Implementing a medical screening and referral program for rural emergency departments.

摘要: Context Emergency Department (ED) overcrowding due to nonemergent use is an ongoing concern. In 2011, a regional health system that primarily serves rural communities in Texas instituted new program medically screen and refer patients nearby affiliated clinics (RHCs). Purpose This formative evaluation describes the goals, process, early implementation experiences at 2 sites adopted before wider within system. Methods Primary data collection including document review, internal stakeholder interviews, direct observation of processes were used for this light goals objectives. Fourteen key informants asked questions related concept, structure, implementation. Results The program, as implemented, aligned with initial but it was dependent on ED screening staff RHC availability. Some adjustments needed, hours, consistency among making referrals, patient education, improving uptake referral. Stakeholders reported lessons learned training, buy-in, Emergency Medical Treatment Labor Act (EMTALA), intraorganizational cooperation. Discussion The able leverage excess capacity RHCs accommodate low-acuity referred from may lead improvements Triple Aim increased satisfaction, better population outcomes, lower per capita costs. Lessons inform similar aimed reduce nonemergency utilization by other systems.