A community paramedic works onsite at a homeless shelter during afternoon and evening hours 4 days a week during periods when an onsite primary care clinic is not open, significantly reducing unnecessary 911 calls and connecting shelter residents to primary care.
A city fire department offers on-the-scene video consultants between emergency physicians and non-emergent 911 callers, leading to fewer unnecessary ambulance transports and emergency department visits, lower costs, more connections of patients to primary care medical homes, and more time for ambulance crews to deal with true emergencies.
Community Health Access Program helps patients who call 911with nonemergent needs. The dispatcher sends a specially trained paramedic, known as an advanced practice paramedic, to the scene along with the ambulance to confirm that the patient does not need emergency care and then either provide treatment, schedule an appointment with a primary care provider, or arrange for same-day transport to a health resource center.
Children's National Health System has an emergency department–based clinic that serves low-income, minority children and teenagers with asthma.
California legislation enhances access to affordable care by limiting the amount hospitals can collect from low- and moderate-income patients who are uninsured or lack adequate coverage and hence face high out-of-pocket medical expenses.
Massachusetts banned ambulance diversions and helped hospitals respond to the ban by improving patient flow, leading to reductions in emergency department length of stay for admitted patients, shorter turnaround times for ambulances, and strong support from emergency department leaders who believe the ban has yielded multiple benefits.
An emergency medical services system uses a data-driven program to identify frequent 911 callers and facilitate access to community-based medical, social service, and other interventions to address their underlying needs, leading to significant reductions in emergency transports and associated costs.
An emergency department uses an eight-variable risk assessment tool to determine which patients should be tested for undiagnosed HIV, leading to the identification of the same number of HIV-positive patients as through universal screening, thus suggesting greater cost-effectiveness.
Emergency department and urgent care physicians and nurses use a protocol to help them decide how to treat patients complaining of pain who may be abusing controlled substances, leading to significantly fewer such patients receiving prescriptions for opioids.
Through a statewide telemedicine program, psychiatrists evaluate patients with mental health issues who present at rural hospital emergency departments, leading to reductions in wait times, inpatient admissions, and costs; increased attendance at followup visits; and high levels of patient and clinician satisfaction.