Social workers at KGH cutting down ER visits - NBC Right Now/KNDO/KNDU Tri-Cities, Yakima, WA |

Social workers at KGH cutting down ER visits

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KENNEWICK, Wash. -- 100 percent of Washington hospitals have signed up to participate in the Seven Best Practices program to reduce unnecessary Medicaid ER visits.

While the plan called for hospitals representing 75 percent of Medicaid visits to enroll by July 1, 2012, the coalition secured 100 percent participation by mid-June. A tremendous accomplishment.

Now the hard work begins to show a measurable difference in the trend in unnecessary Medicaid ER visits. The next milestone will be to show a reduction by January 15, 2013.

One of the seven practices involves using an extensive case management program to reduce inappropriate emergency department utilization by frequent users.

Hector DeLeon has been doing just that at Kennewick General Hospital for almost a year, before the state requirement went into affect. "Depending on the day, but on average we can screen up to 20-30 patients a day," DeLeon said. Some patients are even showing up in ER's up to 30 times a year.

DeLeon says the key is approaching the frequent users and finding out why they keep coming back, and the reason is hardly ever a medical one. " We've sent them to substance abuse facilities, I've sent people to shelters, we've connected people with welfare services. Those are the successful stories because they don't come back to the ER'," he said.

And the hospital has seen a good trend in the last few months as well. "Month to month we are seeing a decrease in those repeat, ER users..They're not coming back to the ER with the same frequency that they have been," said Lisa Teske with Kennewick General Hospital.

As of June, all the hospitals in Washington are using social workers like DeLeon to cut down on unnecessary visits. The state's new prescription monitoring system also lets hospitals within the state know which patients to watch for and to get them the help they need. DeLeon says he works with case managers with other local hospitals to keep an eye on certain patients and come up with a plan for them. He says, while the program is growing, so are the results, and he also gets many calls of appreciation a day, ten to 15 a day.

"They call you back later and thank you and say I'm doing better, I completed treatment, I got a house, I got a job," said DeLeon.