After the Emergency

New Emergency Medicine Consult/Referral Service puts patients and families first

It’s a common scenario in emergency rooms across the country. A patient comes in for care, and after a medical evaluation, the physician decides the patient can go home but needs follow-up with a specialist or a primary care physician. Staff fills out the paperwork and gives the patient instructions. Case closed.

Or is it? All too often, patients fall through the cracks, volleying back and forth between the ED and the clinic. Appointments are made, but few are kept, delaying access for other patients. Some patients end up back in the ED, adding to long waits and unnecessary costs.

That is until the new UMHS Emergency Medicine Consult/Referral Service Program launched in January. Now, we are better serving our 1,000 ED patients a month who need a follow-up referral or PCP.

Last fall, Jennifer Gegenheimer-Holmes, R.N., B.S.N., M.H.S.A., director of operations, Emergency Department, leaned on “lean thinking.” She worked with Deborah Sullivan, R.N., B.S.N., ED follow-up coordinator, Angelika Esser, then-manager of the ED document verification team, and Jeff Desmond, M.D., service chief, Adult Emergency Medicine.

Gegenheimer-Holmes says, “We wanted to ensure that paperwork, approvals, authorizations, diagnostic imaging and instructions were taken care of before patients arrived for their appointments. We realized we needed an entirely different referral process altogether.”

She approached Josephine Aguirre, director, Physician and Consumer Communications in the Department of Public Relations and Marketing Communications, who said, “We already have a model in place for handling consult requests as part of our M-CALL service.”

In 2006, M-CALL coordinated almost 14,000 consult requests for Integrated Health Associates. Building on this model, another star program was born.

Today, ED medical staff tell patients they are requesting a follow-up appointment with a specialist or PCP and give them a card with the name of the clinic and a toll-free number.

Emergency Medicine Consult/Referral coordinators take it from there. They call the patient the business day after their ED visit to coordinate the next appointment, communicate with the PCP regarding coordination of care and request insurance authorizations for managed care patients.

Within the first 24 hours of implementing this new system, everyone saw a difference. Emergency Medicine coordinator Karen Burr recounted how a patient with an orthopaedic referral—and limited insurance—was now getting the follow-up care he needed. Burr tied up the loose ends for him, even directing him to health care resources he could apply for and discussing a payment plan that would work with his budget.

“We don’t expect all 1,000 patients referred from the ED each month to come here for follow-up,” says Laura Rowland, manager, Physician and Consumer Services, “but our aim is to assist all 1,000.”

Just one more way we put patients and families first at UMHS.