Emergency Department Discharge Center Program Evaluation from a "Learning Organization" lens: Methods, Lessons Learned, and Future Directions

Bibi S Razack, Naya B Mahabir, Lisa Iyeke, Lindsay Jordan, Roland Hope, Emily Diaz, Lyze Barcia, Diana Fuzailov, Helena Willis, Marina Gizzi-Murphy, Frederick Davis, Adam Berman, Mark Richman, Nancy Kwon
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Abstract

Our ED's Discharge Center (EDDC) facilitates appointments and paper-based social determinants of health (SDoH) screening. No criteria guide EDDC utilization. The ED's provider-administrator-run, patient-satisfying follow-up call program contacts only ~25% of discharges. We describe Learning Organization-principle-guided evaluation of EDDC efficiency, aiming to create EDDC time to expand the follow-up program. We reviewed appointment-making, SDoH-screening, and follow-up program data. We surveyed patients to determine whether adopting SHOUT tool criteria (no home, no primary care physician, or insurance) might yield more-judicious EDDC utilization. EDDC staff's 20 minutes/patient yielded fewer ED returns and admissions. Most patients improved post-discharge and made appointments themselves; 6% met SHOUT criteria for EDDC assistance; 4.5% would benefit from SDoH screening. Adopting SHOUT criteria would create significant time for EDDC-staffed follow-up program expansion. QR-code-accessible SDoH surveys would screen thousands more patients, minimizing EDDC staff involvement, saving 95% of the effort while retaining 100% of the benefit.
从 "学习型组织 "视角看急诊科出院中心项目评估:方法、经验教训和未来方向
我们的急诊室出院中心 (EDDC) 为预约和纸质健康社会决定因素 (SDoH) 筛查提供便利。EDDC 的使用不需要任何标准。急诊室由医疗服务提供者-管理员运营的、令患者满意的随访呼叫计划仅接触了约 25% 的出院患者。我们介绍了在学习型组织原则指导下对 EDDC 效率进行的评估,旨在为扩大随访计划创造 EDDC 时间。我们回顾了预约、SDoH 筛选和随访计划的数据。我们对患者进行了调查,以确定采用 SHOUT 工具标准(无家可归、无主治医生或无保险)是否能更明智地利用 EDDC。EDDC 工作人员为每位患者花费的 20 分钟减少了急诊室返院和入院人数。大多数患者在出院后病情有所好转,并自行预约了就诊时间;6% 的患者符合接受 EDDC 援助的 SHOUT 标准;4.5% 的患者将受益于 SDoH 筛查。使用 QR 码进行 SDoH 调查可筛查成千上万名患者,最大程度减少 EDDC 工作人员的参与,节省 95% 的工作量,同时保留 100% 的收益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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