Frequent ED utilizers
A case management program to address patient needs
INSTRUCTIONS Frequent ED utilizers: A case management program to address patient needs
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Frequent ED utilizers: A case management program to address patient needs
GENERAL PURPOSE: To provide information about a hospital-based case management program to reduce avoidable ED visits. LEARNING OBJECTIVES: After completing this continuing-education activity, you should be able to: 1. Outline the purpose and design of the research described. 2. Identify the study's interventions and outcomes of significance.
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- Primary care settings offer which advantage over ED visits?
- more personalized care
- more efficient use of resources
- more appropriate treatments
- Which criterion did the hospital use to identify patients as frequent utilizers?
- patients who cause staff burnout and ED overcrowding
- patients who are best served by episodic, acute care
- patients with a significant number of ED visits
- The initial ED case management program sought to
- improve the quality of care in the ED.
- increase alignment of frequent utilizers with a PCP.
- reduce the number of ED visits.
- Which criterion was required for patients to be considered for case management?
- at least 20 ED visits in the previous year
- vetting by a review committee
- referral by ED staff
- What's the goal of involving the patient in designing the care plan?
- to identify the barriers to receiving care in a less acute setting
- to motivate the patient to seek lower cost treatment
- to decrease the patient's motivation to seek care at the ED
- Inaccessibility of care plans in the medical record was addressed by
- migrating to a new EHR.
- consulting the compliance officer.
- instituting an ED information exchangesystem.
- Which step was taken to ensure HIPAA compliance for program evaluation by county researchers?
- approval by the clinical research manager
- review by the nursing governance research council
- implementation of a business associate agreement
- Which statement concerning older frequent utilizers is accurate?
- They had more preintervention ED visits than younger patients.
- They had fewer preintervention ED visits than younger patients.
- They had fewer postintervention ED visits than younger patients.
- Preintervention, the average number of visits for those with Medicaid coverage was
- significantly higher than for those without Medicaid.
- significantly lower than for those without Medicaid.
- approximately equal to those without Medicaid.
- What was learned about mental health issues in this patient group?
- More of the 22 patients had substance abuse codes than behavioral/mental health codes.
- A majority of the frequent utilizers were coded for mental health concerns.
- Behavioral/mental health issues aren't drivers of calling 911.
- Which chief complaint was found most frequently among the EDCMP participants?
- infection symptoms
- gastrointestinal symptoms
- Individualized case management was shown to
- improve the health of frequent utilizers.
- improve the quality of care in the ED.
- reduce the frequency of ED visits.
- Which statement related to the costs of the EDCMP is accurate?
- It averaged $12,000 per individual.
- Private insurance companies benefitted most with the highest overall cost savings.
- It will likely reduce overall costs of operating the ED.
- This study showed that ED staff frustration and burnout can be lessened by
- the option to refer patients to the EDCMP.
- patients who are content with their care.
- implementing morale-building activities.
- Regarding Medicaid-insured participants, the “ER is for Emergencies” initiative
- was determined not to be a confounding factor in this study.
- had less impact on reducing ED visits than the EDCMP.
- was developed by case management staff at this hospital to educate patients.
- Which recommendation would make data analysis easier for the researchers?
- expanding EHR program capabilities to allow for database queries
- coding each patient's data into a statistical program
- permitting researchers direct access to the EHR at each institution
- The outcomes evaluation plan for this program was
- devised as part of the initial research plan.
- ongoing during implementation of the program.
- conducted by an external agency.
- EMS personnel estimated that what percentage of frequent utilizers had chemical dependency or mental health problems?