Case Management

Pilot program identifies the cause of frequent ED visits; patients overcome barriers

Case Management Monthly, December 1, 2009

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The UHCC modeled its program for handling frequent ED visitors after one established at Swedish Medical Center in Englewood, CO, says Pamela O’Donnell, ED case manager at UHCC. “I read an article about ED overcrowding and ‘frequent fliers’ by someone at Swedish Medical Center. We used their forms and adapted them to our situation.”

To find the sample patient population for the pilot program, the hospital’s information technology department looked at all the ED admissions from the previous six months and compiled a list of the 50 most frequent ED visitors.

“Ideally, we would be able to address each of those top 50 visitors,” O’Donnell says, but instead the committee decided to first deal with a small group and evaluate the program. Based on those results, the committee would decide whether they could take on a larger group of patients.

The committee identified patients with primary care physicians (PCP) in the same hospital system. It eliminated patients with sickle cell anemia, which requires frequent ED visits, and mental health problems, which limit a patient’s ability to comply with healthcare regimes.

After applying those filters, the committee had six patients who met the hospital’s desired criteria:
• More than 10 visits to ED in the past year
• Have PCP at UHCC (previously or currently)
• Have no diagnosed psychiatric issues at this time

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