Certain patients present a health care conundrum. “Super-utilizers” account for only five percent of patients, but they accrue more than 60 percent of health care costs. These patients make frequent trips to hospital emergency rooms or have repeated inpatient hospital stays, resulting in costly health care, but not necessarily good-quality care. For example, one Pennsylvania woman had more than 50 CAT scans within a short span of time at various area hospitals. Super-utilizers often have multiple chronic medical conditions and social complexities that make their care difficult...
One percent of Americans account for 20 percent of the nation’s health care costs; five percent account for 50 percent. Who are these patients? They are known as “super-utilizers”—patients who make frequent trips to the emergency room and have many hospital admissions. Often they are alone and need help determining where to go and how to get healthier.
In six of the Robert Wood Johnson Foundation’s Aligning Forces for Quality (AF4Q) sites, communities are reducing ER visits and hospitalizations for super-utilizers. In her new article, “Caring for...
When MN Community Measurement, leader of AF4Q in Minnesota, first started publicly reporting data, the belief was that patients would use the data to make choices about what doctor to see. This, in turn, would drive improvement. What has been surprising, according to Jim Chase, president of MN Community Measurement, is the amount of attention providers have given the public reports and the comparisons they make to their peers’ performance. “We’ve been using it in a variety of ways: to improve our services, to improve our clinical workflows, to implement tools so we could...
Quality Field Notes features key lessons learned by regional alliances of clinicians, patients, and payers in Aligning Forces for Quality communities as they work to transform local health care and provide models for national reform. The first topic in this series focuses on reducing inappropriate emergency department use. Seventy percent of visits to emergency department (ED) are not true emergencies or could be prevented with...
If you’ve ever had trouble deciding where to go when you or someone you care about needs medical attention, you’re not alone. It’s common to wonder if you should go to the emergency department (ED) or your primary care physician (PCP). Cincinnati Aligning Forces for Quality, led by the Health Collaborative, is helping patients answer this question with the “Make the Right Call” campaign.
The campaign is supporting the Greater Cincinnati community by helping to reduce avoidable ED admissions. Many people who use emergency departments for non-emergencies...
AF4Q in South Central Pennsylvania is empowering hospital staffs in order to avoid hospital readmissions. York & Gettyburg Hospital have implemented a program “Purposeful Pause” using LEAN thinking stolen from the automobile industry. All staff have the ability to “stop the line” in relation to patient discharge if they anticipate problems. If anyone involved in the patient’s care feels that anything is getting in the way of the patient transition to their next care phase or puts them in danger of a readmission, a Purposeful Pause allows the staff...
Aligning efforts and establishing partnerships across systems is becoming a necessary fact for health care providers and organizations as both look to achieve the Triple Aim of improved health outcomes, improved health care quality and reduced costs. This type of effort is what is underway in New Mexico.
In August 2011, the Albuquerque Coalition for Healthcare Quality, the local Aligning Forces for Quality (AF4Q) Alliance, launched its Regional Transforming Care at the Bedside (TCAB) initiative across New Mexico. In April 2012, HealthInsight New Mexico, New Mexico’s Quality...