AHRQ proposes ED discharge tool pilot study

The Agency for Healthcare Research and Quality (AHRQ) is proposing a pilot study that leverages an emergency department (ED) discharge tool to reduce unnecessary visits, cut healthcare costs and streamline the quality of care delivered to ED patients, according to an Aug. 27 Federal Register notice.

The AHRQ is seeking approval from the Office of Management and Budget for a pilot at three Johns Hopkins EDs in Baltimore that will test a prototype ED discharge tool in a limited number of settings. The pilot will assess the feasibility for use with patients; the methodological and resource requirements associated with tool use; the feasibility of measuring outcomes; the costs of implementation; and preliminary outcomes or impacts of tool use. The study would revise the tool based on the results from the pilot test, according to the notice.

Specifically, ED staff will utilize the tool to identify patients who excessively use the ED and target interventions to reduce readmissions. Frequent ED use is defined as: one or more previous ED visit within the last 72 hours; two or more previous ED visits within the last three months, or three or more ED visits within the past year.

The discharge tool would collect data from the patient's record and from the patient himself to identify individuals with risk factors associated with readmission. A user manual also will be provided to assist in adopting appropriate interventions. High-risk patients will receive follow-up phone calls with staff inquiring about ability to acquire insurance, medication regimens and other issues. Also as part of the study, AHRQ will perform focus groups of patients, ED personnel and tool implementers to determine the impact of the tool, according to the notice.

The AHRQ requested Office of Management and Budget approval for the pilot; the agency is accepting public comment on the proposed project through Oct. 28.

To view the full notice, go here.