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Rural Project Examples: Emergency department and urgent care services

Effective Examples

Midcoast Maine Prescription Opioid Reduction Program
Updated/reviewed March 2017
  • Need: Reduction in the number of emergency department dental patients abusing opioid prescriptions in rural southeastern Maine.
  • Intervention: Using a one-page opioid prescription guideline, opioid prescribing and emergency room visits for dental pain decreased.
  • Results: The rate of opioid prescription dropped nearly 20% after implementation, and in comparing the 12-month period before and after implementation, dental pain emergency department visits decreased from 26 to 21 per 1,000.

Other Project Examples

Piedmont Mountainside Hospital's Freestanding Emergency Department
Added December 2017
  • Need: The North Georgia Medical Center (NGMC) of Ellijay, Georgia had been losing money and patients. Many residents living in Ellijay were seeking hospital care elsewhere, leaving NGMC treating an average of only 6 patients in the year prior to closing their doors in 2016.
  • Intervention: With approval from the state, Piedmont Mountainside Hospital (PMH) leased the space from NGMC and opened the state's first freestanding emergency department. Medical services were again made available for patients in Ellijay and surrounding areas.
  • Results: Within the first 6 months of operation, over 5,000 emergency visits were made to the freestanding ED, an average of 30 patients per day.
SCDMH Emergency Department Telepsychiatry Consultation Program
Added December 2017
  • Need: The shortage of mental health professionals in rural South Carolina resulted in an influx of patients admitted to emergency departments who were in need of psychiatric care.
  • Intervention: South Carolina Department of Mental Health partnered with the Duke Endowment to create the SCDMH Emergency Department Telepsychiatry Consultation Program. Rural emergency departments can now reach a psychiatrist to assess a patient via telehealth.
  • Results: The program has improved access, affordability, and provided quality care for rural providers and patients with mental illness.
Regional Behavioral Health Network
Updated/reviewed April 2017
  • Need: Multiple organizations in five rural counties of east central Illinois were struggling with how to treat patients with behavioral health issues or how to access services for them in a timely manner.
  • Intervention: The Regional Behavioral Health Network was established with a 24-hour toll-free crisis line, providing immediate access to trained crisis clinicians.
  • Results: Improved access to and a higher quality of behavioral healthcare for patients in rural east central Illinois.
Simulation in Motion-South Dakota (SIM-SD) EMS Educational Outreach Program
Updated/reviewed January 2017
  • Need: To provide increased educational opportunities for emergency care personnel in rural and frontier South Dakota.
  • Intervention: A technologically advanced training was created to enhance the delivery of emergency patient care.
  • Results: Hundreds of EMS staff and volunteers received training that in turn helped them in the field of emergency patient care.
funded by the Federal Office of Rural Health Policy Health Care Coalition of Lafayette County’s Heath Information Technology Workgroup
Updated/reviewed September 2016
  • Need: To ensure the quality and sustainability of rural West Central Missouri's health services through the use of technology.
  • Intervention: The Health Care Coalition of Lafayette County convened a Health Information Technology (HIT) workgroup to establish electronic medical and prescription records, telemedicine capabilities, and training for Lafayette County and surrounding areas.
  • Results: The workgroup fully equipped a local emergency department with HIT, launched electronic prescriptions for nearly a dozen Lafayette County providers, and identified acute needs hindering the adoption of electronic health records.
Level One Cardiac Care and Partnership
Updated/reviewed March 2016
  • Need: Fast diagnosis and stabilization in order to survive a cardiac emergency in the rural areas around Davenport, Washington.
  • Intervention: Lincoln Hospital is prepared to quickly assess needs, deliver medications, and air transport heart attack patients to Sacred Heart Medical Center in Spokane, Washington.
  • Results: Increased survival rates and other quality of life outcomes for heart attack patients from the rural areas of Lincoln County, Washington.
Recovery-Oriented System of Care (ROSOC)
Updated/reviewed January 2016
  • Need: To serve adults in Mendocino County, California with chronic substance use disorders, mental health diagnoses, and/or complex medical conditions who frequently utilize emergency departments and jail services.
  • Intervention: A safety net organization was formed that works with medical providers and law enforcement to reduce the high cost of caring for frequent utilizers through intensive care coordination activities.
  • Results: Greater overall stability in the lives of clients, with less utilization of low-efficacy, crisis-oriented services, hospitalizations, and incarcerations.