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Evaluating an Emergency Department Discharge Center: A Learning Organization Approach for Efficiency and Future Directions.
Cureus
November 2024
Emergency Medicine, Northwell Health Long Island Jewish Medical Center, New Hyde Park, USA.
Introduction Our pilot Emergency Department Discharge Center (EDDC) facilitates post-discharge appointments, and screens for social determinants of health (SDoH) with a long, paper-based tool. No criteria guide which patients to refer to EDDC for appointment-making. Patients screening positive for SDoH are texted or emailed a list of community-based organizations (CBOs) to contact; the screening tool doesn't assess patients' interest or ability to contact CBOs.
View Article and Find Full Text PDFFederally Qualified Health Centers and Performance of Medicare Accountable Care Organizations.
JAMA Netw Open
November 2024
Duke-Margolis Institute for Health Policy, Duke University, Washington, DC.
Importance: Federally qualified health centers (FQHCs) have increasingly participated in the Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs), one of the most widespread value-based programs. Although FQHCs may strengthen ACOs' ability to provide affordable care to diverse Medicare beneficiaries, evidence on ACOs' performance by FQHC participation is limited.
Objectives: To compare beneficiary characteristics, utilization, expenditure, and quality between ACOs with and without FQHC participation and assess changes in ACO performance after including first FQHCs.
Test results pending at discharge among emergency department patients experiencing homelessness.
Am J Emerg Med
November 2024
Department of Emergency Medicine, Denver Health Medical Center, Denver, CO, United States of America; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America; Colorado Social Emergency Medicine Collaborative, Denver, CO, United States of America.
Background: Persons experiencing homelessness (PEH) are vulnerable emergency department (ED) patients due to high rates of multi-comorbidity and mortality, as well as a lack of follow up care. Communication of test results pending at discharge (TPAD) is an important area of post-ED follow up care. We examined phone access, successful contact, and change in treatment among PEH and non-PEH with TPAD from the ED.
View Article and Find Full Text PDFExperiences of Parents Earning Low Wages in Raleigh, North Carolina: Compounding Effects of Caretaker Responsibility, Piecemeal Resources, and Lack of Economic Opportunities.
J Hunger Environ Nutr
April 2023
Rudd Center for Food Policy and Obesity, University of Connecticut, United States; Department of Allied Health Sciences, University of Connecticut, United States.
We conducted interviews with parents earning low wages to understand their experiences related to financial responsibilities and use of government and informal resources in Raleigh, North Carolina. Inadequate economic opportunities and assistance programs, and high costs of living, compounded into cycles of playing catch up on expenses. Assistance programs aimed at alleviating hardships related to poverty were described as piecemeal.
View Article and Find Full Text PDFHigh Reliability in a Safety Net Hospital Leading to Operational Excellence.
J Patient Saf
August 2024
Professor Emeritus, University of Mississippi Medical Center, Jackson, MS.
Objective: The objective of this work was to establish sustainable systems for quality improvement in an Academic Medical Center and Safety Net Hospital.
Method: High reliability principles of leadership engagement, a culture of safety, and sustainable performance improvement were used. Target areas for improvement were clinical outcomes for patients, public reputation scores, and lower cost of care.
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