Very High Intensity Users of Middlemore Hospital Emergency Department
A randomised controlled trial of intergrated care compared to usual care on hospital admissions, costs and patient outcomes in very high intensity users of Middlemore Hospital Emergency Department
Associate Professor Timothy Kenealy
200 participants
Aug 29, 2011
Interventional
Conditions
Summary
This project aims to further improve care for patients who frequently attend Middlemore Hospital Emergency Department (ED). About 850 adults attend ED five or more times each year for ‘medical‘ (rather than surgical and other) services. We call these people Very High Intensity Users (VHIU). These people might have unmet needs. Counties Manukau DHB has established a new pathway for VHIU clients whereby, upon discharge from ED or a medical ward, health and social care is coodinated by a community-bsed case manager. The DHB wishes to ascertain whether the programme reduces re-admissions to hospital.
Eligibility
Inclusion Criteria1
- Presented to Emergency Department 5 or more times in the last year; able to give written consent
Exclusion Criteria1
- Under regular care from renal, haematology services; assigned to surgical, orthopaedic, obstetric, gynaecology services; principal problem mental health
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Interventions
A systematic assessment of health and social service needs followed by multidisciplinary case review followed by coordinated care and advocacy. The intervention involves undertaking an enhanced risk assessment on admission into the emergency department followed by a case conference with dedicated clinicians. A care plan is then determined in conjunction with a dedicated clinical team, pharmacists, cultural support, and social workers and at discharge, a locality coordinator will be assigned to visit the patient in their home until their health stabilises and their access to social support services is realised. The service will not exceed 6 months.
Locations(1)
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ACTRN12611000496910