A multidisciplinary Care Coordination Team improves emergency department discharge planning practice

Area of Science:

• Health Services Research
• Geriatric Medicine
• Emergency Medicine

Background:

• Hospitals face challenges meeting service demand, known as "access block," often due to insufficient aged-care beds and post-acute care options.
• Royal Melbourne Hospital, a tertiary referral center, identified these issues through patient needs audits.

Purpose of the Study:

• To establish a multidisciplinary Care Coordination Team (CCT) to facilitate community discharge for emergency department patients.
• To improve care for vulnerable populations including the frail elderly, homeless, and frequent emergency department users.

Main Methods:

• A risk screen was implemented in the emergency department to identify patients for CCT referral.
• The CCT managed 2532 patients in its first year, representing 5.8% of emergency department attendances.
• Patient outcomes and satisfaction were assessed through surveys and admission rate comparisons.

Main Results:

• Nearly half of CCT-referred patients were discharged home with community service referrals.
• Hospital admissions from the emergency department decreased significantly post-CCT implementation (30.9% vs. 32.6%).
• High satisfaction levels were reported by staff, patients, carers, and community service providers.

Conclusions:

• The Care Coordination Team effectively reduced emergency department access block by connecting patients with appropriate community services.
• The CCT model demonstrates success in improving patient flow and satisfaction within a major metropolitan hospital setting.