{
  "abstract": "Aims and Objectives Homeless (No Fixed Abode – NFA) patients represent a highly vulnerable group frequently attending emergency departments (EDs) with complex medical, psychological, and social needs. An audit at our ED identified inconsistent documentation of homelessness status and poor referral compliance to housing, safeguarding, and GP services. This gap in care results in missed opportunities for continuity of care, patient safety, and inclusion health.The aim of this Quality Improvement Project was to improve documentation and referral rates for NFA patients within the ED to ≥90% by August 2025. This project integrates the RCEM Inclusion Health Best Practice Guidelines into our ED electronic patient record (EPIC) workflows, embedding social determinants of health within emergency care.Method and Design The project employed structured Plan–Do–Study–Act (PDSA) cycles between September 2024 and August 2025.Staff awareness was assessed on statutory ‘Duty to Refer’ followed by educations sessions. EPIC EPR prompts and ‘FYI’ flagging at ED Reception for homelessness documentation.Collaboration with safeguarding and housing (Jigsaw) teams, and introduction of discharge care packs for patients.Departmental Clinical guideline introduced to ensure the pathways are clearly followed. Monthly data audits tracked documentation, referral completion, and safeguarding actions. Process mapping and stakeholder meetings ensured multidisciplinary engagement and sustainability planning through introduction of a departmental clinical guideline.Results and Conclusion Documentation of NFA status improved from almost nil to 100%, GP/housing referrals from 30% to 75% and safeguarding referrals from 10% to 35%. Staff feedback showed enhanced confidence and awareness of inclusion health principles. The implementation of the departmental clinical guideline ensures that the work done through the project is carried on in the future as well ensuring this vulnerable group of patients receive the continuity of care they deserve. This QIP demonstrates that integrating RCEM guidance within electronic systems and ED workflows can meaningfully improve safety, continuity, and dignity of care for homeless patients.Abstract 4265 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Frimley Park Hospital"
      ],
      "name": "Anoop Chakrapani"
    },
    {
      "affiliations": [
        "Frimley Park Hospital"
      ],
      "name": "Sarah Cowan-Rawcliffe"
    }
  ],
  "title": "4265 Improving referral pathways for homeless (no fixed abode) patients in the emergency department",
  "uid": "2ff58b8b-accc-5a47-9aae-7b25fcefedd0"
}