title: Decreasing avoidable hospital admissions with the implementation of an emergency department case management program.
abstract: With the passage of the Affordable Care Act, increased emphasis has been placed on optimizing quality and reducing expenditures. The use of an emergency department case manager (EDCM) is reemerging as an important initiative in the quest to provide high-quality care and decrease unnecessary hospital admissions. A pilot study of the use of EDCMs was conducted in one of the authors' EDs during a 6-month trial period. By using evidence-based criteria, the EDCM helped in real time to verify admission criteria, assisted with inpatient versus outpatient designation, found community alternatives to hospital admission, and initiated discharge planning for patients who required admission and were at high risk for readmission. EDCMs also worked with pharmacists to assist with medication management for patients who required assistance with obtaining prescriptions. Because of the pilot study's success, the authors' health care system will be implementing EDCMs throughout the organization.
authors.affiliation: 1Scripps Health, San Diego, CA.
authors.forename: Ghazala Q
authors.initials: GQ
authors.lastname: Sharieff
authors.forename: Matt
authors.initials: M
authors.lastname: Cantonis
authors.forename: Michelle
authors.initials: M
authors.lastname: Tressler
authors.forename: Mary
authors.initials: M
authors.lastname: Whitehead
authors.forename: Jamie
authors.initials: J
authors.lastname: Russe
authors.forename: Eric
authors.initials: E
authors.lastname: Lovell
mesh_terms: D019090:Case Management / Q000458:organization & administration* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine / Q000379:methods; D006333:Heart Failure / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D010865:Pilot Projects
keywords: ED case manager; alternatives to admissions; avoidable hospital admissions; verification assistance