Journal of Nursing and Health Studies

Integrative Care Management: Optimizing High Quality and Value-Based Care Delivery in the Emergency Department

EuroSciCon Event on Nursing Diagnosis & Midwifery
September 10-11,2018 Prague,Czech Republic

Lisa A Hall

Advocate Good Shepherd Hospital, USA

ScientificTracks Abstracts: J Nurs Health Stud

DOI: 10.21767/2574-2825-C4-011

Abstract

According to research, an estimated five percent of the population uses approximately 50 percent of the healthcare resources in the United States. They present to the emergency department (ED) point of entry with comorbid medical, behavioral, and psychosocial concerns. The ED individualized care plan (ICP) addresses the unique needs of this medically complex, high-risk, and often vulnerable patient population. The ICP improves the quality of healthcare delivery and hospital reimbursement, while mitigating the costs associated with ED recidivism, and unnecessary hospital readmissions. In the past, this population received very fragmented medical services and episodic care in the ED. The ICP is essential to combat the “silo” approach to healthcare, which often results in higher healthcare costs and creates duplication of services. The ICP was subsequently recognized as a best practice and the program successfully implemented across 13 hospital sites in the Advocate Health System. The ICP aligns with the Integrated and Population Health Care models, acknowledging the link between medical and behavioral health concerns. The ED case manager-social work dyad serves as the operational driver of the program. The ICPs are fluid and expected to evolve over time with the specific needs of the patient. The current program at Advocate Good Shepherd Hospital consists of over 900 individualized, adult and pediatric plans of care. The organizational cost savings have exceeded over 6 million dollars, with a reduction of ED recidivism of 60 percent, and an overall reduction of unnecessary admissions of 50 percent. The ICP serves as a microcosm of the larger Population Health Care Models, demonstrating an innovative approach to delivering high quality and patient-centric heath care, in a cost-effective manner. This program can easily be adapted in any healthcare setting, and presents an exciting way forward in successfully shifting our current healthcare paradigm.

Biography

Lisa A Hall is responsible for the coordination and implementation of strategies to ensure quality, cost effective, and patient centered health care delivery. Equip patients and families with the necessary tools and resources to make informed healthcare decisions, and provide assistance to effectively navigate through the healthcare system. Emphasis on enhanced clinical outcomes by implementation of safe patient transitions of care (TOC) from the Emergency Department (ED) to a more appropriate healthcare setting.

E-mail: lisahall22@comcast.net