2.50
Hdl Handle:
http://hdl.handle.net/10755/324152
Category:
Abstract
Type:
Presentation
Title:
Implementing Best Practices to Reduce Unnecessary Emergency Department Visits
Author(s):
Buker, Reid
Author Details:
Reid Buker, MN, RN, email: reid.buker@providence.org
Abstract:
Evidence-based Practice Abstract Purpose: Washington state currently provides Medicaid coverage to approximately 1.2 million low income clients. Without Medicaid, many of these individuals would be unlikely to obtain medical care. Recently, in response to the high cost of Medicaid, the state threatened to eliminate payment to EDs for the treatment of Medicaid patients who presented with non-emergent conditions. The Washington State Health Care Authority, the Washington State Hospital Association and the Washington chapter of the American College of Emergency Physicians worked collaboratively to identify “7 Best Practices” to decrease unnecessary ED visits. Design: Members of the Emergency Department Consistent Care Program (EDCCP), a multi-disciplinary team of nurses, physicians, behavioral health staff, and community service agencies, collaborated to implement the “7 Best Practices” in the emergency department. Setting: A level III trauma/emergency department with an annual volume of 66,000 patients. Participants/Subjects: Members of the EDCCP utilize the “7 Best Practices” to reduce unnecessary visits by Medicaid “Patient Review and Coordination” (PRC) clients with multiple non-acute visits which includes those who exhibit aggressive and/or drug seeking behaviors. Methods: The “7 Best Practices” employed in the ED include: 1) Implementation of the Emergency Department Information Exchange (EDIE) system. This online system allows hospitals around the state to share patient specific information, including the number of ED visits to hospitals within the state over a 12 month period, as well as sharing patient care guidelines among EDs in the state; 2) Development and distribution of patient education materials to help patients understand appropriate avenues for care (e.g. PCP, urgent care clinic, ED); 3) Utilize the EDCCP team to disseminate information on all frequent users of the ED to health care providers and staff; 4) Development and posting in EDIE of individualized care guidelines for patients who frequent any ED within the state 5 or more times in a 12 month period; 5) Establish guidelines for the use and prescribing of narcotics within the ED; 6) Enroll ED providers and nurses in the Prescription Monitoring Program. This program allows providers to pull up patient specific information showing all narcotic prescriptions over a 12 month period; 7) Conduct quality improvement efforts focused on the unnecessary use of the ED by comparing monthly performance reports of providers and hospitals from around the state. Results/Outcomes: Results following implementation show the rate of low acuity visits for Medicaid clients is 10.9 visits/month, which is 28% less than the statewide average rate of 15 visits/month. In addition, the average monthly Medicaid cost of $4,497 is 30% less than the statewide average Medicaid cost of $7,230. Implications: The “7 Best Practices” can be successfully implemented in the ED setting. These practices are expected to decrease unnecessary emergency department visits, save money for hospitals and the state, and increase patient safety with consistent and appropriate care at every ED. In addition, the practices have provided a way for EDs to monitor patient visits and prescriptions, therefore decreasing prescription drug abuse and ED shopping.
Keywords:
Redice ED Visits
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleImplementing Best Practices to Reduce Unnecessary Emergency Department Visitsen_GB
dc.contributor.authorBuker, Reiden_GB
dc.author.detailsReid Buker, MN, RN, email: reid.buker@providence.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324152-
dc.description.abstractEvidence-based Practice Abstract Purpose: Washington state currently provides Medicaid coverage to approximately 1.2 million low income clients. Without Medicaid, many of these individuals would be unlikely to obtain medical care. Recently, in response to the high cost of Medicaid, the state threatened to eliminate payment to EDs for the treatment of Medicaid patients who presented with non-emergent conditions. The Washington State Health Care Authority, the Washington State Hospital Association and the Washington chapter of the American College of Emergency Physicians worked collaboratively to identify “7 Best Practices” to decrease unnecessary ED visits. Design: Members of the Emergency Department Consistent Care Program (EDCCP), a multi-disciplinary team of nurses, physicians, behavioral health staff, and community service agencies, collaborated to implement the “7 Best Practices” in the emergency department. Setting: A level III trauma/emergency department with an annual volume of 66,000 patients. Participants/Subjects: Members of the EDCCP utilize the “7 Best Practices” to reduce unnecessary visits by Medicaid “Patient Review and Coordination” (PRC) clients with multiple non-acute visits which includes those who exhibit aggressive and/or drug seeking behaviors. Methods: The “7 Best Practices” employed in the ED include: 1) Implementation of the Emergency Department Information Exchange (EDIE) system. This online system allows hospitals around the state to share patient specific information, including the number of ED visits to hospitals within the state over a 12 month period, as well as sharing patient care guidelines among EDs in the state; 2) Development and distribution of patient education materials to help patients understand appropriate avenues for care (e.g. PCP, urgent care clinic, ED); 3) Utilize the EDCCP team to disseminate information on all frequent users of the ED to health care providers and staff; 4) Development and posting in EDIE of individualized care guidelines for patients who frequent any ED within the state 5 or more times in a 12 month period; 5) Establish guidelines for the use and prescribing of narcotics within the ED; 6) Enroll ED providers and nurses in the Prescription Monitoring Program. This program allows providers to pull up patient specific information showing all narcotic prescriptions over a 12 month period; 7) Conduct quality improvement efforts focused on the unnecessary use of the ED by comparing monthly performance reports of providers and hospitals from around the state. Results/Outcomes: Results following implementation show the rate of low acuity visits for Medicaid clients is 10.9 visits/month, which is 28% less than the statewide average rate of 15 visits/month. In addition, the average monthly Medicaid cost of $4,497 is 30% less than the statewide average Medicaid cost of $7,230. Implications: The “7 Best Practices” can be successfully implemented in the ED setting. These practices are expected to decrease unnecessary emergency department visits, save money for hospitals and the state, and increase patient safety with consistent and appropriate care at every ED. In addition, the practices have provided a way for EDs to monitor patient visits and prescriptions, therefore decreasing prescription drug abuse and ED shopping.en_GB
dc.subjectRedice ED Visitsen_GB
dc.date.available2014-08-04T13:28:27Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:27Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.