Program Aims to Reduce Frequent ER Visits
Wednesday, May 22, 2013
The University of Illinois Hospital & Health Sciences System is taking steps to reduce frequent emergency room visits and readmissions to the hospital.
UI Health launched a three-year, $1.5 million project called Emergency Patient Interdisciplinary Care Coordination for Frequent ER Visitors, or EPIC, at a kick-off event in April.
"We are tremendously excited about this initiative, because it represents our health system's very real commitment to delivering personalized health to underserved populations," says Dr. Joe G.N. "Skip" Garcia, vice president of health affairs for UI Health.
With this project, Garcia said, UI Health is investing in the city and the state's most vulnerable patients - those who frequent emergency rooms - and will use this as an opportunity to "learn how we can better manage the care and improve the health of our patients across our entire system."
Terry Vanden Hoek, professor and head of emergency medicine at UI Health, says the emergency room is "a window into the health care system that can show us where the system is not working" and help to reduce health care costs.
Vanden Hoek says patients who are often in the ER or readmitted to the hospital have complicated medical needs. They may have congestive heart failure, asthma, sickle cell disease, diabetes or hypertension - chronic diseases that are not being managed adequately, he said.
In the EPIC program, staff will identify frequent emergency room and readmitted patients during the admission process and connect them to services to help them manage their own complex health issues. Patients will be identified using electronic medical records and a health information exchange system between UI Health and the Medical Home Network, a consortium of Chicago hospitals, Vanden Hoek said.
The program will be explained to the patient, and an EPIC team member will be called in to consult, just as a cardiologist might be called in for a patient with a heart condition, Vanden Hoek said. The team will then do a complete screening evaluation for enrollment in a transitional care program.
The transitional care team may include community health workers, a social worker trained in patient motivation, and a nurse care manager. During the 30-, 60- or 90-day transitional care program, patients will learn how to manage their health, what caregivers they need to see and when, and what other resources they can depend on.
The resources of all of UIC's health science colleges are available to the EPIC team, says Dr. Kathryn Christiansen, visiting director of UIC nursing and health care clinical practice. For example, she said, the UIC College of Pharmacy knows best how to ensure that patients take their medications correctly, while the UIC College of Nursing can offer expertise in care management.
EPIC will address both medical complexity and psychosocial complications, says Stephen Brown, associate director of clinical practice and business development, who is a former ER social worker.
"The best predictor of whether a patient with a chronic pain condition is able to manage their disease or is frequently readmitted to the hospital is not a medical test or procedure, but a psychological measure called self-efficacy - a sense of confidence in one's ability to cope," Brown said.
Christiansen says EPIC is not a substitute for a primary-care physician, family practitioner or clinic, but it provides patients with the knowledge and resources they need to manage their condition.
"Ultimately, that will lead to a successful hand-off of the patient to their primary-care provider," she said.
The University of Illinois Hospital & Health Sciences System provides comprehensive care, education and research to the people of Illinois and beyond. The UI Health System includes a 462-bed tertiary hospital; the University of Illinois at Chicago colleges of Medicine, Dentistry, Pharmacy, Nursing, and Applied Health Sciences, the UIC School of Public Health and UIC's Jane Addams College of Social Work; 21 outpatient clinics located in Chicago; 12 federally qualified health centers throughout the city; and College of Medicine and affiliated health care facilities in Urbana, Peoria and Rockford.
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