Reducing Patient Emergency Department Visits at A Local Community Health Center

Abstract

Repeated inappropriate and non-urgent emergency department (ED) visits can lead patients to diminishing quality of life. The lack of initiative for a health center to implement strategies encouraging patients to seek follow-up care for their symptoms with their patient care providers (PCPs), increases the risk for fragmented care. The aim of this Doctoral in Nursing Practice (DNP) quality improvement (QI) project was to implement evidence-based (EB) practice interventions with the multidisciplinary staff algorithm for repeated ED visits and the wallet-sized patient information flyers, in reducing frequent ED visits at Kalihi- Pālama Health Center (KPHC). The Stetler Model framework was utilized for this project. The interventions were implemented from November 2018 to January 2019 at KPHC. Four care coordinators (CCs) participated in an education program discussing the approach for frequent utilizers of the Queens Medical Center (QMC) ED with ≥ three visits in the past six months, who were coming in for follow-up care to KPHC post-discharge from the ED. Three of four CCs were involved in the implementation period, passing out wallet-sized information cards and simultaneously utilizing the KPHC education program algorithm as a guide, to manage patient care. Two of the 10 total patients assigned to the three CCs were able to be reached and received the wallet information cards. They followed-up for self- care management of their symptoms throughout the implementation period at KPHC. Results revealed that a 100% of the two individuals involved in the project stopped going to the ED in the two -month period and yielded a 20% decrease in repeat ED visits.