Posts Tagged ‘emergency room’

Infographic: Alternatives for Potentially Preventable ER Visits

April 15th, 2016 by Melanie Matthews

Ten common conditions represented more than 2 million annual emergency room visits in New York at an estimated cost of about $1.3 billion, and nine out of 10 of them could have been avoided or treated elsewhere, according to research issued by Excellus BlueCross BlueShield.

A new infographic by Excellus BlueCross BlueShield highlights key findings from the study, including the impact of preventable visits and the geographic regions with higher rates of preventable visits.

Asked by its C-suite to quantify contributions of its multidisciplinary care team for its highest-risk patients, AltaMed Health Services Corporation readily identified seven key performance metrics associated with the team. Having demonstrated the team’s bottom line impact on specialty costs, emergency room visits, and HEDIS® measures, among other areas, the largest independent federally qualified community health center (FQHC) was granted additional staff to expand care management for its safety net population.

Care Coordination of Highest-Risk Patients: Business Case for Managing Complex Populations chronicles AltaMed’s four-phase rollout of care coordination for dual eligibles—a population with higher hospitalization and utilization and care costs twice those of any other population served by AltaMed.

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3 Emergency Department Interventions to Curb ‘Ultra-Utilizer’ Use

March 31st, 2015 by Patricia Donovan

Drawing upon an 18-month pilot to curtail wasteful utilization in Ohio ERs, especially by Medicaid beneficiaries identified as ‘ultra-utilizers,’ Mina Chang, Ph.D., chief, health services research and program development section of the Bureau of Health Services Research for the Ohio Department of Job & Family Services, looks at three ED-based interventions targeting this population.

The ED care team approach is very similar for the three targeted ultra-utilizer groups: severe mental illness, non-mental health conditions, and chronic back pain. It’s based on a strong medical and clinical leadership oversight. The integrated interdisciplinary teams include managed care and community providers, and care management or care managers. They came together based on the patients’ medical profiles, developing an individual care treatment plan for each of the patients including the testing. The team would continue to outreach to those patients, to address their social and medical needs and to coordinate care for those patients.

The treatment plan at the summary level was made available to older participating EDs in the past intervention. The patient will be also flagged at those EDs. And the intent is if the member showed up at the ED, the ED attending physician would be able to reference on the treatment plan and also communicate with the interdisciplinary teams as necessary.

For the mental health stream, the designated provider is a comprehensive mental health center that works together with the managed care claims to develop treatment plans. And the summary level of the treatment plan will be shared with the participating EDs from the two health systems.

For these streams we also have a 24/7 crisis center so the EDs can tap into them to have the most updated treatment plan faxed over as needed.

We also have another integrated care team for the non-mental health population led by Metro Health’s medical home team. These designated providers work with our managed care plans to develop a treatment plan for each participating patient and the summary will be shared with the participating ED from the three health systems.

Finally, similar of design was a back pain stream with a pain clinic as the designated provider. This designated team works with our managed care plan care managers. In turn, they built a care treatment plan for those participating patients, and shared the treatment plan summary with the participating ED and the three health systems.

We already have very encouraging results. Almost all members reported their outreach from the team has been excellent or good. And that’s after we instituted the intervention. The majority of the members reported they have input into treatment plans, so most of them slowly follow up with their providers.

The unique area noted by the mental health team is that transportation, fear and timely appointments are the most common barriers preventing ultra-utilizer patients from seeking follow-up care after ED visits.

We also observed increasing success for members keeping appointments. Our teams also noted that communication is key, not only between the participating test site, since there are so many moving parts, but also within the test site, such as the pain clinics or the emergency department.

Source: 5 Interventions to Reduce Avoidable ER Use by the Medicaid Population

Reducing Avoidable ER Use

5 Interventions to Reduce Avoidable ER Use by the Medicaid Population looks at the collaborative effort among five Ohio regions to target key reasons for avoidable ER visits among Medicaid beneficiaries and roll out test interventions in a rapid cycle quality improvement approach.

Infographic: Overcrowding in the ER

July 30th, 2014 by Melanie Matthews

Between 1995 and 2010, annual emergency room visits in the United States grew by 34 percent, while the number of hospitals with ERs declined by 11 percent, according to a new infographic from the George Washington University MHA program.

The infographic also looks at the impact of overcrowding on U.S. emergency rooms, including the major causes of congested ERs and the impact on care delivery and proposed solutions to the problem of overcrowding.

Overcrowding in the ER

Evidence is lacking to support the effectiveness of public policy interventions based on performance measurement, such as public reporting of data and pay for performance. To succeed, emergency clinicians need to understand and practice in alignment with national performance measures.

Quality And Performance Measurement: A Guide For Emergency Physicians reviews the origin and evolution of performance measurement, explains the current landscape of reporting, and discusses projections for future hospital quality measure implementation through 2014.

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Infographic: Trauma Triage and the ER

December 10th, 2013 by Jackie Lyons

Trauma is the leading cause of death for individuals ages one to 44, and it costs $260 billion annually, according to a new infographic from the Nursing School Hub.

Triage is a technique used to evaluate and categorize patients in trauma situations when there is insufficient resources to care for everyone at once. This infographic identifies the most common trauma cases, the best emergency medicine programs and provides a walk through of three established triage systems.

Triage and the ER

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You may also be interested in this related resource: Leading a Hospital Turnaround: A Practical Guide.