SHM Converge Scientific Abstract ePoster Gallery-Development of an Emergency Department Case Management Case-Finding Tool

Pdf Summary

The Duke Emergency Department team developed the Duke Case Management Priority Score (CMPS), an automated screening tool designed to improve case finding for high-risk ED patients. Case managers traditionally identify patients through manual chart review or provider request, which is time-consuming and inefficient. The goal of CMPS was to help case managers more quickly identify patients at risk for returning to the ED or being hospitalized within 7 or 30 days, allowing more time for interventions that may reduce readmissions and unnecessary admissions.<br /><br />CMPS was built through interdisciplinary consensus and placed in the electronic medical record, going live on 9/1/2022. It uses 11 weighted demographic and utilization variables to generate a score. Case managers can view which variables influence the score by hovering over it in the record. Four factors were weighted heavily enough to trigger automatic intervention: an ED consult order for case management, prior ED or hospital utilization, complex care/behavioral flags, and hospice enrollment.<br /><br />The initial findings suggest CMPS was more predictive than the previous manual case-finding approach. Patients identified as high risk by CMPS had different baseline characteristics than those classified as low risk, except for gender. Compared with manual case finding, CMPS had higher odds ratios for identifying patients who later returned to the ED or required hospitalization at both 7 and 30 days.<br /><br />Overall, the authors conclude that CMPS may be more accurate than manual methods, improve ED case management efficiency, and help reduce ED revisits and hospitalizations. Future work will further analyze the variables used in CMPS to refine its predictive performance.

Asset Subtitle

David Gallagher

Meta Tag

Author List Adam Glenn, Amy Fraccola, Aparna S. Kamath, Ashley Barry, Barbara Bentley, David Gallagher, James Howard, Katie Flanagan, Marcia Moulton, Rosimeire Santos

Category Innovations

Concept Emergency Department Case-Finding Tool

Concept Duke Case Management Priority Score

Concept Return to the Emergency Department

Concept Hospitalization

Concept High-Risk Patient

Distinguished Non-Finalist

Presenter Organization Duke University

Presenting Author David Gallagher

Track Transitions of Care

Keywords

Duke Emergency Department

case management

priority score

automated screening

high-risk patients

electronic medical record

readmission prediction

ED revisits

hospitalization risk

utilization variables

Emergency Department Case-Finding Tool

Duke Case Management Priority Score

Return to the Emergency Department

Hospitalization

High-Risk Patient