Seven Best Practice Resources

The goal of the Seven Best Practices program is to redirect care to the most appropriate setting, reduce low acuity, and reduce preventable Medicaid emergency room visits. The plan, which attempts to address the root of the problem—chronic medical conditions, substance abuse issues, and lack of primary care access—focuses on high users and will:

1. Track emergency department visits to reduce “ED shopping”;
2. Implement patient education efforts to re-direct care to the most appropriate setting;
3. Institute an extensive case management program to reduce inappropriate emergency department utilization by frequent users;
4. Reduce inappropriate ED visits by collaborative use of prompt (72 hour) visits to primary care physicians and improving access to care;
5. Implement narcotic guidelines that will discourage narcotic-seeking behavior;
6. Track data on patients prescribed controlled substances by widespread participation in the state’s Prescription Monitoring Program (PMP); and
7. Track progress of the plan to make sure steps are working.

See below for one-page document outlining Seven Best Practices. Our success will work to prevent the state from enacting payment cuts to both hospitals and physicians for emergency room services.

UPDATED Seven Best Practices [PDF]. (April 9, 2015)

WA/ACEP put together the below list of educational resources to help Emergency Departments meet each Best Practice requirement.

We hope that your ED Director has shared the below resources with you. If not, please visit each of the resources to ensure your hospital meets the requirement.

Best Practice A: Exchange patient information among emergency departments

• Information Exchange Slides (4/27/12)

Best Practice B: Help patients understand and use appropriate sources of care

• Managing Difficult Conversations
• Role of Primary Care and Community Physicians
• Brochure (contact WA/ACEP to order)

Best Practice C & D: Patient Review and Coordination (PRC) Information and PRC Client Care Plans

• Patient Review and Coordination (PRC) Slides May 1

Best Practice E: Narcotics Guidelines

• Opioid Abuse (5/2011)
• Narcotics Guidelines and Prescription Monitoring

Best Practice F: Prescription monitoring

• Prescription Monitoring Program

Best Practice G: Use of Feedback Information

Please send the following information to Amanda Avalos at HCA.

• Rate of unnecessary visits
• Rate of visits by PRC clients
• Rate of PRC clients with treatment plans
• Rate of prescriptions with long-acting opioids

Overview

• Best Practices Slides (4/19/12)
• Best Practice FAQ Sheet
• WSMA video: Reducing Preventable ER Visits (30:50)
• WSMA video: Reducing Preventable Emergency Room Visits (5:25)
• Letter from the WA/ACEP Board of Directors Regarding Opioid Guidelines

Implementing Best Practices Improves Emergency Care, Reduces Washington’s Medicaid Costs by $30 million A report on a collaborative effort of hospitals and physicians to reduce emergency visits and coordinate patient care also has good news for the Washington State budget. Preliminary data from the first 6 months of the initiative suggest the state is saving more than 10 percent in Medicaid fee-for-service emergency care costs. Read