Non-Urgent Emergency Room Usage: Proven Ways to Redirect Care to Appropriate Settings, an October 18, 2006 audio conference on CD-ROM, highlight strategies by two healthcare organizations on reducing inappropriate emergency room (ER) use.
Click here to listen to some pre-conference comments from our audio conference presenter.
A recent study by the Institute of Medicine found that ER visits increased from 90.3 million in 1993 to 113.9 million in 2003. Numerous studies have found that a number of these visits are for non-urgent medical care that could be treated in primary care settings. Health plans and disease management companies are seeking to reduce the use of the ER for non-urgent care. Directing non-urgent care to primary care settings can reduce costs, improve the coordination of care for patients and preserve the ER for those who truly need emergency care.
During this 90-minute audio conference, Roberta Burgess, clinical case manager, Community Care Plan of Eastern Carolina and Jerry Kiplinger, vice president and executive director of the Georgia Enhanced Care program for APS Healthcare, discuss how to target unnecessary and inappropriate use of the ER.
You will get details on how to:
- Create patient education programs that truly educate on when ER use is appropriate;
- Use nurse lines to potentially redirect unnecessary ER use;
- Determine how different populations -- Medicare, Medicaid and commercial -- use the ER and what that means for reducing inappropriate use;
- Develop a health plan design that discourages unnecessary ER usage; and
- Identify members who might inappropriately use the ER and intervene before they do so.
Here's what participants said about the live program:
"Good review of ways to decrease inappropriate ER use...The techniques used to reduce non-urgent ER usage are effective, efficient, and beneficial to all," said Anna Churgai, RN, CCM. Clinical and Operational Training Coordination with Sharp Community Medical Group.
"Good to hear the information and be challenged to think about ways to reduce ER utilization based on discussion," said Marcia Bartlett, a senior clinical quality management specialist with Priority Health.
"Very helpful in providing ideas for discharge planning instructions for members," said an executive with a California healthcare system.
You can "attend" this program right in your office and enjoy significant savings – no travel time or hassle; no hotel expenses. It's so convenient! Invite your staff members to listen in.
WHO WILL BENEFIT FROM THIS AUDIO CONFERENCE?
CEOs, medical directors, disease management directors, managers and coordinators, health plan executives, care management nurses, business development and strategic planning directors.
ABOUT OUR PANELISTS:
Roberta S. Burgess, BSN, RN
Roberta Burgess is a nurse case manager for the Community Care Plan of Eastern Carolina (CCPEC). CCPEC is a part of the Carolina Access Medicaid Program called Community Care of North Carolina (CCNC) in the eastern part of the state.
The CCP of Eastern Carolina is a partnership for better health. The Community Care Plan draws together medical and social providers from around the region to provide clients with the best healthcare in eastern North Carolina. Partners include the local hospital, the primary care providers and specialist, the department of Social Services, the health department and local case managers.
Prior to this position, Burgess worked as a nurse case manager in Pitt County, N.C., with HealthAssist, a medical access program for the uninsured. HealthAssist and CCPEC were developed to assist in accessing healthcare in the most appropriate and cost-effective way. Carolina Access Medicaid reinforces standardized care of patients with diabetes, hypertension, congestive heart failure, asthma and frequent emergency room visits. The overall goal is redirecting these populations back to their primary care providers in the community, using case management services for support. Burgess had also previously worked as a nurse case manager for Martin-Tyrell-Washington Health Department in partnership with Washington County School System and ECU School Of Nursing. Burgess had also served as assistant director of nursing at Britthaven Nursing Home and was a surgical intermediate unit staff nurse at Pitt County Memorial Hospital, where she educated individuals and families to reduce readmissions and foster better health.
Burgess holds a Bachelor of Science in Nursing and a Bachelor of Science in Child Development and Family Relations with a minor in Social Work from East Carolina University in Greenville, N.C.
Gerald Kiplinger
Gerald Kiplinger is the vice president and executive director of the Georgia Enhanced Care program for APS Healthcare. He previously served as executive director for the Wyoming Medicaid Program for APS Healthcare.
The Wyoming program was selected by the Disease Management Association of America for the 2005 "Best Government Disease Management Program" in the nation. In addition, the Wyoming program was also selected by Health Industries Research Company and Disease Management Purchasing Consortium (DMPC) as "One of the seven most effective Medicaid Disease Management Programs," and was the first public health program to receive the DMPC "ROI Certification."
Prior to APS Healthcare, Kiplinger worked as a director for a disease management company and was assigned to a healthcare system to implement disease management programs. While there he implemented standing orders, policies and protocols used to standardize the care of patients with diabetes mellitus and cardiovascular disease. Kiplinger was also the director for minority health initiatives and community outreach program.
Kiplinger is a retired Naval Medical Service Corps Officer where he worked as a healthcare administrator and held various positions that supported the Department of Defense healthcare system, active duty military, and their family members. He was selected in 1994 by the Naval Surgeon General and the American Hospital Association to be the American Hospital Association's Senior Fellow from 1995 to 1996. Kiplinger was responsible for the implementation of the TRICARE program for Illinois and Wisconsin that represented over 100,000 covered lives. During this time he implemented new policies and procedures designed to improve delivery of care, access to care and outcomes through prevention program.
He holds a Bachelor of Science in Business from the University of Southern Colorado and a Master's in Business Administration from Troy State University in Alabama.
