Case study: Calif. hospital tests ED referral system

Emergency department crowding--particularly by patients who could be treated in primary care settings--is the bane of hospitals across the U.S. To address this issue, a growing number of hospitals are developing programs which route such patients to community clinics. Most have referral relationships with several area clinics, and help patients get treated at those clinics. In San Diego, meanwhile, the University of California San Diego Medical Center has taken the process a step further, developing a new, integrated scheduling system which streamlines the referral process greatly.

Right now, about 30 percent of the 8,000 to 10,000 patients coming through UCSD's ED don't have a primary care physician or other care manager--and are handling day-to-day care by visiting the ED. The new program, known as Impact ED, lets UCSD staffers book appointments directly in the scheduling systems used by Linda Vista Health Care Center, Mid-City Community Clinic and Mid-City Community Clinic-Pediatrics. (The clinics leave 10 appointment slots open each day for UCSD's use.) The idea is to make sure patients get the routine care they need, making them less likely to "bounce back" to the ED when they're sick again. To date, only 40 percent of patients are showing up for follow-up appointments, but administrators expect that the follow-up rate will improve over time. 

To learn more about the diversion program:
- read this Union-Tribune article

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