Inappropriate and preventable use of the hospital emergency department is not only an inefficient use of healthcare resources, but also a waste of payors' and consumers' healthcare dollars. As consumers and payors take on greater responsibility for the efficiency of the healthcare system, healthcare organizations are targeting avoidable and unnecessary emergency department use.
The robust emergency department management program at Kaiser Foundation Health Plan of Colorado is a three-arm initiative that identifies and targets not only the individuals who have used the ED inappropriately and but also the high-utilizers. It also aims to ensure that patients go to the right place for the right kind of treatment for the condition they have. Preliminary data is proving the value of these programs.
During Reducing Unnecessary Emergency Room Visits: Strategies To Discourage Inappropriate Use and Reduce Preventable Visits, a 45-minute webinar now available as a CD-ROM, via On Demand Web access or as a training DVD, Sara Gray, senior manager of emergency services at Kaiser Foundation Health Plan of Colorado, shared the strategies that Kaiser is using to reduce inappropriate and avoidable ED use through this three-pronged approach.
Ms. Gray shared the details on how Kaiser is:
- Educating patients on when ED use is appropriate;
- Determining how different populations - Medicare, Medicaid, dually eligible and commercial - use the ER and what that means for reducing inappropriate use;
- Identifying members who might inappropriately use the ER and intervening before they do so;
- Working with Kaiser-owned hospitals and other hospitals in the community to assist high-utilizers and inappropriate use; and
- Redirecting care to appropriate settings
We also learned the challenges that the program has encountered and the steps that Kaiser is taking to address these challenges, and preliminary data on the cost savings associated with the strategies that Kaiser is using.
WHO WILL BENEFIT FROM THIS CONFERENCE?
- Medical Directors
- Health Plan Executives
- Hospital Executives
- Clinical and Quality Improvement Executives
- Disease Management Directors
- Managers and Coordinators
- Physician Executives
- Business Development
- Strategic Planning Directors. SHOW LESS READ MORE >
Sara Gray, M.S.P.H. is the senior manager of emergency services at Kaiser Foundation Health Plan of Colorado (KP) Her experience includes over a decade in healthcare, in areas including pre-hospital medicine, clinical education, accreditation management, contract management, and care delivery systems.
Gray joined KP in July of 2003 in the role of ambulance management and today is responsible for the emergency services business line at KP, including oversight of the national ambulance contract, 24/7 nurse and physician telephonic medicine center, and mid-level providers at KP contracted hospitals. In this role, Gray has implemented successful venue management programs based in a clinical call center and reduced inappropriate ED visits for a variety of patient populations.
Prior to 2003, Gray served as a quality manager and accreditation coordinator for American Medical Response.
Gray received a Bachelor of Science in Biochemistry at University of Michigan and a Master of Science in Public Health from University of Colorado.