SHM Converge Scientific Abstract ePoster Gallery-The Safety and Impact of Individualized Care Plans on Healthcare Utilization

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This study evaluated whether individualized acute care plans (ACPs) could improve care for 30 high-utilizing patients with chronic pain-related conditions at a large academic hospital. Most participants were women (63%), Black (60%), and had sickle cell disease (63%) or chronic abdominal pain (37%). The average age was 35.2 years.<br /><br />Patients with pain-associated conditions often cycle through repeated emergency department (ED) visits and hospitalizations. The authors noted that fragmented care, clinician assumptions, and inconsistent treatment practices can delay pain control and lead to avoidable admissions. To address this, the team created patient-specific ACPs with input from both specialists and patients. These plans were placed in the medical record and included consistent, evidence-based recommendations for managing acute pain and reducing unnecessary admissions.<br /><br />Outcomes were compared for 90 days before and after ACP implementation. Before the intervention, the cohort had 413 ED visits and 820 total hospital days. After implementation, ED visits did not significantly decrease, suggesting patients still sought emergency care when needed. However, hospitalizations declined: the median number of hospitalizations dropped from 4 to 2, and total hospital days fell from 820 to 253, both statistically significant. Rates of discharge against medical advice remained similar before and after the intervention (5.5% vs 5.2%), indicating the plans did not worsen patient adherence or satisfaction. Care quality also improved, with a higher proportion of hospitalizations involving hematology consultation in patients with sickle cell disease (41% vs 58%).<br /><br />Overall, the study found that individualized ACPs can safely reduce hospital use and improve the quality of care for patients with complex chronic pain conditions.

Asset Subtitle

Jason Russ

Meta Tag

Author List Adam Nevel, Andrew O'Brien, Areeba Kara, Ben Hunter, Dhwani Patel, Emily Michaels, Jason Russ, Katherine A. Pollard, Lana Dbeibo, Patrick Dugan, Steve Roumpf, Warren Gavin

Category Research

Concept Individualized Acute Care Plan

Concept Emergency Department Visits

Concept Hospitalization

Concept Avoidable Healthcare Utilization

Concept Chronic Pain

Distinguished Non-Finalist

Presenter Organization Indiana University School of Medicine

Presenting Author Jason Russ

Track Outcomes Research

Keywords

acute care plans

chronic pain

emergency department visits

hospitalizations

sickle cell disease

individualized care

patient-specific plans

hospital days

hematology consultation

high-utilizing patients

Individualized Acute Care Plan

Emergency Department Visits

Hospitalization

Avoidable Healthcare Utilization

Chronic Pain