SHM Converge Scientific Abstract ePoster Gallery-Quality Improvement: Complex Patients in Primary Care

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This quality improvement (QI) project in an internal medicine residency clinic evaluated whether continuity of care by the same resident-faculty team could reduce health care utilization among frequent emergency department (ED) users. The intervention included having the same primary care resident and supervising faculty see the patient at each visit, providing education about care, making providers available through the electronic medical record, and closely tracking ED visits and hospitalizations.<br /><br />The team initially identified 100 patients with at least three ED visits or hospitalizations in the prior year and enrolled nine patients between August 2022 and January 2023. After exclusions for PCP change, nursing home placement, and loss to follow-up, six patients remained for analysis. The mean age was 64 years; 50% were male, 67% Caucasian, and 33% African American.<br /><br />Compared with the year before enrollment, 5 of 6 patients had fewer office visits, 3 of 6 had fewer ED visits, and all 6 had fewer hospitalizations. The reduction in hospitalizations was statistically significant (p=0.03), while changes in office visits and ED visits were not statistically significant. Blood pressure changes were mixed and not significant. There were no significant changes in preventive care measures. Hemoglobin A1c and LDL were not analyzed because repeat values were unavailable for all patients.<br /><br />Overall, the project suggests that a dedicated resident PCP team may improve continuity of care and reduce hospitalizations in a small underserved population. The authors note that the sample size was limited, but the findings support continuing and expanding the intervention.

Asset Subtitle

Babray Laek

Meta Tag

Author List Babray Laek, Fritz Lubin, Himanshu Khanna, Mustafa Gecin, Truong Ngo

Category Research

Concept Quality Improvement Project

Concept Emergency Department Visits

Concept Hospitalization

Concept Continuity of Care

Concept Frequent User

Distinguished Non-Finalist

Presenter Organization Upmc

Presenting Author Babray Laek

Track Quality Improvement

Keywords

quality improvement

continuity of care

resident-faculty team

emergency department utilization

frequent ED users

hospitalizations

internal medicine residency clinic

primary care

underserved population

care coordination

Quality Improvement Project

Emergency Department Visits

Hospitalization

Continuity of Care

Frequent User