Trio of Workshops Address ED Care Triage and Social Determinants of Health

MHVC offers the third session on January 31, 2018. In its efforts to provide continuing support to the seven hospitals participating in the ED Care Triage Project, MHVC has hosted a series of workshops to support development of an integrated delivery system. The seven hospitals — Montefiore New Rochelle, Montefiore Mt. Vernon, Nyack, St. John’s, St. Joseph’s, St. Luke’s, and White Plains Hospital — participated in one or more of the workshops on October 25 and November 28, 2017; the next will be held on January 31, 2018.

“The purpose of these workshops is to assist our hospitals in achieving the overarching goal of reducing avoidable Emergency Department (ED) visits,” said Joan Chaya, MHVC Director of Workforce Development and Management. MHVC staff assists the hospital EDs in identifying their high-utilizer population and understanding the main drivers of utilization. According to Natalee Hill, MHVC Director of Quality and Innovation, “Through our workshops we assist our hospitals in the development of a sustainable process. We have tailored the focus of each workshop to address critical areas and techniques to achieve that result.”

The goals:
— connect patients with primary care providers (PCP),
— identify social determinants of health (SDH),
— connect patients to appropriate community based resources that can address SDH needs, and
— screen patients for depression and other behavioral health (BH) conditions, and provide linkages to health homes and care management resources.

The October workshop focused on understanding the drivers of utilization and using data to drive change. MHVC asked the 28 participants from participating hospitals to populate a template that would help them to identify the underlying medical and social needs driving patients’ unnecessary ED utilization. During the workshop, MHVC staff and network representatives asked participants to use this data to understand the needs of the high-utilizer cohort of patients and to identify targeted community providers and CBOs for partnership and intervention.  Each hospital developed two action plans that focused on improving processes within their organizations.

The November workshop focus was on managing high utilizers in the community. The hospitals were asked to invite a community partner they identified in the October workshop that would help them meet the needs of their high-utilizer population. The hospital and the community partner developed two action plans that would allow for definitive and timely linkages between organizations. As a part of this workshop, the technique of Plan-Do-Study-Act (PDSA) was reviewed and added to the action plan to help measure the process the 20 participants put in place.

The January session will focus on confirming each partner has reliable and manageable processes in place to create a sustainable program, especially high-reliability processes and sustainability. For more information, contact Tawana Howard-Eddings, MHVC Director of Practice Transformation, thowarde@montefiore.org.

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