SHM Converge Scientific Abstract ePoster Gallery-Evaluation of a Care Transitions Clinic "Surge" Program

Pdf Summary

The University of Chicago created an ED “Surge” Program in March 2021 within its Ambulatory Care Transitions Clinic to provide lower-acuity ED patients with outpatient care and reduce emergency department crowding. This study aimed to characterize the program’s impact and identify which patients are better served in the ED versus an ambulatory setting.<br /><br />Using data from March 2021 to March 2022, the team reviewed demographics, visit features, and subsequent ED visits and hospitalizations. They defined high healthcare utilization as having two ED visits plus any hospitalizations, and severe visits as those requiring return to the ED or direct admission. Logistic regression and Kaplan-Meier survival analyses were used.<br /><br />During the first year, the program had 200 completed visits among 280 unique patients. The patient population was mostly female, Black/African American, non-Hispanic, insured by Medicaid, and had an average age of 35.8 years. Only 1.43% of unique patients met criteria for high healthcare utilization, and 4.5% of visits were severe. Common diagnoses included sexual health concerns, respiratory infections, and miscellaneous infections.<br /><br />Completed appointments were more likely among Medicaid patients (OR 2.98). Severe appointments were strongly associated with neurologic diagnoses (OR 18.47) and dehydration/lab abnormalities (OR 31.66). Certain diagnoses also predicted faster return to the ED or hospitalization, including COVID-related symptoms, miscellaneous infections, neurologic issues, musculoskeletal problems, kidney/urinary diagnoses, and dehydration/lab abnormalities.<br /><br />Overall, the ED “Surge” Program reduced ED burden and mainly served younger, Black, and government-insured or uninsured patients. The findings suggest that some diagnoses are better managed in the ED than in outpatient follow-up.

Asset Subtitle

Ashley E. Brown

Meta Tag

Author List Ashley E. Brown, Geneatra Green, Juhi Gupta, Katherine Sullivan, Michael Hermsen, Rajlakshmi Krishnamurthy, Sarah Kundrat, Stephanie Chia, Thomas Spiegel, Valerie G. Press

Category Research

Concept Emergency Department Crowding

Concept ED Surge Program

Concept Lower-Acuity Patient

Concept Completion Rate

Concept Outpatient Care

Distinguished Non-Finalist

Presenter Organization University of Chicago Medical Center

Presenting Author Ashley E. Brown

Track Transitions of Care

Keywords

ED Surge Program

ambulatory care transitions

emergency department crowding

outpatient care

lower-acuity patients

logistic regression

Kaplan-Meier survival analysis

healthcare utilization

severe visits

Medicaid patients

Emergency Department Crowding

ED Surge Program

Lower-Acuity Patient

Completion Rate

Outpatient Care