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Show [DECREASING ED UTILIZATION] Department of Nursing Lexi Gundersen INTRODUCTION METHODS FOR IMPROVEMENT - The emergency department has a limited Complex Care Management • System that looks at an individual person in a holistic manner. • Physical needs • Mental needs • Emotional needs Specify number of resources and when it is overburdened the allocation of resources is made more difficult. Distinguishing between patients that truly have emergent situations and those whose needs can be handled elsewhere saves ED beds, medical equipment and money from being wasted. Problem Investigation • What are characteristics of "frequent fliers" of the ED? • Poor overall health/Chronic conditions • Lower socioeconomic status • Unmet needs by a primary care provider • How many visits do they represent? • 4 to 17% of patients who go to the ED represent almost half of ED visits. • How does this affect the general population? • One study in Poland indicated that those who go to overcrowded ED's have a 5% higher mortality rate. • So what can be done? -Robin Quivers " " You start one person at a time. Change one person you can change a village. • Social needs Health care has so many interlocking parts that the best thing a primary care provider can do is act as a driver in assisting the patient connect all the pieces. • So how does this work? • Target the correct patients • Gather an interprofessional team DISCUSSION patients Form a Team How can this be implemented in every primary care clinic? -Provide funding from insurances that reimburses clinics for changing their way of care. -Implement training about complex care management in all interprofessional education. -Train those who are already in the workplace on interprofessional communication. Limitations & Barriers • Seemingly large project that is not well established. • Long periods of time between implementation and arrival of rewards. • Requires communication between different systems. Follow up • Meet/Follow up at regular intervals RESULTS 1. Geisinger health system developed a team that enrolled patients in a complex care management system. At the end of their study the patients had on average decreased their number of ED/acute care visits AND their health care costs had gone down 1500 dollars per month. 2. Another clinic in Tennessee performed a similar program exclusively on Medicaid patients and they also found that health care costs and greatly decreased as well as how many in patient days each patient had. 3. All over the country various medical teams are implementing these same programs. Each are a little bit different, but the result is the same. Individualized complex care management results in higher quality care, decreased costs and decreased use of Conclusion • Despite the difficulties many different groups would benefit from these changes. • Patients who seek help in ED's will receive quicker and better care. • Any individual who pays for healthcare will benefit from the reduction of costs. • Health care providers will be better able to support their patients with quality care. RESOURCES Giannouchos, T. V., Ohsfeldt, R. L., Kum, H., & Foster, M. J. (2019). Characteristics and predictors of adult frequent emergency department users in the United States: A systematic literature review. Journal of Evaluation in Clinical Practice, 25(3), 420-433. https://doi.org/10.1111/jep.13137 Maeng, D. D., Snyder, S. R., Davis, T. W., & Tomcavage, J. F. (2017). Impact of a Complex Care Management Model on Cost and Utilization Among Adolescents and Young Adults with Special Care and Health Needs. Population Health Management, 20(6), 435-441. https://doi.org/10.1089/pop.2016.0167 Powers, B. W., Modarai, F., Palakodeti, S., Sharma, M., Mehta, N., Jain, S. H., & Garg, V. (2020). Impact of Complex Care Management on Spending and Utilization for High-Need, High-Cost Medicaid Patients. American Journal of Managed Care, 26(2), e57-e63. https://doi.org/10.37765/ajmc.2020.42402 Szwamel K., & Kurpas, D. (2019). Assessment of the health care system functioning in Poland in light of the analysis of the indicators of the hospital emergency department (ED) and primary health care (PHC) proposals for systemic solutions. Family Medicine & Primary Care Review, 21(2), 164-173. https://doi.org/10.5114/fmpcr.2019.84553 hospital resources. References: [DELETE IF NA] Wellness Champions Project Sponsored by the Resiliency Center |
