise, the types of physical exams that are being done
may be a function of the preceptor’s profession rather than the clients’ needs. For example, a nurse or
doctor is authorized to supervise blood pressure measurements, but a social worker or pharmacist is
not. Finally, the topics more frequently discussed during encounters, especially in public (i.e. during
Street Outreach) may tend to be the “safer” topics, such as minor medical and dental issues. We should
not let this diminish our concern for other important topics that may be avoided due to stigma, such as
addictions and mental health issues.

Conclusions and Recommendations to Consider

The purpose of routinely collecting pertinent data is to best describe the nature of UDSM programs and
our target population, find and address problems to improve our current clinics, appropriately plan
ongoing and future operations, and identify needs that may require developing new UDSM programs.

This initial data serves as a baseline​ description of our current outreach programs. All three outreach
clinics are well established with a stable number of outreach events per quarter (4-6 Street Outreach
events and 4-6 community-based [EGH and SVDP combined] events per quarter). UDSM volunteers are
developing a favorable rapport among the homeless population in the U-District and discussing and
referring a wide variety of topics and services. Volunteers are distributing available supplies and
documenting requests for supplies and services. Now that we have a systematic way to collect and
manage our data, future data sets should be more reliable and we may find more meaning in the
patterns and trends of the data. This new system is in its infancy and has the potential to be further
developed to help UDSM study and address more complex questions and challenges within our mission.

Regarding outreach interactions​, we are currently tallying the ​number of encounters​ during each
outreach event, but these are not necessarily unique client encounters. In other words, we do not know
how many clients are engaging in multiple (repeat) encounters with us on different dates. UDSM may
want to consider developing a way to monitor this. ​Regarding supplies and services​, outreach managers
are already thinking about publishing wish lists. Wish lists based on our tally of requested supplies can
be used to organize targeted supply drives. Perhaps creating a Donations/Supplies Committee would be
useful for UDSM. Likewise, services requested data can be communicated to our Community Network
Partnerships Committee. It may also be useful to know what ​specific medical problems​ are frequently
encountered during outreach. I recommend to encourage volunteers to begin by collecting qualitative
notes (listing clients’ medical diagnoses) during outreach events. Later, perhaps in Autumn Quarter
2016, the Tally Sheet can be revised to begin tallying to get quantitative data of the common diagnoses.

Since the latter part of Winter Quarter, our Street Outreach volunteers have begun to interact with ​Tent
City 3​, an established and authorized encampment of homeless individuals with permission to occupy a
defined site for a specific length of time. This spawns a few interesting questions. Are the needs and
requests among this group different compared to individuals encountered on the streets or in shelters?
Should UDSM consider developing a new outreach clinic targeted to Tent Cities, especially with current

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efforts among UW students to host a Tent City on our campus grounds? Or are Tent Cities visible enough
to receive adequate attention from other local charity groups? UW seems to be warming up to the idea
of hosting a Tent City, and all the Health Sciences Schools may want to show support with
representative involvement. UDSM may want to use this unique opportunity to both address Tent Cities’
needs as well as reach out to School of Public Health faculty to become actively involved with UDSM to
advise our data and program analysis needs.

Regarding self-evaluation​, there is an online survey that is usually emailed to student volunteers and
preceptors after they have participated in an outreach event. The data from these surveys has not been
integrated into the current data management system. Integration may not be absolutely necessary, but I
encourage UDSM to develop a method for analyzing this valuable survey data. It may begin as a
qualitative analysis by the volunteer coordinators and later be developed into something more
systematic. Scribe feedback should also be surveyed.

Community engagement and community assessments​ are important to health service organizations. If
some ​health outcomes data​ can be monitored in the future, we may be able to perform a ​Health
Impact Assessment (HIA) ​to evaluate what effects UDSM programs have had among our target
population and within the community. Designing and conducting a HIA could be a Master’s level
capstone or thesis project with potential journal publication.

