Contributions
Abstract: EP1434
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Economic burden
Multiple sclerosis (MS) is a chronic, inflammatory and neurodegenerative central nervous system (CNS) disease characterized by recurrent relapses and disability progression. Patients may seek care with an emergency department (ED) for treatment of relapse, which can result in inappropriate visits, and overuse of the ED. A National Committee for Quality Assurance (NCQA) recognized Patient-Centered Specialty Practice (PCSP) is well suited for MS management because of its essential elements: 1) timely access to comprehensive care, 2) enhanced communication between patients and providers, 3) continuous coordination and provision of care, and 4) intensive focus on quality and safety.
Evaluate the effectiveness of patient-centered care improvements to access and quality of care within the MS PCSP's impact on healthcare resource utilization (HRU), specifically ED utilization.
ED utilization by MS patients at the MedStar Georgetown University Hospital (MGUH) was measured for 2016 Q4. In June 2017 the practice instituted patient-centered approaches aimed at improving access and quality of care. The new multimodal approach included establishment of a Nurse Practitioner (NP) urgent care clinic within the Georgetown MS Center to provide same-day appointment access, daily pre-visit planning with care team discussions of patient-specific needs, and increased frequency of patients visits with their clinician and between-visit calls for high-risk patients. ED utilization and NP urgent care clinic visits 2017 Q4 and 2018 Q1 were measured and compared.
In 2016 Q4 prior to transformation, there were 40 ED visits. After transformation, ED utilization decreased by 35%, 2017 Q4 (N=26) compared to 2018 Q1 (N=17), while NP urgent care clinic utilization increased 37% quarter over quarter, 2017 Q4 (N=43) and 2018 Q1 (N=59). Observed ED utilization showed a continual decrease from pre-intervention utilization (2016 Q4; N=40) to post-intervention utilization (2018 Q1; N=17), resulting in a total decrease of 58%.
When patient-centered approaches to care for MS patients were instituted within the MS center including establishment of a NP urgent care clinic there was a decrease in ED utilization. This preliminary data suggests that increasing patient access and quality of care at a MS PCSP decreases utilization of the ED leading to reduced heath care costs and improved patient care.
Study sponsored by Biogen
Disclosure: Susan E. Stuart: Consultant to Biogen, Mallinckrodt, and Sanofi Genzyme
Terrie Livingston: Employee of Biogen
Pat Farmer: Employee of Discern Health
Erika Mitchell: Consultant to Sanofi Genzyme and Teva
Bethany Schreiber: Nothing to disclose
Alexis Ahmad: Nothing to disclose
Nancy Hu: Nothing to disclose
Sonya Powell: Nothing to disclose
Carlo Tornatore: Consultant to Biogen, Genentech, Sanofi Genzyme and Serono
Abstract: EP1434
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Economic burden
Multiple sclerosis (MS) is a chronic, inflammatory and neurodegenerative central nervous system (CNS) disease characterized by recurrent relapses and disability progression. Patients may seek care with an emergency department (ED) for treatment of relapse, which can result in inappropriate visits, and overuse of the ED. A National Committee for Quality Assurance (NCQA) recognized Patient-Centered Specialty Practice (PCSP) is well suited for MS management because of its essential elements: 1) timely access to comprehensive care, 2) enhanced communication between patients and providers, 3) continuous coordination and provision of care, and 4) intensive focus on quality and safety.
Evaluate the effectiveness of patient-centered care improvements to access and quality of care within the MS PCSP's impact on healthcare resource utilization (HRU), specifically ED utilization.
ED utilization by MS patients at the MedStar Georgetown University Hospital (MGUH) was measured for 2016 Q4. In June 2017 the practice instituted patient-centered approaches aimed at improving access and quality of care. The new multimodal approach included establishment of a Nurse Practitioner (NP) urgent care clinic within the Georgetown MS Center to provide same-day appointment access, daily pre-visit planning with care team discussions of patient-specific needs, and increased frequency of patients visits with their clinician and between-visit calls for high-risk patients. ED utilization and NP urgent care clinic visits 2017 Q4 and 2018 Q1 were measured and compared.
In 2016 Q4 prior to transformation, there were 40 ED visits. After transformation, ED utilization decreased by 35%, 2017 Q4 (N=26) compared to 2018 Q1 (N=17), while NP urgent care clinic utilization increased 37% quarter over quarter, 2017 Q4 (N=43) and 2018 Q1 (N=59). Observed ED utilization showed a continual decrease from pre-intervention utilization (2016 Q4; N=40) to post-intervention utilization (2018 Q1; N=17), resulting in a total decrease of 58%.
When patient-centered approaches to care for MS patients were instituted within the MS center including establishment of a NP urgent care clinic there was a decrease in ED utilization. This preliminary data suggests that increasing patient access and quality of care at a MS PCSP decreases utilization of the ED leading to reduced heath care costs and improved patient care.
Study sponsored by Biogen
Disclosure: Susan E. Stuart: Consultant to Biogen, Mallinckrodt, and Sanofi Genzyme
Terrie Livingston: Employee of Biogen
Pat Farmer: Employee of Discern Health
Erika Mitchell: Consultant to Sanofi Genzyme and Teva
Bethany Schreiber: Nothing to disclose
Alexis Ahmad: Nothing to disclose
Nancy Hu: Nothing to disclose
Sonya Powell: Nothing to disclose
Carlo Tornatore: Consultant to Biogen, Genentech, Sanofi Genzyme and Serono