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June 28, 2017

How this health system cut young trauma patients' rehospitalization for violence to 4 percent

Daily Briefing

    Regional One Health implemented a violence-intervention program to reduce the percentage of young trauma patients who required rehospitalization—and the program is seeing dramatic results, AHA News reports.

    How to reduce avoidable visits—in the ED and beyond

    Rx for Change

    Memphis-based Regional One launched the program, called Rx for Change, in 2013 to help patients between ages 14 and 24 who had been victims of violence—including shootings, stabbings, or physical assault—avoid rehospitalization for a similar condition. Together with about 25 community partners, Regional One aims to offer patients participating in the program concrete assistance toward identifying and meeting a personal goal, ranging from vocational training and enrolling in community college to acquiring a personal identification card.

    According to AHA News, Regional One launched the program with funding allocated by the city of Memphis, and the health system has been able to sustain the program at no cost to participating patients through the hospital's foundation and various grants.

    How it works

    To enroll patients in the program, Elgin Tunstall, chief violence intervention liaison at the health system, meets with young patients who have been admitted to the health system's critical care unit to discuss the program's goals.

    Patients who decide to participate work with Tunstall to identify a personal goal they would like to achieve. As Tunstall put it, the initial visit is "when you get the opportunity to talk to them and ask, 'what is it that we need to do to make sure you don't come back here?"

    Usually, Tunstall arranges to meet the patient at his or her home within three days of discharge from the hospital. According to Tunstall, the home visit gives him a "feel for their living conditions, the environment, and an opportunity to set realistic goals that they can achieve." Via home visits and phone calls, Tunstall typically will work with the patients for anywhere from six months to a year, depending on how severely they have been injured.

    Patients are further supported through various community organizations that partner with the health system to provide patients with the tools necessary to accomplish their goals. "We could not do this alone," Tunstall explained. "By building and maintaining relationships across the community, we can address the many factors that can lead someone to choose a lifestyle of violence, and instead give them better options."

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    Positive results

    According to Regional One, prior to the program's implementation, 44 percent of trauma victims discharged from the health system were readmitted at a later date because of another instance of violence. However, among the about 180 patients who have participated so far in the program, only 4 percent have returned because of another violent incident (AHA News, 6/19).

    How to reduce avoidable visits—in the ED and beyond

    In these case studies, Advisory Board experts profile nine opportunities to use population health management to reduce avoidable emergency department visits, inpatient stays, and procedures.

    Download the case Studies

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