Regarding the data management system​, I found it useful to review each clinic’s data separately before
combining the data. Therefore, I plan to create a third Master Spreadsheet by separating the data from
the two community-based clinics so that each has its own spreadsheet file. After Summer Quarter 2016,
I recommend that for every new school year, new Master Spreadsheets be created from the template
file for each outreach clinic and include all four quarters (Autumn, Winter, Spring, and Summer). Old
Master Spreadsheet files should be archived. In preparation for this report, I created an Excel
spreadsheet file to help me analyze our current data. In the future, an Excel template can be created to
make the data analysis process more systematic. A Word template can also be created for ease of
formatting quarterly and annual reports.

I recommend that UDSM consider publishing quarterly and annual reports ​that include both program
data summaries and budget spending summaries. Both financial data and outreach clinic data can be
integrated to guide future UDSM program planning, fundraising, and decision-making. A data manger
and financial manager could oversee this. I recommend the data manager be a graduate/professional
level Health Sciences student because such experience is desirable when supervising undergraduate
Scribes and Data Analyst Interns (see below under Future Plans).

Future Plans
Health Sciences Interprofessional Education
UDSM provides valuable opportunities for service learning, interprofessional collaboration, and
community engagement and is poised to be one of the organizations involved with UW’s future plans of
coordinating Interprofessional Education (IPE) among the six Health Sciences schools. With this in mind,
the importance of tracking data related to experiential learning within UDSM becomes clear. The
number of students involved, from which Health Sciences schools, how many are receiving academic

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credits, the number of hours they serve, and their qualitative feedback about their experiential learning
would all be pertinent information. A system to gather and monitor such data has yet to be designed.

Undergraduate Internships
UDSM has designed an unpaid internship opportunity for undergraduates in UW’s School of Public
Health (SPH) to serve as UDSM Data Analysts. The interns’ duties include monitoring outreach data,
making recommendations to improve the quality and quantity of data collected, summarizing and
interpreting the data, proposing new ideas to solve problems or improve current programs, creating
reports, and communicating with UDSM leaders, fellow students and UW faculty. Data Analyst Interns
may develop ideas that evolve into Capstone projects.

Master’s Degree Practicums and Capstones

UDSM has outlined a Practicum and a Capstone project for UW Master of Public Health candidates. A
strong referral network is essential to UDSM’s mission. The UDSM Practicum involves assessing the most
pressing referral needs of the U-District’s homeless population, researching the existing medical and
social services in Seattle, determining what resources would be most relevant for direct referral
partnerships with UDSM, and cultivating those relationships into formal partnerships. Identifying missed
opportunities to engage the homeless in primary care is another important objective for UDSM. A
Capstone project that involves designing and conducting a qualitative study to describe themes and
trends surrounding experiences of missed preventative care and missed continuity of care would be
highly informative.

Free “Walk-In Clinic”

UDSM is developing a proposal for a new clinic with the aim of providing free, problem-focused, medical
care to those in the U-District who are not accessing needed care due to various barriers. Among the
homeless population, barriers include cost, inconvenient hours, and feeling uncomfortable in traditional
waiting rooms. The “UDSM Walk-In Clinic” (the name is not chosen yet) could provide initial care and
refer patients for ongoing care to providers who are knowledgeable about the issues of homelessness.
This may be one way to bridge the gap between the homeless and the medical establishment and catch
those who are “falling through the cracks” of our health care system. The opinion poll currently on our
Tally Sheet is only the first step in gathering data to guide and inform this proposal. New data-driven
ideas are needed and welcome.

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Special Thanks
The UDSM Leadership Team who provided input on the development of the data management system:

(Alphabetical)

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Appendix A: UDSM Outreach Tally Sheet

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Appendix B: Screen Shot Samples of Master Spreadsheets

Below is the view after scrolling to the right.

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(More samples on next page…)

Appendix B: Screen Shot Samples of Master Spreadsheets (Continued)

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(More samples on next page…)

Appendix B: Screen Shot Samples of Master Spreadsheets (Continued)

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Appendix C: Supplies and Services Categories

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