Patients who attend emergency departments five or more times a year account for 11% of attendances. The West National Institute for Health and Care Research Applied Research Collaborative (NIHR ARC) evaluation of the programme supporting high impact users in emergency departments’ (SHarED) found attendance went down 33%.
These patients are known as ‘high impact users’. High impact users often experienced extremely challenging situations in their lives, such as violence, exploitation, alcohol and drug abuse, homelessness, chaotic life conditions, chronic pain, complex medical conditions, and, particularly, mental health conditions.
The Health Innovation West of England programme ‘Supporting high impact users in emergency departments’ (SHarED) aimed to improve the management of high impact users. Working with six EDs in the region, SHarED helped staff identify, proactively manage, monitor and review these patients. A key part of the programme was personalised care plans with information about the patient’s situation and health conditions. The plans helped staff engage with patients about their behaviour and needs, and gave recommendations on how to interact with and care for them.
The evaluation showed SHarED was successful in reducing ED attendance and hospital admissions among high impact users, while improving their care. ED attendance went down by 33% and hospital admissions reduced by 67% for those high impact users enrolled in SHarED where data was available.
Read the case study in full here…
