{"id":135,"date":"2016-05-03T14:54:13","date_gmt":"2016-05-03T18:54:13","guid":{"rendered":"http:\/\/blog.camberry.ca\/?page_id=135"},"modified":"2016-05-25T12:12:04","modified_gmt":"2016-05-25T16:12:04","slug":"ed-visits-bme","status":"publish","type":"page","link":"https:\/\/blog.camberry.ca\/?page_id=135","title":{"rendered":"ED Visits BME"},"content":{"rendered":"<p><strong><u>Emergency Department Visits for Conditions Best Managed Elsewhere<br \/>\n<\/u><\/strong>Percentage of patients or clients who visited the emergency department (ED) for conditions ?best managed elsewhere? <strong><br \/>\n<\/strong><em>Direction of improvement: decrease<\/em><\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter size-full wp-image-132\" src=\"http:\/\/blog.camberry.ca\/wp-content\/uploads\/2016\/05\/EDBME.png\" alt=\"EDBME\" width=\"965\" height=\"575\" srcset=\"https:\/\/blog.camberry.ca\/wp-content\/uploads\/2016\/05\/EDBME.png 965w, https:\/\/blog.camberry.ca\/wp-content\/uploads\/2016\/05\/EDBME-300x179.png 300w, https:\/\/blog.camberry.ca\/wp-content\/uploads\/2016\/05\/EDBME-768x458.png 768w\" sizes=\"(max-width: 965px) 100vw, 965px\" \/><\/p>\n<p><strong>Summary\/Analysis<\/strong><\/p>\n<p>Common theme in change ideas is analysis of TNA and improvement to advanced access.<\/p>\n<p><u>Effectiveness:<\/u><\/p>\n<p><strong>Trent Hills<\/strong> ? their dual approach to improving access and ER diversion patient education worked in reducing the rate<\/p>\n<p><strong>Bancroft<\/strong> ? The TNA approach was implemented here but the data actually worsened where other FHT?s using same approach resulted in improvement.<\/p>\n<p><strong>Aurora ? Newmarket:<\/strong> tracking patients coming to the clinic with BME conditions proves if the other actions are working to divert patients form ED<\/p>\n<p><strong>Sunnybrook:<\/strong> targeting patient education ? ensuring patients know where to go when they need care<\/p>\n<p><strong>West Park:<\/strong> directly discussing BME conditions with the patients using the ED. Patient Education keeps this indicator low for this FHT.<\/p>\n<p><u>Recommendation: <\/u><\/p>\n<p>Implementation of both improved access to care and directing education at patients using the ER for CTAS 4 and 5 visits (pamphlet handed to patient in ER). The highest performing FHTs focus on patient education both in regards to access to clinics or their provider and about their specific conditions they may be needing immediate care for.<\/p>\n<p><u>Implementation (PDSA) Suggestions:<\/u><\/p>\n<p>Insert PCP change idea here?<\/p>\n<p>&nbsp;<\/p>\n<p><strong>DETAILS<\/strong><\/p>\n<p><u>Haliburton Highlands<\/u>??? <em>8.77 ?&gt; 7.96<\/em><\/p>\n<ul>\n<li>Development of after-hours clinic<br \/>\n<strong>-&gt;?clinic open Mon-Thurs 5pm to 8pm, Sat 9am ? 12pm<\/strong><\/p>\n<ul>\n<li>Existence of after-hours clinic should bring this performance measure more in-line with LHIN average<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><u>Kawartha North<\/u>???? <em>4.20 ?&gt; 3.67<\/em><\/p>\n<ul>\n<li>Ensure accurate data collection to ascertain current and future targets<br \/>\n<strong>-&gt;utilize QIDSS position and communication with area hospital<\/strong><\/p>\n<ul>\n<li><em>Process was initiated to obtain data from local hospitals<\/em><\/li>\n<li><em>Increase in performance may be due to better awareness of open access clinic and after hours clinic<\/em><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><u>Trent Hills<\/u>????? <em>4.17 ?&gt; 3.85<\/em><\/p>\n<ul>\n<li>Improve access to urgent apt.?s at clinic, see above indicator<\/li>\n<li>Reinforce relationship with local hospital, CMH to advise patients with conditions BME to book apt. with FHT<br \/>\n<strong>-&gt;?work with CMH ER dept. to continue diverting our patients with level 4 and 5 complaints back to the FHT<\/strong><\/p>\n<ul>\n<li><em>This is a two year goal, did not anticipate any change in this measurement<\/em><\/li>\n<li><em>Have begun discussion with CMH on all levels of collaboration, anticipate that there should be further improvements in this area<\/em><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><u>West Durham<\/u>??????? <em>0.92 ?