Access Health Connecting Sinai Emergency Department Patients to - - PowerPoint PPT Presentation

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Access Health Connecting Sinai Emergency Department Patients to - - PowerPoint PPT Presentation

Apr 24, 2023 358 likes •477 views

Access Health Connecting Sinai Emergency Department Patients to Health-Promoting Resources Susan Markley, MS, MBA David Baker, DrPH, MBA Vice President Business Director, Ambulatory and Physician Practice Development Outcomes HealthCare

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Facebook: /HealthCareAccessMaryland Twitter: @hcamaryland Website: www.hcamaryland.org

Access Health

Connecting Sinai Emergency Department Patients to Health-Promoting Resources

David Baker, DrPH, MBA

Director, Ambulatory and Physician Practice Outcomes LifeBridge Health Susan Markley, MS, MBA Vice President Business Development HealthCare Access Maryland

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Identified Problem

  • Frequent Emergency Department

users

  • Defined as a patient with 4+ ED

visits in prior 4 months

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Geocoding Frequent Users of Sinai ED

Addresses of October 2013 ED Visitors with 4+ Visits in Prior 3-4 Months

Sinai ED

Key Sinai ED freq user

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Hospital Expectations

1. Reduce avoidable ED usage:

– Poorly controlled diabetes – Asthma – Heart failure – COPD – Sickle cell disease – SA & BH issues

2. Improve access to care providers for preventive care and chronic condition management 3. Increase proportion of persons with health insurance

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Access Health Program

Initiative…

  • Helps high utilizers access timely, appropriate care
  • Facilitates coordination w/ health-promoting resources
  • Minimizes avoidable ED/hospital utilization
  • Includes weekend and evening staffing
  • Continues for next 2.5 years

Coordinators assist high-risk ED patients…

  • Obtain same-day/next-day appointments
  • Connect to social support services, access insurance
  • Through home visits, following them for up to 3 months

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Metrics

  • Increase access points to safety net primary

care providers for preventive and chronic conditions

  • Reduce ED re-visit rates
  • Increase proportion of individuals with health

insurance

  • Increase number of women that access and

engage in prenatal care

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Enrollment Data Preliminary ED Utilization Data 11/1/14

Measureable Outcomes

  • 125 ED frequent user

clients enrolled

  • 49 home visits
  • 32 clients have been signed

up for health insurance

  • 52 primary or specialty care

appointments made

  • Decrease in missed

appointments for program enrollees from 28.6% in June to 16.7% in August

  • 81% of clients enrolled in

August and September have not had a repeat Sinai ED visit.

  • For August enrollees: 80%

reduction in visits, compared to their prior 4- month visit history.

  • For September enrollees:

86% reduction in visits, compared to their prior 4- month visit history

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Challenges 5 Months In….

  • Staffing
  • Increasing voluntary enrollment rate
  • Behavioral health issues
  • Balancing staff time
  • Sick person engagement
  • IT
  • Timely PCP appointments
  • Unmet / unrealistic goals

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Elements of Success

  • Close partnership
  • Use of data
  • Enrollment & care planning
  • CRISP
  • Hospital champions
  • Training / education
  • External partners
  • Longer term client follow up

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  • Focused strategy for top users
  • Cerner-based referral capability for

ED physicians

  • CRISP ENS analysis
  • Enhanced communication with

Parkwest PCPs

  • Analysis of pre/post ED & hospital

utilization for enrolled patients

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Facebook: /HealthCareAccessMaryland Twitter: @hcamaryland Website: www.hcamaryland.org

Thank you! Questions?