The Agency for Healthcare Research and Quality has proposed a pilot test of an emergency department discharge tool.
The goal of the tool is to reduce unnecessary ED visits, decrease ED costs and improve ED patient care. The tool, which will be tested in three EDs at The Johns Hopkins Hospital in Baltimore, involves several components:
• An ED staff member will screen ED patients' medical records for frequent ED use, defined as one or more visits within the past 72 hours, two or more visits within the last three months or three or more visits within the past year.
• The ED discharge tool will collect data from frequent ED users to identify risk factors for suboptimal ED discharges and revisits, including lack of insurance, lack of a primary care physician, psychiatric disease, substance use, difficulty caring for oneself and difficulty understanding ED discharge instructions.
• One month after the ED visit, a project research assistant will call patients to assess their memory of discharge instructions.
• Three months after the ED visit, a research assistant will call uninsured patients to determine if they were able to get insurance.
AHRQ will conduct focus groups with the ED staff who implement the discharge tool, participating patients and post-ED care providers to identify the tool's effectiveness. AHRQ will also measure the frequency of ED revisits and costs.
Comments on the proposed project are due Oct. 28.
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