A partnership with Consistent Care provides a solution to the epidemic of overuse of the Emergency Department.
Our staff are skilled at working with patients to identify ways to reduce unnecessary use of the emergency department. We employ registered nurses and community health workers (“Client Advocates)” who have experience in providing patient-centered case management. Our staff help patients negotiate the healthcare system and improve access to primary care, coordinate specialty care, provide access to available community resources, and educate patients about self-management skills.
Case management services like those offered by Consistent Care Services are covered by HIPAA under the permitted uses and disclosures of protected health information for treatment (read the U.S. Department of Health and Human Services Fact Sheet here).
Upon presenting to the ED, frequent users are identified by the existing health information exchange and referred by ED staff or health plans to Consistent Care.
Enrolling in Consistent Care
Consistent Care RN case managers evaluate patient medical history to determine eligibility and identify patient drivers and social determinants of health.
Patient Contact and Education
Case management team members connect with patients to address barriers to access, educate about alternative services, and to ultimately reduce inappropriate use of the ED.
Local Community Engagement
Patients are connected to social resources during monthly meetings that foster collaboration between agencies and engage the community in case management.
Care Plan Creation
ED-specific care plan guidelines detailing patient drivers and their prescribing and care recommendations are integrated into the existing ED health information exchange.
Follow Up by Following Through
Unlike other case management services, Consistent Care client advocates live and work in the same communities as their patients and are able to act as “boots on the ground” to follow up with patients through outreach visits and personalized case management.
Future ED Visits
Consistent Care ED-specific care plan is received immediately in the ED if patient returns.
Care Plan Updated
Care plans are regularly updated to reflect changes in recommendations.
For most of our clients, we establish a goal of 50% reduction of inappropriate ED use within 90 days, secondary to the resolution or management of their known drivers.