Care in the gap: Utilizing the ED to improve your hospital's clinical and financial outcomes

The hospital emergency department (ED) is at a crossroads in modern medicine. It is the front line of care for many patients, yet the ED is costly to operate and is not always fully equipped to help patients during the critical post-discharge period. Still, in the face of these challenges, some hospitals are reducing costs while simultaneously improving outcomes after an emergency care visit.

At Becker's Hospital Review's 13th Annual Meeting, in an executive roundtable sponsored by SCP Health, Randy Pilgrim, MD, enterprise chief medical officer for SCP Health, shared insights into how SCP Health helps healthcare organizations' EDs use innovative approaches to close gaps in care while delivering better financial, patient satisfaction and clinical outcomes. Top of Form

SCP Health has more than 50 years of experiences as a provider of clinical care in hospitals and health systems, which includes providing emergency and hospital medicine along with creating solutions that connect the patient care journey. In recent years SCP Health has been focused on modernizing its approach by using technology such as texting and telehealth to more effectively manage patient populations.

Three key takeaways were:

  1. The ED is a critical access point for hospitals. "You have to have it," Dr. Pilgrim said. EDs deliver a tremendous volume of care, often for very sick patients with chronic diseases, are an entry point to the hospital — generating approximately 50 percent to 70 percent of admissions — and are a frequent interface with the rest of the healthcare system. But operating an ED means bearing high fixed costs and dealing with significant risks, such as declining reimbursement and high levels of uncompensated and undercompensated care.
  2. ED visits are all too often followed by major gaps in care. The care gap begins when patients leave the ED. On their own, patients must often figure out their discharge instructions, arrange for any follow-up care, adapt to new medication routines and get better.

Unfortunately, often this doesn't turn out well. SCP Health data show that of patients discharged from the ED with moderately complex conditions, many will experience rehospitalization shortly after discharge. In particular, 50 percent of rehospitalizations occur within 7.5 days of discharge and 50 percent of repeat ED visits happen within 10 days.

  1. Healthcare organizations can address the gap two ways: clinical and non-clinical interventions. Clinical interventions support ongoing care and lower-intensity clinical interactions while bridging longitudinal care needs. But non-clinical interventions like basic patient navigation are often ignored or aren't executed in an optimal fashion. The right solution can help with many basics more effectively: connecting with the primary care provider, getting timely appointments, helping with discharge instructions and encouraging patients to fill and take new meds.

"All the data we have show if you just do those four things, you make a massive impact in terms of return visits," Dr. Pilgrim said. SCP Health data also show that when their call center contacts the patient on behalf of their ED physician, they get a 90 percent response rate from patients, compared with significantly lower numbers when payers follow up. "It's something so simple — I didn't think it would be that good," he said.

This care gap represents a major opportunity for healthcare organizations to transform their EDs into a strategic asset. By addressing the post-discharge care gap through the ED, hospitals and health systems can drive better care quality across the continuum, increase patient satisfaction and reap financial benefits of risk-based models.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars