ED Community Placement Project (EDCPP): Right Service-Right Venue Approach in Managing ED Frequent Users

2.50
Hdl Handle:
http://hdl.handle.net/10755/335138
Category:
Full-text
Type:
Presentation
Title:
ED Community Placement Project (EDCPP): Right Service-Right Venue Approach in Managing ED Frequent Users
Other Titles:
Evidence-Based Practice Implications Within Emergency Care
Author(s):
Mitchell, Karen Elizabeth
Lead Author STTI Affiliation:
Gamma Gamma
Author Details:
Karen Elizabeth Mitchell, RN, MSN, CMCN, kemitchell@ucsd.edu
Abstract:
Session presented on Saturday, July 26, 2014: ED Community Placement Project (EDCPP): Right Service -Right Venue approach in managing ED frequent users. Karen Elizabeth Mitchell, RN, MSN,CMCN, Department of Emergency Medicine, University of California San Diego Health System, San Diego, CA ED Community Placement Project (EDCPP): "Right Service -Right Venue" approach in managing ED frequent users. Authors: Karen Elizabeth Mitchell, RN, MSN, CMCN, Christian Tomaszewski, MD, MBA, and Catherina Mandani, RN, MSN, PhD(c). Background Statement: San Diego has the 3rd largest homeless population in the United States, following New York and Los Angeles. Homeless patients without medical homes account for nearly 1/3 of the ED visits, resulting in longer ED wait times and avoidable inpatient admissions. Many of these patients are non-funded or under-insured contributing to rising unreimbursed healthcare costs. Emergency departments (ED) are ill equipped to meet the psychosocial, housing, substance abuse treatment and mental health needs of homeless community. Intervention Detail: The Emergency Department Community Placement Project (EDCPP) is designed to bridge the highest ED users into community-based homeless prevention services, substance abuse treatment, and intensive case management. The goal for this project is to reduce recidivism amongst the neediest and costliest patients by 20% through provision of resources to address substance abuse, homelessness and mental health issues. A cohort of 215 patients was electronically pre-identified in EPIC electronic medical records. Inclusion criteria included homeless with frequent ED visits (2 or more visits per month over the past 12 months) and associated complaints of co-occurring disorders, substance abuse and alcohol related illness. Upon patient presentation the Best Practice Advisory (BPA) flag is initiated and triggers targeted interventions. The ED physician/psychiatrist places Community Placement Order. Patient consenting, screening and placement (to community partners) are performed by ED Staff. Setting and methods: Emergency Department is an urban, academic teaching healthcare facility. Annually treating 42,300 patients. Results: Six month analysis: Cost savings of $168,231. Based on program expenses, (contractual bed cost) of $38,234 (6mos) = 4 .4 (ROI). 78 % reduction in ED visits among EDCPP placed patient cohort. 3.8% increase in Press-Ganey patient satisfaction scores. Given results, program planned for expansion to other healthcare system EDs and extended pt populations.
Keywords:
evidence based project; recidivism reduction; community collboration
Repository Posting Date:
17-Nov-2014
Date of Publication:
17-Nov-2014 ; 17-Nov-2014
Other Identifiers:
INRC14H12
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleED Community Placement Project (EDCPP): Right Service-Right Venue Approach in Managing ED Frequent Usersen
dc.title.alternativeEvidence-Based Practice Implications Within Emergency Careen
dc.contributor.authorMitchell, Karen Elizabethen
dc.contributor.departmentGamma Gammaen
dc.author.detailsKaren Elizabeth Mitchell, RN, MSN, CMCN, kemitchell@ucsd.eduen
dc.identifier.urihttp://hdl.handle.net/10755/335138-
dc.description.abstractSession presented on Saturday, July 26, 2014: ED Community Placement Project (EDCPP): Right Service -Right Venue approach in managing ED frequent users. Karen Elizabeth Mitchell, RN, MSN,CMCN, Department of Emergency Medicine, University of California San Diego Health System, San Diego, CA ED Community Placement Project (EDCPP): "Right Service -Right Venue" approach in managing ED frequent users. Authors: Karen Elizabeth Mitchell, RN, MSN, CMCN, Christian Tomaszewski, MD, MBA, and Catherina Mandani, RN, MSN, PhD(c). Background Statement: San Diego has the 3rd largest homeless population in the United States, following New York and Los Angeles. Homeless patients without medical homes account for nearly 1/3 of the ED visits, resulting in longer ED wait times and avoidable inpatient admissions. Many of these patients are non-funded or under-insured contributing to rising unreimbursed healthcare costs. Emergency departments (ED) are ill equipped to meet the psychosocial, housing, substance abuse treatment and mental health needs of homeless community. Intervention Detail: The Emergency Department Community Placement Project (EDCPP) is designed to bridge the highest ED users into community-based homeless prevention services, substance abuse treatment, and intensive case management. The goal for this project is to reduce recidivism amongst the neediest and costliest patients by 20% through provision of resources to address substance abuse, homelessness and mental health issues. A cohort of 215 patients was electronically pre-identified in EPIC electronic medical records. Inclusion criteria included homeless with frequent ED visits (2 or more visits per month over the past 12 months) and associated complaints of co-occurring disorders, substance abuse and alcohol related illness. Upon patient presentation the Best Practice Advisory (BPA) flag is initiated and triggers targeted interventions. The ED physician/psychiatrist places Community Placement Order. Patient consenting, screening and placement (to community partners) are performed by ED Staff. Setting and methods: Emergency Department is an urban, academic teaching healthcare facility. Annually treating 42,300 patients. Results: Six month analysis: Cost savings of $168,231. Based on program expenses, (contractual bed cost) of $38,234 (6mos) = 4 .4 (ROI). 78 % reduction in ED visits among EDCPP placed patient cohort. 3.8% increase in Press-Ganey patient satisfaction scores. Given results, program planned for expansion to other healthcare system EDs and extended pt populations.en
dc.subjectevidence based projecten
dc.subjectrecidivism reductionen
dc.subjectcommunity collborationen
dc.date.available2014-11-17T13:45:13Z-
dc.date.issued2014-11-17-
dc.date.issued2014-11-17en
dc.date.accessioned2014-11-17T13:45:13Z-
dc.conference.date2014en
dc.conference.name25th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationHong Kongen
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen
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