The Checkpoint Program: Collaborative Care to Reduce the Reliance of Frequent Presenters on ED

Area of Science:

• Healthcare management
• Public health interventions
• Patient care coordination

Background:

• Emergency Departments (EDs) face increasing pressure from frequent presenters.
• Existing ED models struggle to address complex patient needs and reduce repeat visits.
• The Checkpoint program was developed to offer intensive, community-based case management.

Observation:

• Frequent ED presenters exhibited distinct patterns: steady high utilization or increasing trends.
• The study used a single group interrupted time series design to track ED visits.
• Patient engagement and year-on-year ED visit data were evaluated pre- and post-intervention.

Findings:

• Following the Checkpoint intervention, both patient groups showed two consecutive year-on-year reductions in ED visits.
• Overall ED presentations decreased by 53% from a peak of 22.5 visits per patient annually.
• The program resulted in estimated savings of approximately $7100 per patient.

Implications:

• Integrated, intensive community-based case management can effectively reduce ED re-presentation rates.
• The Checkpoint program shows promise for improving care coordination and patient outcomes.
• Further research is needed to determine optimal structures and funding for sustainable programs.