Quality Field Notes: Case Studies for Reducing Inappropriate Emergency Department Use

This set of case studies examines successful initiatives in three Aligning Forces for Quality communities that aim to reduce inappropriate emergency department use.

In Albuquerque, the New Mexico Coalition for Healthcare Quality (NMC4HQ) launched a campaign to educate patients about whether medical situations warrant a visit to an emergency department (ED) or an outpatient care facility. After the campaign, four local hospitals shared data and reported that non-emergency visits had dropped between 6 and 16 percent depending on the hospital, compared with the previous year—an average of 1,573 fewer non-emergency ED visits per hospital.

In Milwaukee, the Wisconsin Collaborative for Healthcare Quality (WCHQ) is leading an ED Care Coordination Initiative to connect high-risk patients in Milwaukee County with medical homes so they can receive timely, well-coordinated primary care. In 2012, the initiative scheduled more than 7,000 follow-up appointments for targeted patients. Forty-seven percent of patients kept these appointments, and roughly 46 percent returned for a second appointment within six months.

In Detroit, the Greater Detroit Area Health Council (GDAHC) leads a program in primary care practices to decrease ED use for primary care-treatable conditions. The initiative engages practices to reduce their patients’ avoidable ED use by implementing straightforward, “low-tech” interventions. Before the initiative, participating practices had increasing rates of ED use for PCP-treatable conditions, which peaked at 49 visits per 1,000 practice-affiliated Blue Care Network members in 2009. After the initiative began in 2010, rates decreased to 7.3 visits per 1,000.



Resources on Reducing Avoidable ED Use


Encouraging Appropriate Use of the Emergency Department

This issue brief presents key lessons about what’s working in Aligning Forces for Quality communities to reduce emergency department overuse.

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The emergency room waiting area.

Resource Guide

This resource guide provides links and additional information for providers and organziations interested in learning more about reducing avoidable ED use.

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Doctors go over a patient's charts in the emergency room.

Case Studies From Aligning Forces

These three case studies from Albuquerque, Detroit, and Wisconsin highlight how three Aligning Forces communities tackled inappropriate ED use.

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An Interview With Jenifer Hughes

We sat down with Jenifer Hughes, executive vice president of Administrative Network, Inc., to find out how Detroit is implementing simple, low-tech interventions across a group of practices to help patients understand their options when they encounter a medical issue after-hours.

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Reducing Avoidable ED Visits

Find out how low-tech, common sense solutions achieved significant reduction in unnecessary ED visits in Detroit.

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