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Navigator program aims to keep homeless patients out of the hospital

NCT ID NCT04961762

Knowledge-focused Sponsor: Unity Health Toronto Source: ClinicalTrials.gov ↗

What the study statuses mean

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Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing
Running, but no longer taking on new participants.
Completed This study
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Jun 27, 2026 · Last updated Jun 27, 2026

Summary

This study tested whether a navigator program, where a Homeless Outreach Counsellor helps patients follow their discharge plan and connect with community services, improves outcomes for homeless adults after a hospital stay. Over 650 participants were randomly assigned to receive the navigator program or usual care. The main goal was to see if more people had a follow-up visit with a primary care provider within 30 days of leaving the hospital.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance
Navigator Program (case management by a Homeless Outreach Counsellor)
What this could lead to
If successful, this program could improve follow-up care and reduce hospital readmissions for homeless adults, pointing toward a scalable support model.
What could go wrong
This is a single completed trial; results may not apply to all regions or health systems. The program's effectiveness depends on local resources and staff availability.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Not a phased trial

Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.

Participants

656 people

The number who actually took part.

Started

Oct 2021

Finished

Aug 2025

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * 18 years of age or older * Have an unplanned admission for any medical cause to the General Internal Medicine service, any Medicine subspecialty service, the Cardiac Intensive Care Unit, and the Medical Surgical Intensive Care Unit * Identified as being homeless at the time of admission or anytime during the index hospital admission. This includes patients who are: unsheltered (absolutely homeless and living on the streets or in places not intended for human habitation), emergency sheltered (staying in overnight shelters for people who are homeless, as well as shelters for those impacted by family violence), or provisionally accommodated (whose accommodation is temporary or lacks security of tenure). Exclusion Criteria: * Unable to provide informed consent to the study * Previously received services from the Homeless Outreach Counsellor within 90 days of admission

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As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Case management Homeless persons Hospital readmission Primary care

Contacts and locations

Locations

  • St. Michael's Hospital

    Toronto, Ontario, M5B1W8, Canada

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