How You Can Influence Emergent Room (ER) Visits and Improve Outcomes

How You Can Influence Emergent Room (ER) Visits and Improve Outcomes

New dialysis patients are four times more likely to seek medical care at Emergency Department (ED) than any other Medicare beneficiaries and six times more likely than other adults in the United States, according to Lovasik, et al in their JAMA article. Almost 50% of these ER visits result in hospitalizations that could have been avoided, which not only means lost revenue for the dialysis units but also poor quality of life for patients.

These patients face a long list of clinical complications outside of their kidney disease and therefore require frequent and thorough assessment and treatment. These complications can include anemia, bone mineral disorders, malnutrition, and inflammation. On top of this, dialysis patients consult multiple specialists and take 10 or more different medications on average leaving plenty of room for missteps in providing appropriate, efficient, and well-informed care.

Here are some ways YOU can prevent ED visits for your patients:

  • Medication reconciliation – Dialysis patients commonly reconcile medication and for those patients who are under care of multiple specialists such as endocrinologist, cardiology, etc, checking on the medications more frequently is important. This will eliminate any duplicate orders, overdosing, and other concerns that may result in an ED visit.
  • Monitor medical errors closely – Medical errors are 3rd leading cause of death in U.S and are widely under-reported due to staff’s concern of retaliation. Encourage your staff to focus on causes of medical errors and discuss openly on ways to prevent them.  For more information on medical errors, please read our blog on this topic.
  • Post hospitalization care – With a 34% readmission rate among ESRD (End Stage Renal Disease) patients, they  likely seek ED care without proper transitioning care. Reinforce discharge instructions upon leaving the hospital and assist patient with follow up appointments. Provide extra care and support for these vulnerable patients in order to maximize outcomes on either end.
  • New dialysis patients –  New onset end stage kidney disease patients face complications that, without proper care, result in higher infection rate, hospitalizations, and in some unfortunate and sometimes avoidable cases, mortality. Educate your new patients on self care and intensify care for them through coordinating access placement, promote adequate fluid and nutrition management. Please refer to our case study for further details on caring for the new dialysis patients.

A large portion of ED visits and costs incurred by dialysis patients are for non emergent needs that could have been treated at the facility or with good preventative care. Therefore, carefully evaluate all ED visits on monthly basis and correct root causes.

For more information on how we could assist you in improving patient care, contact us below.

For more information on this topic or with questions on improving quality of care at your facility, please contact us completing the form below.

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