Submission Type

Innovation Highlight


Introduction: Services such as physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), social work (SW), care management, and elder life specialists have long been an established part of care for patients admitted to Maine Medical Center (MMC) but not for patients in the Emergency Department (ED). Methods and Results: Driven in part by changes in Medicare reimbursement models, care management established a presence in the Emergency Department (ED) in 2003 with a focus on care planning and cost avoidance. In recent years PT, OT, SLP, SW, and the Hospital Elder Life Program (HELP) have increased their ED involvement substantially. These services not only support care management decisions but have become an invaluable part of the ED team. The timing, staffing models, and roles of these services in our emergency department are described. Discussion: There was strong leadership support to create these positions in the ED. Increased patient volume hospital wide has required staffing flexibility. Initial concerns for slowing the ED where anecdotally resolved. Other hospitals in our system are interested in this approach. Conclusions: While the value of this work feels self-evident and is already established for admitted patients, descriptive and outcome-oriented studies for ED patients would be enlightening.



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