Community Case Management
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Ethical Responses Needed if Clinicians Say Discharge Is Unsafe
For some patients, there are no caregivers at home. Others may be living in unsafe conditions. Ethicists can help by brainstorming scenarios, and trying to connect resources accordingly.
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Novel Program Decreases Transport to ED for Hospice Patients
Ventura County, CA, paramedics underwent 30 hours of training on crisis counseling, grief, and palliative care. When EMS responded to a 911 call and determined a patient was in hospice, they contacted trained staff. During a three-year study period, the percentage of hospice patients transported to the ED was 36% in the first year, 33% in the second year, and 24% in the third year. This was compared to 80% of hospice patients transported, on average, during the six months before project implementation.
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Financial Counselors Find Unmet Needs at Vaccine Clinics
Everyone has to wait 15 minutes after receiving their COVID-19 vaccine. Financial counselors at Spectrum Health make good use of this time.
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Multilayered Approach to 911 Calls Targets Social Needs, Cuts ED Visits
Many EDs fill up with patients without serious medical concerns, but social or mental health problems clinicians may not be well-equipped to address. Putting social workers and other resources on scene to address these needs can expedite an appropriate response. Another potential solution is to meet these patients where they are, eliminating the need for an ED visit altogether.
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Start Small, Employ Relevant Personnel to Manage Complex Social Problems
Every hospital relies on a problem-solving method for performance improvement. The key is putting the right people on an intervention.
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Address Social Determinants of Health with Multidisciplinary Team, Community Partnerships
An ED Social Medicine team tackles social issues that often sabotage positive health outcomes and prompt repeat ED visits. The team includes clinicians, social workers, mental healthcare providers, patient navigators, a pharmacist, and transitional care personnel.
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The Struggle to Immunize Long-Term Care Staff
Almost two-thirds of healthcare workers in thousands of skilled nursing facilities have turned down the COVID-19 vaccine, even though the mortality rates of long-term care residents are among the highest of any population. Historically, long-term care workers have shunned influenza vaccinations, citing skepticism about the vaccine’s efficacy or that they do not get the flu. The COVID-19 vaccine raises its own set of suspicions. -
Safety Protocol Can Prevent Self-Harm Incidents
Patients often present to the ED with behavioral health concerns, but psychiatric experts recognize the environment is hardly optimal for easing anxiety or calming a troubled mind. Further, patients with psychiatric concerns often wait in the ED for extended periods before they are connected with appropriate care, a time that can be fraught with danger for individuals at risk for self-harm. Recognizing the safety challenges at issue, a multidisciplinary team at Massachusetts General Hospital developed and implemented a protocol aimed at protecting such patients. -
Hospital Reduces HAPI Rate by Half with Huddles, Rounds
A hospital that had struggled to reduce hospital-acquired pressure injuries (HAPIs) has found success with an approach that emphasizes empowering frontline staff and consistent, structured huddles. After one year, the culture has changed, and HAPIs have been cut by 50%.
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Tips to Improve Relationships with Patients Over the Phone
Phone communications jumped in importance over the past year of the pandemic, but there are tactics case managers can use to improve their technique and build rapport with patients or clients over the phone. One tip is to listen for audible clues about the person’s mood and energy level.