3. In which of the following settings does your organization operate? (choose one)

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1 Thank you for participating. Results from this survey will be used internally at the National Health Care for the Homeless (HCH) Council to assess the research and quality improvement interests and capabilities of HCH grantees and other homeless health care agencies. It will also be used in aggregate form to describe the Practice Based Research Network (PBRN) in grant applications and publications. Individual staff and practices will not be described. For the purposes of this survey, "research" is defined as systematic inquiry that results in generalizable knowledge. Research explores: availability and access to care; quality of health care delivery models, screenings and treatments; outcomes of clinical and behavioral interventions; and costeffectiveness of care. Research can expose patients to various levels of risk and should therefore be reviewed by an Institutional Review Board and include a method of providing informed consent to participants. "Quality improvement" is defined as the process of collecting and comparing health care data to identify approaches to care that are working and those that need refinement with the end goal of enhancing patient outcomes, provider skills or knowledge, and system level performance within an individual organization or group of related organizations. Regular quality improvement activities involve minimal risk to patients. 1. In what state is your organization located? State: 2. What is your position title? (choose one) Medical Director HCH Coordinator CEO 3. In which of the following settings does your organization operate? (choose one) Stand alone HCH clinic HCH clinic affiliated with a Community Health Center (FQHC) HCH clinic affiliated with a public health department HCH clinic affiliated with a hospital Shelter based site Medical respire care program 4. How many sites (including satellite practice sites) are associated with your organization? Patient Population & Services Page 1

2 The next few questions refer to the services and staffing at your Health Care for the Homeless program. If your HCH program is part of a larger agency, such as a health department, please only answer questions in regards to the HCH program.. What principle patient populations do you serve? (check all that apply) Children Families Single adults Unaccompanied youth (13 18 years old) Elderly Pregnant women Veterans Rural residents LGBTQ. Please provide an estimate of your annual unduplicated patient volume. Single adults Persons in families Unaccompanied youth (13 18 years old) Page 2

3 7. Which of the following services are provided directly by your organization? (check all that apply) Primary health care Mental health counseling Psychiatry Substance abuse Medical respite Dental Vision Podiatry Specialty care Prenatal Perinatal Pediatric Geriatric Pharmacy Complementary/alternative medicine Case management/social services Street outreach Other outreach Supportive housing Housing assistance Mobile clinic Health education Financial counseling/eligibility assistance Employment assistance Basic needs Emergency shelter Domestic violence shelter Transportation Interpretation Page 3

4 8. Who provides services at your organization? (check all that apply) Physician Physician Assistant Advance Practice Nurse Nurse Medical assistant Dentist Dental hygienist Pharmacist Substance abuse counselor Social worker (MSW/LICSW) Ophthalmologist/Optometrist Podiatrist Psychiatrist Psychologist Mental health counselor (MA level) Case Manager Community Health Worker Outreach worker Electronic Medical Records 9. Does your organization have an Electronic Medical Record (EMR) system?, but we are in the process of converting from paper to EMR Page 4

5 10. Would your organization be willing to pull patient data from the EMR for research or quality improvement activities in collaboration with the National HCH Council and other HCH grantees? t sure 11. Has your organization ever participated in or conducted research? 12. Does your organization have dedicated research staff and/or an internal research department?, we have dedicated research staff, we have dedicated research staff and a research department, we do not have dedicated research staff or a research department Page

6 13. How many FTE of dedicated research staff do you have? < Does your organization have an internal or external research review process established for participating in a study? Internal review process External review process (e.g. IRB review by an academic affiliate) Both internal and external review processes in place review process established 1. What types of partners have you collaborated with in research? (check all that apply) Academic institutions Community organizations Other health centers Hospitals Government agencies t sure Page

7 1. How does your organization support research activities (check all that apply)? External federal External academic External foundation External local or community agency External supporting staff effort External supporting research materials/supplies/equipment Internal operations budget Internal supporting staff effort Internal supporting research materials/supplies/equipment Staff must fit research activities into their other full time duties 17. What percentage of your research projects have been externally funded in the last 10 years (e.g. foundation or government grants)? 0% 2% 0% 7% 100% Page 7

8 18. Please list up to of the most important research projects your organization has conducted in the past 10 years. For the next two items, we are trying to understand the facilitators and barriers to conducting research and participating in research collaborations. If your organization has not participated in research, please consider which factors would encourage you to participate and factors that have prevented or would prevent you from participating in the future. 19. Which of the following factors contribute to a positive research experience for your organization? (check all that apply) Improvement in health care delivery Improvement in health outcomes Knowledge gained Patient satisfaction Provider satisfaction Relationship building between agencies Receipt of additional clinic resources (e.g. funding, staffing, equipment) Recognition in presentation of study findings Page 8

9 20. Which of the following factors contribute to a challenging research experience for your organization? (check all that apply) Exclusion from research process (design, implementation, analysis, dissemination) Lack of recognition in presentation of findings Little or no benefit to clinic or patients Limited resources (e.g. funding, staffing, equipment) Lack of internal support from staff 21. Is your organization a member of the HCH Practice Based Research Network (PBRN)? *The mission of the HCH PBRN is to facilitate improvement of health care practice and policy for individuals and families experiencing homelessness through effective use of research. Members of the HCH PBRN are invited to help develop research projects and review proposals, or can simply wait to be invited to participate in studies that as they arise. Health Care for the Homeless grantees and medical respite care programs are welcome to join at no cost., but we would like to join the network and we are not interested in joining at this time t sure 22. Please provide contact information for the staff member who can represent your organization on the HCH PBRN. Name (First and Last) Position title Phone number address Page 9

10 23. Which of the following topics or areas would your organization be interested in knowing more about through research? (check all that apply) Chronic disease management Infectious diseases Reproductive health Substance abuse Mental health Cognitive impairment Multiple chronic conditions Housing Aging population Women Children Veterans LGBTQ 24. Would your organization be willing to participate in an unfunded research project? Quality Improvement Page 10

11 2. What are the current Quality Improvement priorities at your organization? (check all that apply) UDS data/clinical indicators [The Uniform Data System (UDS) is a national dataset reported annually by 330 health center programs regarding patient demographics, services utilization, disease burden, staffing, and costs. UDS data help health centers evaluate their performance internally and can be used in aggregate to compare the health center patient population to the general US patient population.] Agency/state/other benchmarks Patient safety Information/record management 2. Would your organization be interested in unfunded Quality Improvement projects with the HCH PBRN? If yes, please specify topics of interest Page 11

12 27. Does your organization need training or technical assistance regarding the Uniform Data System (UDS)? If yes, please specify training and technical assistance needs 28. If you could add one more data element reported through UDS, what would it be and how would it be measured? Patient Satisfaction 29. Does your organization currently assess patient satisfaction? t sure 30. Would your organization be willing to share practices, including the instruments used to assess patient satisfaction, with the National HCH Council to assist other agencies? If yes, please send to Molly Meinbresse (mmeinbresse@nhchc.org) or we will contact you directly Page 12

13 31. Would your organization like assistance in the assessment of patient satisfaction? If yes, please specify technical assistance needs 32. If you have not done so already, please describe any training or technical assistance needs your organization has regarding research, quality improvement, and data collection. Thank you for participating! Page 13

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