As we covered last year, super users or super utilizers of emergency care are a big deal for emergency facilities. For hospitals, these visits can be repetitive and costly. For patients, thethenselves often don't actually get the care or support they need via their visit to the emergency room. These patients are often struggling with housing, food insecurity, transportation issues, or other exacerbating problems.
The Affordable Care Act and Medicaid are certainly in flux and in question these days. But regardless, super utilizers will continue to be a challenge for hospitals. So what can a hospital do, while also not leaving any patient literally (or figuratively) out in the cold?
As we shared last year, there are three important concepts for fixing the super user problem in ERs:
- Stop people from falling between the cracks.
- Create a broad treatment team.
- Resolve the root of the problem, the first time.
So we were thrilled when we heard about a new program at Kaiser Permanente that is solving this pressing problem in exactly these ways.
The Portland Business Journal reports that Kaiser's pilot program stations navigators throughout the ER to support patients in accessing services or resources they may need. That way, if a patient comes to the ER for a twisted ankle, but really needs a warm meal, he's put in contact with the appropriate people. If it's housing difficulties that are the root cause of the ER visit, well then that can be addressed.
The results are powerful and should be given careful attention. Among 254 patients being closely managed, re-admissions dropped by 55 percent, hospital admissions by 38 percent and, the number of days in the hospital, by 30 percent.
Dr. Briar Ertz-Berger led the program and calls it a way to address "upstream" challenges these patients have. She explains that navigators work in a multidisciplinary team -- nurses, doctors, social workers, etc. -- to make connections among the services and solutions that the patient needs to make the care more effective.
We want to applaud Dr. Ertz-Berger for creating this courageous and innovative program. And it certainly demands a key question from all of us: What inexpensive thing -- paid for now -- will help us avoid the more expensive, bad thing, later? So often, we are penny wise and pound foolish -- avoiding immediate expenses but paying for it later.
In the same way that poverty can create negative cycles for patients, excessive cost-cutting in hospitals can get us bad results, and ultimately increase costs.
Multidisciplinary programs can benefit from telemedicine tools. Try iClickCare for free, on your team: