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PASCO -- Local hospital and community health officials were surprised to learn that parents with young children were among those most likely to use an emergency room as their primary source of medical care.
Lourdes Health Network, Community Health Center La Clinica and Miramar Health Center teamed up on a project about a year ago to find ways to divert people from emergency rooms when an ER visit wasn't need.
Instead, the goal was to find a "medical home" for these patients, many of whom are on Medicaid and have no family physician or primary health care provider.
The project is funded through a two-year, $352,000 grant from the state Department of Social and Health Service that pays for staff at all three locations to help patients learn how to get the right medical care at the right time and in the right place, said Erin Tomlinson, the grant writer for Lourdes Foundation.
The Tri-Cities was one of four communities in the state to receive a grant, in part because of the unique proposal by Lourdes to work with the two community clinics.
"All three organizations share similar missions and target similar populations," Tomlinson said. "This was a wonderful opportunity to do something to open doors to access (to care)."
While the three target similar populations, they found through the course of the project's first year that the population inappropriately using the emergency department for primary care wasn't quite as broad as they expected.
"We are finding a lot of parents with young children," Tomlinson said.
As the parent of three children, Tomlinson said she understands that the decision to take a sick child to an ER is an emotional one.
Janet Wright, Lourdes' vice president of patient care services, said ERs are the traditional health care safety net where people know they can get treated.
"It's the easiest choice," Wright said. "It's always the most expensive choice, but it is the easiest with quickest access."
The project has four components offered at each of the three locations: an after-hours nurse triage telephone line, on-site case management, on-site behavioral management counseling and an education and awareness campaign.
Once those involved realized who most needed intervention, they were able to craft the education portion to address the needs of parents with young children, Tomlinson said.
One of the most important pieces is connecting families with a primary care physician with whom they can build a trusting relationship so they'll feel comfortable going to their own doctor when they or their children need care.
"That opens up (emergency) services for those who truly do need to be there," Tomlinson said.
The on-site case manager helps direct patients -- once they've been seen and treated in the ER -- to follow-ups with a primary care physician who can get to know the patients' history and needs.
The case managers check in with patients after their ER visits and make sure they're getting the follow-up care.
Wright said that ultimately will save the patients money and ensure they get better quality care.
Blanca Leal, front office supervisor for Miramar, said the after-hours nurse triage line offers patients a number to call to talk about symptoms and decide whether an ER visit is necessary.
The on-site behavioral management counselor helps people learn to manage chronic illnesses such as diabetes with behavioral modifications.
La Clinica CEO Carl Walters II said the project has shown the two clinics where they needed to expand services or hours to provide patients with an alternative to the emergency room.
The project also has encouraged the three health care providers to put aside any competitiveness and work together for the sake of the community, Walters said.
"This has been an absolutely wonderful partnership, he said. "If you look at where the nation is going toward integration of behavioral and medical services ... this fits in well."
-- Michelle Dupler: 582-1543; mdupler@tricityherald.com
