View in EDS

Implementation of an Acute Care Clinic Model to Improve Access to Care and Reduce Low Acuity Emergency Department Use.

Saved in:
Bibliographic Details
Title: Implementation of an Acute Care Clinic Model to Improve Access to Care and Reduce Low Acuity Emergency Department Use.
Authors: Bellantoni, Julia, Katz, Maya, Hayes, Jason, Peng, Mandy, Purdy, Harrison, Schilling, Lisa M., Lum, Hillary D., Juarez‐Colunga, Elizabeth, Mahi, Mahfuza Haque, Shanbhag, Prajakta, Tietz, Sarah
Source: Journal of the American Geriatrics Society. Jun2026, Vol. 74 Issue 6, p1738-1746. 9p.
Subjects: Health services accessibility, Medical care use, Elder care, Human services programs, Research funding, Emergency room visits, Evaluation of human services programs, Outpatient medical care, Primary health care, Clinical trials, Descriptive statistics, Research methodology, Quality assurance, Clinics, Data analysis software, Critical care medicine, Regression analysis, Old age
Abstract: Background: High utilization of the emergency department (ED) by older adults contributes to adverse health outcomes and increased cost of care. Studies have investigated interventions aimed at reducing low acuity ED visits, with increased primary care accessibility being among the most effective. This paper aims to describe the implementation of a novel acute care clinic model to improve same‐day availability for urgent concerns within geriatric primary care. Methods: We conducted a quasi‐experimental difference‐in‐differences (DID) analysis to evaluate the impact of an Acute Care Clinic (ACC) model implemented within an outpatient geriatrics clinic between March 2022 and August 2023. Patient‐level descriptive statistics were used to characterize ACC patients. Clinic‐level outcomes were compared between geriatrics clinic patients (including ACC patients) and a reference group of patients who receive primary care at internal medicine clinics within the same health system using monthly aggregated data over a 24‐month period (6 months pre‐ and 18 months post‐intervention). Results: There were 1102 ACC visits (764 distinct patients) in the implementation period. ACC patients were more medically complex than both the geriatrics clinic overall and the reference group (average HCC score 2.4). Same‐day labs were ordered in 34% of ACC visits and same‐day imaging was ordered in 15% of ACC visits. Compared to the reference group, the geriatrics clinic showed a potentially greater reduction in calls escalated due to lack of same‐day access (−3.1%; p = 0.08) and a larger increase in same‐day scheduling (+2.8%; p = 0.13), though neither reached statistical significance. Conclusions: An ACC model was successfully implemented within a geriatric primary care clinic and there was a trend toward improvement in same‐day clinic access for these medically complex older adults. Further review of patient triage processes, financial impact, and patient satisfaction is needed for program evaluation, refinement, and expansion. Summary: Key points ○An acute care clinic (ACC) was successfully implemented within geriatric primary care to improve access for urgent low acuity concerns.○While no statistically significant difference in low acuity Emergency Department visits or patient access was found after implementation, there was a trend toward improvement in same‐day clinic access.○The ACC was identified as clinically meaningful to clinic and operational leaders and has been permanently implemented as a service in the geriatric primary care clinic.Why does this paper matter? ○This paper describes the implementation and initial program evaluation of a model of care designed to improve access for urgent concerns within geriatric primary care. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Background: High utilization of the emergency department (ED) by older adults contributes to adverse health outcomes and increased cost of care. Studies have investigated interventions aimed at reducing low acuity ED visits, with increased primary care accessibility being among the most effective. This paper aims to describe the implementation of a novel acute care clinic model to improve same‐day availability for urgent concerns within geriatric primary care. Methods: We conducted a quasi‐experimental difference‐in‐differences (DID) analysis to evaluate the impact of an Acute Care Clinic (ACC) model implemented within an outpatient geriatrics clinic between March 2022 and August 2023. Patient‐level descriptive statistics were used to characterize ACC patients. Clinic‐level outcomes were compared between geriatrics clinic patients (including ACC patients) and a reference group of patients who receive primary care at internal medicine clinics within the same health system using monthly aggregated data over a 24‐month period (6 months pre‐ and 18 months post‐intervention). Results: There were 1102 ACC visits (764 distinct patients) in the implementation period. ACC patients were more medically complex than both the geriatrics clinic overall and the reference group (average HCC score 2.4). Same‐day labs were ordered in 34% of ACC visits and same‐day imaging was ordered in 15% of ACC visits. Compared to the reference group, the geriatrics clinic showed a potentially greater reduction in calls escalated due to lack of same‐day access (−3.1%; p = 0.08) and a larger increase in same‐day scheduling (+2.8%; p = 0.13), though neither reached statistical significance. Conclusions: An ACC model was successfully implemented within a geriatric primary care clinic and there was a trend toward improvement in same‐day clinic access for these medically complex older adults. Further review of patient triage processes, financial impact, and patient satisfaction is needed for program evaluation, refinement, and expansion. Summary: Key points ○An acute care clinic (ACC) was successfully implemented within geriatric primary care to improve access for urgent low acuity concerns.○While no statistically significant difference in low acuity Emergency Department visits or patient access was found after implementation, there was a trend toward improvement in same‐day clinic access.○The ACC was identified as clinically meaningful to clinic and operational leaders and has been permanently implemented as a service in the geriatric primary care clinic.Why does this paper matter? ○This paper describes the implementation and initial program evaluation of a model of care designed to improve access for urgent concerns within geriatric primary care. [ABSTRACT FROM AUTHOR]
ISSN:00028614
DOI:10.1111/jgs.70404