Revolutionizing ED Transitions: Cutting Low-Acuity Visits through Resource Optimization and Addressing Social Determinants of Health

Explore the development and implementation of an innovative emergency department (ED) transition program designed to reduce frequent ED visits among patients with low-acuity concerns. The program targets individuals who have visited the ED three or more times in the past year for issues classified as low acuity based on CPT billing codes. Its primary objective is to identify barriers to care, such as access, education, resources, and support, and provide solutions that facilitate care management by the patient’s primary care provider (PCP) or in an urgent care setting. Early data has shown a decrease in low-acuity ED utilization and a increase connectivity to their primary care practitioner.
The program leverages various technologies, including routine telephonic outreach and scheduled educational communications via text, mail, and EHR options. A care coordinator works in collaboration with managed care organizations (MCOs) to inform patients about available resources and educational platforms provided by their insurance. Patients are contacted approximately one week after an ED visit to introduce the program and assess barriers to care. Based on individual needs, the care coordinator provides tailored resources and support.
Each enrolled patient receives a personalized call plan by mail, detailing information such as PCP hours, nearest urgent care facilities, poison control contacts, and various support options, including a nurse advice line. Monthly educational content is delivered via text, focusing on common childhood illnesses and their management, with topics selected based on seasonal trends.
Additionally, if a patient returns to the ED for further low-acuity visits while enrolled in the program, a notification is sent to the care coordinator, enabling timely re-education and support for the family.
Learning objectives: Explain the importance of guiding families in selecting appropriate care levels for common or low-acuity childhood illnesses. Demonstrate how to educate families on choosing the right level of care for common childhood illnesses. Analyze the factors contributing to frequent ED visits for low-acuity concerns. Evaluate the effectiveness of different educational strategies in guiding families to appropriate care levels.
Outcomes for the ED transition program: Reduced ED utilization: Decrease the number of low-acuity ED visits among enrolled patients within a specified timeframe (e.g., 6 months) compared to a baseline. Improved access to primary care: Increase the number of patients accessing their primary care provider for non-emergency health concerns, leading to timely and appropriate care. Enhanced patient education: Increase patient and caregiver knowledge regarding common childhood illnesses and appropriate care settings. Increased resource utilization: Promote the use of alternative resources, such as urgent care facilities and telehealth services, resulting in a shift from ED reliance. Barrier identification and mitigation: Successfully identify and address specific barriers to care through follow-up assessments, leading to tailored solutions for individual families. Referral to appropriate care: Increase the number of referrals made to community resources and support services that address identified barriers, such as transportation or financial assistance. Monitoring and re-education: Implement an effective monitoring system that triggers timely follow-up for patients returning to the ED, ensuring that re-education and support are provided as needed.