title: Nurse care managers, new programming aim to provide more outpatient care alternatives for ED patients on the margin.
abstract: The University of Michigan Health System is developing clinical programming and deploying specially trained care managers as part of an initiative aimed at eliminating unnecessary hospital admissions. The ED-based care managers will assess every patient who comes to the ED, but focus their time on developing outpatient care alternatives for patients on the margin when physicians are making admission vs. discharge decisions. The initial focus of the program will be on patients placed in observation, but developers plan to expand the program to include slightly more complicated patients as physicians become more comfortable with outpatient treatment alternatives. While the care managers are already being deployed in the ED, program developers are working with community partners to create a toolbox of outpatient care alternatives such as a visiting nurse program that can be activated by ED referral. Illustrating the potential for such a program, one new study showed that in a sampling of Medicare patients who underwent six common surgical procedures, nearly one in five of these patients had an ED visit within one month of their hospital stay, and more than half of these patients ended up back in the hospital.
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D016529:Emergency Nursing; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D009718:Nurse Administrators; D024802:Nurse's Role; D010343:Patient Admission / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data