BWFH Emergency Department initiative expands to BWH
An innovative project that began in the Emergency Department at Brigham and Women’s Faulkner Hospital over a year ago is now expanding to Brigham and Women’s Hospital with help from the Brigham Care Redesign Incubator and Startup Program (BCRISP).
Luis Lobón, MD, MS, Chief of Emergency Medicine at Brigham and Women’s Faulkner Hospital and Vice Chair of Community Emergency Medicine at Brigham Health, says that patients who present in the ED but leave without being seen who are most worrisome to emergency medicine providers. “We noticed here at BWFH that the number of patients who leave without being seen was increasing. We knew part of it had to do with being busier and our space being limited, but we wanted to make sure patients were not leaving for other reasons and that they were safe. That was our main purpose,” he says.
So, without any funding, Dr. Lobón and his team at BWFH came up with an intervention. “Our ED Patient Advocate Jane Flint will get a list of patients who left without being seen and call them,” explains Dr. Lobón. The calls are customer service/service recovery based. Flint will ask the patient how they are feeling and if they found care somewhere else. Flint has found that many patients leave because they feel better or their primary care provider is able to see them. But others leave because they had to wait too long or felt that their needs were not being adequately met. These patients provide the ED with valuable insight into how to use staff, space and other resources more efficiently to better serve the community.
The program has been a great success at BWFH. In fact, many attending physicians who see patients at both BWFH and BWH have expressed a desire to see the program expanded to BWH. Likewise, Dr. Lobón has shared the good news with BWFH leadership, as well as his BWH colleagues who have all expressed interest. The only barrier is staffing.
That’s where BCRISP comes into play. BCRISP has granted BWHC’s EDs with $50,000 to fund staff for one year to make calls to patients who leave either BWFH’s or BWH’s ED without being seen. The BCRISP organizers hope the pilot program will impact population health management, such as decreasing readmission rates and follow-through with appointments.
Under the multicampus ED call back pilot program, the scope of calls will be increased to include not only the patients that left without being seen but also some high-risk population groups that may require special attention after being discharged from the ED. Some of those groups may include, but not be limited, to patients over 60 or below 14, newly diagnosed hypertensives or diabetics and patients that required complex wound repairs or fracture/dislocation management.
In the future, Dr. Lobón says the EDs at BWFH and BWH are looking at more initiatives that will include a similar multicampus approach.