A small town hospital in my state decided to do something about the bane of every ER nurses life: frequent flyers. The ones that come up to the triage desk and you tell them to have a seat in the lobby, you don't need their name because it is etched in your brain.
Anyway, this hospital decided to hire a social worker whose job it became to identify these people and work with them to decrease their visits. She started with 24 people and reduced their visits from 294 to 178 in a years time. Saved almost 300,000 dollars. Many of the people had untreated mental illness or stress related problems, were unemployed or homeless. She hooked them up with psychiatrists or social workers, etc.
Why doesn't every ER do this? Sometimes I think that the hospital doesn't want them to stop coming. Medicaid money is better than no money I guess
Every hospital should do this, but yeah, I wonder about the $$$ issue too.
ReplyDeleteWe have outreach workers in the ER at our major downtown hospital, and a program designed to work with the top users of 911 dollars (public health in canada) most of whom are homeless. Both of these have cut down the number of visits and number of 911 calls.
ReplyDeleteI think maybe the futility to some extent. Our most frequent of frequent flyers, aka ER mascot, has actually been hooked up with psych and social workers, who have provided him with everything from free housing to free outpatient psych care and meds. He just prefers to live on the street, spend his disability check on hotels, weed and hookers, and come to the ER at the end of the month when the money runs out with "suicidal thoughts". There was actually a meeting among the hospitals in the county on what to do with him. Some people are just beyond help.
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