&gt; 0.74<\/em><\/p>\n<ul>\n<li>Continue to educate patients about Urgent Care and Same Day availability for FHT providers<br \/>\n?<strong> health analytics branch data to serve as performance measure<\/strong><\/p>\n<ul>\n<li><em>Continue to make patients aware of our urgent care and same day availability<\/em><\/li>\n<li><em>Using promotion (posters, waiting room tv ads) as well as out admin staff clearly communicating to patients via telephone of the availability of afternoon\/evening urgent care or same day apt. slots <\/em><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>?<\/strong><\/p>\n<p><u>Bancroft<\/u>????? <em>4.25 ?&gt; 4.45<\/em><\/p>\n<ul>\n<li>Implement advanced access principles for all physician and NP<\/li>\n<li>Understand demand and supply<\/li>\n<li>Increase supply of visits if necessary<\/li>\n<\/ul>\n<p><strong>-&gt;?Use EMR to track TNA, supply vs. demand, continuity, and cycle times<br \/>\n<\/strong><strong>-&gt;?use EMR to measure patients apt.?s annually<\/strong><\/p>\n<ul>\n<li>Implementation of Health Links System Navigator RN and Data Management Coordinator greatly improved outcomes for Health Link Patients<\/li>\n<li>Improve data integration with hospitals, earlier reporting of patients who visit ER<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Southlake FHT: <em>1.03 &#8212; ? <\/em><\/p>\n<p>Health For All FHT: <em>1.19 ? ?<\/em><\/p>\n<p>Aurora Newmarket FHT:? <em>0.75 ?&gt; 0.48<\/em><\/p>\n<ul>\n<li>Divert patients from ER by managing conditions BME in office<\/li>\n<li>Create patient awareness of clinic hours, after hours times ? post online and in office<\/li>\n<li>Internally track patients presenting to clinic with conditions under BME specifications ? using stamp in EMR<\/li>\n<\/ul>\n<p>North York FHT:? <em>0.56 &#8212; ? <\/em><\/p>\n<p>Sunnybrook Academic FHT: <em>0.51 ?&gt; 0.48<\/em><\/p>\n<ul>\n<li>Patient education (re. on call access) ? eNewsletter<\/li>\n<li>Streamlining patient pamphlet with sticker to stick up at home with info about on call access<\/li>\n<li>Have patients in ED tried contacting FHT first? ? M&amp;M team doing retrospective chart audits of specific topics to assess for trends<\/li>\n<\/ul>\n<p>West Park FHT: <em>0.82 ? 0.56<\/em><\/p>\n<ul>\n<li>Distribute educational materials ? pamphlets to more patient pop. than just those visiting ED?s on clinic info, what to use which setting for, hours, etc.<\/li>\n<li>Contact patients who use ED to make apt to come in and discuss conditions BME ? use ED discharge data or hospital EMR where possible<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Emergency Department Visits for Conditions Best Managed Elsewhere Percentage of patients or clients who visited the emergency department (ED) for conditions ?best managed elsewhere? Direction of improvement: decrease Summary\/Analysis Common theme in change ideas is analysis of TNA and improvement to advanced access. Effectiveness: Trent Hills ? their dual approach to improving access and ER [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":85,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-135","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages\/135","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=135"}],"version-history":[{"count":1,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages\/135\/revisions"}],"predecessor-version":[{"id":136,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages\/135\/revisions\/136"}],"up":[{"embeddable":true,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages\/85"}],"wp:attachment":[{"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=135"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}