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Emergency Department and Urgent Care Usage

Emergency Department and Urgent Care Usage. South Carolina AAP Meeting AnMed Children’s Health Center Anderson, South Carolina July 2011. Objectives. Demonstrate use of PDSA cycles to reduce usage of ED, Minor Care, and Kids Care by Children’s Health Center patients.

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Emergency Department and Urgent Care Usage

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  1. Emergency Department and Urgent Care Usage South Carolina AAP Meeting AnMed Children’s Health Center Anderson, South Carolina July 2011

  2. Objectives • Demonstrate use of PDSA cycles to reduce usage of ED, Minor Care, and Kids Care by Children’s Health Center patients

  3. AnMed Children’s Health Center • 5.5 FTE pediatrician practice • Hospital owned • > 90% Medicaid • Pediatric teaching center for Family Medicine Residency Program • ED, Minor Care, and Kids Care • Hospital owned • Kids Care opened Oct 1, 2010 • CHC doctors help staff Kids Care

  4. CHC Office • Hours 8 am – 5 pm • First appt at 8:15 am • Closed Noon-1:15pm • Phones on 8:30 am-Noon and 1:30PM-5PM • Sick visit/Same day openings available every day

  5. Kids Care • Hours: 10am-9pm Mon-Fri • Noon-7pm Sat and Sun • CHC pediatricians working multiple shifts • Ranging from 7-30/month

  6. PDSA #1 • Plan: Obtain number of our patients seen in ED, Minor Care, and Kids Care by month Jan-May • Do: Daily log of CHC patients seen

  7. PDSA #1 • Study: Large numbers of CHC patients are visiting other facilities • ACTION: Determine numbers of CHC patients seen by time of day • Before 8:30 am • Between 8:30 am-5:00 pm • After 5:00 pm

  8. PDSA #2 • Plan: Determine numbers of CHC patients seen by time of day • Before 8:30 am • Between 8:30 am-5:00 pm • After 5:00 pm • Do: Breakdown patient logs by time of arrival

  9. PDSA #2 • ACTION: • 1) How many doctors working in clinic each day? • 2) Overbooking quadrupled • 4 overbooks / doctor / half day clinic session • 3) Verbally encourage patients to call office first

  10. PDSA #3 • Plan: Determine # of docs available per clinic/per day • Do: Obtain from clinic schedule

  11. PDSA #3 • Study: No correlation between number of doctors available and number of patients seen elsewhere during office hours • ACTION: • 1) Continue overbooking • 2) Plan to have phones operational all day • Started April 1, 2011 • 3) Plan to stagger lunches and have office hours Monday and Fridays through lunch • Started May 1, 2011

  12. PDSA #4 • Plan: Does ED, Minor Care, Kids Care patient volume impact office visit numbers Jan-present? • Do: Look at total office visits in 2011 compared to 2010

  13. PDSA #4 • Study: Office visits are down in some months and visits elsewhere are up • ACTION: Brochure designed to hand out to patients at Kids Care, ED, Minor Care to emphasize importance of medical home

  14. PDSA #5 • Plan: Combine patient visit numbers from Kids Care and CHC office • Do: Compare patient visit numbers from Jan – May 2011 to same time period in 2010

  15. PDSA #5 • Study: Productivity numbers that include patient visit numbers from our work in Kids Care are better • Action: • 1)Continue monitoring • 2)Compare numbers after brochure implementation

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