Homeless Shelter Users and Their Experiences as EMS Patients: A Qualitative Study.

Introduction: Patients who are users of homeless shelters interact with EMS and Emergency Departments (ED) as means of accessing the healthcare system. Patients in this population are known to have chronic health conditions as well as being frequent users of EMS. In this study, we researched how patients living at a homeless shelter experienced EMS. Methods: A phenomenological qualitative approach methodology was used to interview individuals at the largest homeless shelter in Omaha, Nebraska in 2017. Data was transcribed then coded for thematic analysis. Results: Eighteen adult individuals participated with four major themes emerging: Frequency and Medical Histories, Perceived Positive Experiences, Perceived Negative Experiences, and Awareness of EMS. Professionalism and being non-judgmental toward a homeless shelter user appeared to best describe the difference between a positive EMS experience from a negative one. Patients of this population have an awareness and appreciation to the role of EMS. They are also aware and recognize overuse of EMS by others and biases from EMS towards patients of this population. There are recognized opportunities to improve the relationship and role of EMS with patients using homeless shelters and services. Conclusion: Support for increased EMS awareness, research, and relationship building with homeless shelter users and shelters is needed.