Development of the Primary Care Homeless Organizational Assessment Tool (PC-HOAT) Framework to Evaluate Primary Care Services for the Homeless

Providing quality health care for homeless individuals can be an accomplished if primary care health service organizations are managed using evidence that supports relevant structures. The delivery of quality health care necessitates adequate knowledge of the design of health service organizations. Development of the Primary Care Homeless Organizational Assessment Tool (PC-HOAT) will be the first organization assessment tool of its kind to compare quality from services that deliver primary care to the homeless.  This tool will provide organizational leaders and stakeholders a snapshot of the existing organizational structures and processes associated with greater quality of primary care for the homeless. By using this tool, leaders will better understand their organization’s strengths and weaknesses; guide discussions regarding operations; and provide information to inform future strategies. If organizations possess certain organizational characteristics defined through multiple domains, (i.e. accessibility, leadership, information systems, and patient-centered care), it will be more likely to have better quality performance indicators.  

The presentation will focus on the initial development of the tool that began with identify relevant organizational characteristics by using two Institute of Medicine reports, the Clinical Microassessment Tool, a homeless provider’s perspective, the Chronic Care Model, Starfield’s manuscript on primary care, and a manuscript by the National Homeless for Health Care Council.  The seven core references provide (a) multi-dimensional perspectives, (b) information extensively cited in the literature, (c) information specific to primary care, and (d) information specific to the homeless.  The results are a framework that included eight domains and 82 questions. 

The tool has been tested for reliability and validity using key informant interviews and two surveys distributed nationwide.  Statistical analysis is currently being performed.