Drop-In Wound Care: Calgary's Wound Care Model Centred Around People Experiencing Homelessness

Abstract

People experiencing housing insecurities or homelessness face significant barriers to equitable healthcare. A drop-in wound care service was established to mitigate social barriers and improve accessibility. This model facilitates direct access to a multidisciplinary team of trauma-informed medical staff on a walk-in basis. A retrospective chart review was performed on patients seen at the drop-in clinic from January 2021 to December 2021. A total of 119 patients were serviced over 798 visits, with 254 unique wounds managed. 82.8% of patients were living unsheltered, in emergency shelters or in provisional accommodation at the time of assessment. Trauma wounds, lower leg ulcers and frostbites represented the top three complaints. 69.7% of all patients returned to service for at least a second visit, with a median of 4 visits per patient over 42.5 days. Unsheltered patients were most likely to return to service (87.5%) but were most likely to be lost prior to wound closure (68.8%). Timely access to care with consistent follow-up is essential for quality wound care. Our drop-in service presents a working model for providing equitable wound care to socially disadvantaged patient populations. The effectiveness of this model is highlighted by the continual expansion serving 909 and 1029 visits in subsequent years.