The Health Care for the Homeless Clinicians’ Network works with homeless health care providers to foster the development and distribution of clinical case reports that best illustrate unique health care issues or services for homeless people. Our objective is to build a body of literature that has educational value for the field of homeless health care and for other practitioners whose clients may include homeless patients. This page includes background information about case reports and how to prepare them. We strongly encourage you to share your own clinical experiences with colleagues.
What Is A Case Report?
A Case Report tells a clinical story that has unique value to the field of practice. In a case report, the clinical case presentation is examined in the context of current scientific knowledge and is shared for the purpose of educating others or stimulating further scientific inquiry and the development of a new understanding or knowledge. Some cases are published because they support findings of previously published cases or because they illustrate an important point in the care of a patient. Case reports serve as foundational elements for more sophisticated scientific endeavors as illustrated by The Evidence Pyramid in Figure 1.
On a practical level, sharing lessons learned through case reports can improve the quality of care provided to patients and help reduce the sense of isolation experienced by many homeless health care providers. Health Care for the Homeless (HCH) clinicians frequently must adapt evidence-based practice standards to best meet the unique needs of patients who are unhoused. These adaptations are not always part of the common practices that are taught during basic educational programs, and many of the adaptations have not been studied scientifically. Instead, most practice adaptations result from clinical experience and from what our patients have taught us as providers. These valuable “lessons learned” can enhance the clinical practice of HCH providers.
In the web presentation “Writing a Clinical Case Report”, Burge cites the following types of cases as worth reporting:
- Uncommon observations
- A new theory
- Questions regarding a new theory
- Unusual combination of conditions or events that cause confusion
- Adverse responses to therapies
- Personal impact
In addition to these reasons for case reporting, HCH clinicians have have an obligation to publish cases that include:
- Very common observations or practices not documented previously;
- Unique aspects of homeless practice such as outreach and engagement into care, case management and collaborations, and clinical adaptations to care; and
- Homeless persons’ competing priorities and how the health care plan and case management need to accommodate these realities.
 Markinson A. Evidence Based Medicine Tutorial. Medical Research Library of Brooklyn, SUNY Downstate Medical Center. 2004. Accessed August 2007.
Burge SK. Writing A Clinical Case Report. Family & Community Medicine, University of Texas Health Science Center at San Antonio. 2004. Accessed August 2007
Share Your Story
- Submit A Clinical Case: The HCH Clinicians’ Network invites you to share your clinical story. Network staff are prepared to assist any clinician who wishes to develop and publish a case report. Case reports can be published in peer-reviewed publications or on the National Health Care for the Homeless Council (NHCHC) web site. Staff will work individually with an author to attain the goal desired. To start the process, please complete the Case Report Worksheet and submit to firstname.lastname@example.org.
- Protect Patient Privacy: All cases intended for submission to a peer-reviewed journal must have a written permission from the patient that their case may be used. Clinicians submitting worksheets should follow the policies and procedures for consent for publication as prescribed by their center or agency. For the NHCHC web site publication of a case, written permission from the patient is preferred. However if the provider has been unable to receive consent, the case may be submitted with exclusion or alteration of any of the 18 Identifiers as detailed in The Privacy Rule. The case report must clearly state that the information in the case has been altered to protect the privacy of the patient or client.
- Peer Review Process: All Case Reports are peer-reviewed before posting on the NHCHC web site. Three reviewers which would include a content expert, a peer from the same profession, and a HCH clinician critique the case using the Case Report Review Tool. Based on the recommendations of the reviewers the case report, a determination will be made whether the case report meets the standard for publication on the NHCHC web site.
- An example of a Case Report Worksheet and the Case Report that followed: To assist clinicians, the completed Case Report Worksheet and the actual final document for the case “Got Milk?” Responding to Pediatric Dental Injuries of Homeless Children are available to review as an example by clicking on them. The “Got Milk?” case report was initiated following a clinical discussion among HCH providers. Initially, the details were roughly sketched out and given to the Network staff. The Network staff person collaborated with the clinician to complete the details, the literature review, and the final document. The case began as an idea; it was developed with the support of staff and illustrates several key aspects of the work that HCH providers undertake daily in their practice.
Tools and Resources for Case Report Development
Case Report Worksheet
Case Report Review Tool
Case Example (Completed “Got Milk?” Case Report Worksheet & “Got Milk?” Case Report)
- Web Resources:
- Herreid CF. What Makes a Good Case? National Center for Case Study Teaching in Science, University at Buffalo site. Available at http://ublib.buffalo.edu/libraries/projects/cases/teaching/good-case.html Accessed June 24, 2005. [Rules for good storytelling]
- Researching and Writing a Case Report. School of Optometry, University of Waterloo site. 2005. Step-by-step description for researching and writing a case report] Available at http://www.lib.uwaterloo.ca/discipline/opt/opt.html Accessed June 23, 2005.
- Santelman L. How-to-Guides. Applied Linguistics, Portland State University. [Under Teaching Related Materials are guides: How to read research, How to critique, and Resources on How to Write a Literature Review. Available at http://web.pdx.edu/~dbls/Howtos.html Accessed July 29, 2005.