Patient views on emergency department screening and interventions related to housing

Objectives: EDs serve as a healthcare "safety net" and may be uniquely suited to screening for and addressing patients' unmet social needs. We aimed to better understand patient perspectives on ED-based screening and interventions related to housing instability, as a step toward improving future efforts. Methods: We present findings from a qualitative study using in-depth, one-on-one interviews with ED patients who had become homeless in the past six months. Qualitative interviewees were asked their thoughts on ED staff asking about and helping to address homelessness and housing issues. Interviews were professionally transcribed verbatim. Multiple coders identified interview text segments focused on ED-based housing screening and intervention, which were then independently analyzed thematically and discussed to reach consensus. Researchers also categorized each participant's overall opinion on ED housing screening and interventions as positive, neutral, or negative. Results: Qualitative interviews were conducted with 31 patients. Four themes related to ED-based housing screening and interventions emerged: 1) patients generally welcome ED staff/providers asking about and assisting with their housing situation, with caveats around privacy and respect; 2) ED conversations about housing have potential benefits beyond addressing unmet housing needs; 3) patients may not consider the ED as a site to obtain help with housing; 4) patients' experiences navigating existing housing services can inform best approaches for the ED. Most participants expressed overall positive views of ED staff/providers asking patients about their housing situation. Conclusions: Study participants generally felt positively about screening and interventions for housing in the ED. Insights from this study can inform future ED-based housing instability screening and interventions.