ARTICLERethinking Emergency Department VisitsResar, Roger K. MD; Griffin, Frances A. MPA, RRTAuthor Information Institute for Healthcare Improvement, Cambridge, Massachusetts. Correspondence: Frances A. Griffin, MPA, RRT, Institute for Healthcare Improvement, 20 University Rd, 7th Floor, Cambridge, MA 02138 (fgriffin@IHI.org). Journal of Ambulatory Care Management: October/December 2010 - Volume 33 - Issue 4 - p 290-295 doi: 10.1097/JAC.0b013e3181f53424 Buy Metrics Abstract Efforts to date have been unable to reverse the trend of increased emergency department utilization. The Institute for Healthcare Improvement has developed a framework for reducing avoidable emergency department visits on the basis of the formation of local coalitions. These coalitions include interested partners approaching improvement by integrating community resources and nonmedical solutions. Targeted patient populations are identified via homogeneous characteristics. Open-ended interview questions are used to identify possible community and nonmedical solutions to complement medical strategies. This article describes the framework and process of testing. If validated, this approach will have significant policy implications. © 2010 Lippincott Williams & Wilkins, Inc.