Perceptions of Medically Complex Patients Enrolled in an Ambulatory Intensive Care Unit at a Healthcare-for-the-Homeless Clinic

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Figure 1.
Qualitative themes of the streamlined unified meaningfully managed interdisciplinary team (SUMMIT) A-icu impact using the Gelberg behavioral model for vulnerable populations framework.

Table 1.

Description of the Interviewed Sample

Characteristic	n = 25 (%)
Average age (years) at interview	53.2 (SD 8.7)
Female^*	10 (40%)
Race/Ethnicity^±
Black	1 (4%)
American Indian/Alaska Native	6 (25%)
Hispanic	1 (4%)
White	17 (68%)
Average time enrolled in SUMMIT at time of interview	14 months
>6 months with SUMMIT	19 (76%)
Interviewed before joining SUMMIT	3 (12%)
Prescence of depression/psychosis diagnosis	19 (76%)
Prescence of alcohol use disorder diagnosis	12 (48%)
Presence of drug use disorder diagnosis	16 (64%)
Average Elixhauser comorbidity score	5.64 (SD 2.0)

↵*Female vs male sex was obtained by what was recorded on the patients’ electronic health record at time of consent and enrollment.
^±Race/Ethnicity was obtained by having participants select their race and ethnicity on our baseline survey.
Abbreviations: SUMMIT, streamlined unified meaningfully managed interdisciplinary team; SD, standard deviation.

Table 2.

Description of Themes and Exemplars

Domain/Theme:	Description or Exemplar:
Domain 1: Patient Perspectives of Their Own Health and Healthcare
Theme 1: Inability to Separate Medical and Social Complexity	Patients describe compounding acute and chronic medical conditions intertwined with substance use, pain, mental health, and past and current trauma, stigma
Domain 2: What the SUMMIT A-ICU Provided:
Theme 1: Patients valued team-based care with improved access to needed care	“I was offered the chance to switch over to the Summit Team and I sensed… it’s because I needed more attention. I needed the hour-long appointments, I needed more involvement” (63 yo Male, Pt 106)
Theme 2: Patients perceived SUMMT team members as family	“They welcome my dog, they welcome me. They make me feel a part of the family and I have no family. This is all I got.” (59 yo Male, Pt 103)
Theme 3: Patients felt destigmatized and treated with respect and dignity	“I’m just grateful to be acknowledged. It’s important for my mental, as well as the spiritual. I’m a human… they made me feel valid and valuable. That’s huge.” (56 yo Male, Pt 117)
Theme 4: Patients perceived evolving self-efficacy through engagement in SUMMIT	“I used to get overwhelmed and frustrated with stuff and I would cancel appointments. I wouldn’t go to them…that’s changed. If I got an appointment and it’s all done and she arranges the ride for me…so all I have to do I show up. I can do that.” (69 yo Female, Pt 123)