This Nurse Leader Cut LOS by 40% in the Emergency Department

http://www.healthleadersmedia.com/nurse-leaders/nurse-leader-cut-los-40-emergency-department-0?spMailingID=9348186&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=980998666&spReportId=OTgwOTk4NjY2S0#

Around 2012, Ajimol Lukose, DNP, RN-BC, nursing director at Swedish Covenant Hospital in Chicago, noticed a trend—more patients with behavioral health issues were seeking treatment in the emergency department. This development came on the heels of the state cutting $113.7 million in general funds from its mental health budget, and Chicago closing of six of its 12 city-run mental health clinics.

“There was a reduction in mental health clinics, so the follow-up or outpatient programs were limited. That resulted in patients showing up in the emergency department,” Lukose told me.

On any given day, there could be as many as six or seven behavioral health patients in the ED.

“Our emergency department was struggling with patients with mental health issues staying there for three and four days and waiting for state transfer, especially unfunded patients,” she said.

At the same time, Lukose needed to implement a project for the doctorate of nursing practice degree she was working toward. She has a background in psychiatric nursing and thought she could help address some of the issues around caring for this patient population by developing a safe care delivery model to improve care quality and reduce length of stay in the ED.

Her results were even better than expected.

Sometimes Tiny Is Just The Right Size: ‘Microhospitals’ Filling Some ER Needs

http://khn.org/news/sometimes-tiny-is-just-the-right-size-microhospitals-filling-some-er-needs/

The two-story SCL-Health Community Hospital-Westminster opened outside Denver last fall. The microhospital offers emergency medical care, labor and delivery services, inpatient beds, two operating rooms, radiology services and an on-site laboratory. (Courtesy of Emerus and SCL Health)

http://www.healthcaredive.com/news/think-small-making-the-case-for-microhospitals/423710/

Eyeing fast-growing urban and suburban markets where demand for health care services is outstripping supply, some health care systems are opening tiny, full-service hospitals with comprehensive emergency services but often fewer than a dozen inpatient beds.

These “microhospitals” provide residents quicker access to emergency care, and they may also offer outpatient surgery, primary care and other services. They are generally affiliated with larger health care systems, which can use the smaller facility to expand in an area without incurring the cost of a full-scale hospital. So far, they are being developed primarily in a few states — Texas, Colorado, Nevada and Arizona.

“The big opportunity for these is for health systems that want to establish a strong foothold in a really attractive market,” said Fred Bentley, a vice president at the Center for Payment & Delivery Innovation at Avalere Health. “If you’re an affluent consumer and you need services, they can fill a need.”

SCL Health has two microhospitals operating in the Denver metropolitan area and another two in the works. Microhospitals “are helping us deliver hospital services closer to home, and in a way that is more appropriately sized for the population compared to larger, more complex facilities,” said spokesman Brian Newsome.

The concept is appealing, and some people suggest they should be developed in rural or medically underserved areas where the need for services is great.

 

CT Scans For Minor Injuries On A Rapid Rise In California Emergency Rooms

CT Scans For Minor Injuries On A Rapid Rise In California Emergency Rooms

CT scanner in hospital with patient

Health care ‘homes’ save Minnesota $1 billion

http://www.startribune.com/health-care-homes-save-minnesota-1-billion/368187001/

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Reform strategy asks clinics to take more responsibility for managing patients.