Reducing Avoidable ED Use

Beth Harvey, MD, FAAP
Lead, Physician Champions
Pediatric Transforming Clinical Practice Initiative

One goal of the Pediatric Transforming Clinical Practice Initiative (P-TCPI), in alignment with the common measure set, is to reduce avoidable emergency department use. The P-TCPI team is partnering with the ER is for Emergencies group to help target interventions to reduce avoidable ED use and to address the behavioral health issues that also impact ED use.  To make progress on this goal, the P-TCPI Physician Champion team recently piloted materials to communicate with families about medical home versus emergency department care and fever.

We partnered with the medical home neighborhood team led by Kate Orville, whose parent experts informed our materials and helped us to script how to approach families who were high utilizers and had recently gone to the ER. They also informed our messages to proactively educate families about fever.

We learned that parents have a desire to learn about medical decision-making to build competency. We used a book, What to Do When Your Child Gets Sick, and a targeted curriculum of materials to support parents in managing common avoidable ED diagnoses like fevers, vomiting and diarrhea, upper respiratory infections, and ear infections.

Parents also had a desire for ongoing reminders of how to use the healthcare system, including   how to reach the office after hours, what the office hours are, what virtual or local urgent care options exist, which ED is preferred and why, the advantages to calling in for advice, and how to reach poison control.

Talking to your clinic’s families about why they chose to go to the ED will tell you a lot about their stressors, work schedule, transportation and translation needs, and you will be surprised by how many parents don’t understand your after-hours availability or are intimidated to use it.  Once the materials the Physician Champion team piloted are finalized they will be available to use.


*Editor’s note: Reducing avoidable ED use is one of the great topics planned for our next Pediatric Population Health Forum, presented by Amerigroup, to be held in Yakima on September 22nd. Learn more and register today!