BRANCH OF VINCENTIAN FAMILY INVOLVED IN PROJECT: Sisters of Charity of Saint Elizabeth

NAME OF SYSTEMIC CHANGE PROJECT: De Paul Center Systemic Change Initiative

Base Practice for engaging patients in the management of their health care.

PROJECT ADDRESS: St. Joseph’s Regional Medical Center, 703 Main Street, Paterson, NJ 07503

NAME OF CONTACT PERSON: Sr. Fran Demarest

LENGTH OF TIME THE PROJECT HAS BEEN IN EXISTENCE: < one year

PROJECT WEBSITE: www.stjosephshealth.org

Using the Emergency Department for primary care services is a national problem. The uninsured and underinsured have few alternatives, therefore when an illness or sickness occurs their only option is the ER. Reasons are obvious “patients do not have alternatives i.e. insurance, easy access and or the ability to understand the process of accessing health care. At the time of discharge from the ER the discharge plan is “make an appointment with your primary care doctor (PCP). It became obvious, “If the patient had a PCP they wouldn’t be in the ER”.

Patients need direction and support to accomplish a positive outcome. With the opening of the DePaul Center at St. Joseph’s, we were in a position to begin to reshape our ambulatory primary and specialty programs. SJHMC analyzed the problem and evaluated access to our ambulatory programs. We found that we needed to be more accessible and efficient. We needed to engage patients in resolving their health issues. We could not continue to operate “as usual”. A fresh look at the needs vs. availability forced us to make available primary care when and where it can be best accessed. Therefore, we began the process of increasing access to care for uninsured and underinsured by implementing the following:

PHASE I – January – April 2010

At the time of discharge from the ER, patients without insurance or patients enrolled in Charity Care are given an appointment for follow-up services. This appointment is given before the patient leaves the ER .

This appointment occurs within the week of discharge. The location of this service is directly across the street from the hospital. The episodic problem is addressed until resolved. If patients are not enrolled in Charity Care they complete an application for Charity Care determination at the time of this follow-up visit at the Episodic Care Clinic (ECC). The ECC is located at the DePaul Center, it is esthetically pleasing, there is ample parking and the hours of operation are 4:30 pm to 8:00 pm. Monday – Friday. Approximately 10 patients are scheduled each evening, walk-ins are accepted. The ECC staff and physicians start on time, they are professional and engaging.

PHASE II – May – July 2010

To ensure Patients are assisted with establishing a “medical home” to avoid further use of the ER and ensure they receive comprehensive services, a case worker will provide them, at the time of their final ECC visit, with an appointment for a physical examination at the Family Health Center (FHC). They will then be able to have all of their health care needs through the FHC, thus avoiding the use of the ER for primary care needs.

The establishment of this process will provide a continuum of care necessary in obtaining optimum health. “Good Health” constitutes employment and or education. Both of which reduce poverty. In turn family structures change as well as attitudes and feelings of self esteem.

Evaluation – August 2010

Number of patients scheduled for ECC care.

Number of patients keeping appointments.

Number of patients scheduled for a physical at FHC.

Number of patients keeping appointments.

Cost analysis.



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