Rural Project Examples: Emergency department and urgent care services
Midcoast Maine Prescription Opioid Reduction Program
Updated/reviewed May 2020
- 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
SCDMH Emergency Department Telepsychiatry Consultation Program
Updated/reviewed February 2023
- 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 (SCDMH) partnered with The Duke Endowment to create the SCDMH Emergency Department Telepsychiatry 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.
Maine Critical Access Integrated Paramedics
Added August 2022
- Need: With the nearest hospital more than an hour away, the local community health center in rural Jackman, Maine struggled to maintain its ability to offer 24/7 care to due to staffing and budgetary challenges.
- Intervention: Critical Access Integrated Paramedics provide urgent care to patients after hours and on weekends.
- Results: The Jackman Community Health Center has been able to offer round-the-clock care to clinic patients, while also increasing the level of EMS service available to the community.
Regional Behavioral Health Network
Updated/reviewed April 2022
- Need: Multiple organizations in rural 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.
Tele-ICU for Veterans
Updated/reviewed June 2021
- Need: To enhance care for patients in critical condition.
- Intervention: Two VA facilities in Oklahoma and Ohio are connected through audiovisual equipment using smart technology in order for providers to monitor patients and consult with clinical staff at the bedside.
- Results: From October 2019 to April 2021, there were 11,058 video assessments performed on ICU patients at the Oklahoma facility by tele-ICU staff. This resulted in 17,578 hours of patient care time.
Simulation in Motion-South Dakota (SIM-SD) EMS Educational Outreach Program
Updated/reviewed January 2021
- 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 emergency medical services (EMS) staff and volunteers received training that in turn helped them in the field of emergency patient care.
HCC of Lafayette County's Heath Information Technology Workgroup
Updated/reviewed January 2019
- 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.
Piedmont Mountainside Hospital's Freestanding Emergency Department
Updated/reviewed December 2018
- Need: The North Georgia Medical Center (NGMC) of Ellijay, Georgia had been slowly losing money and patients for years. Many residents living in Ellijay were seeking hospital care elsewhere, leaving NGMC treating an average of only 6 patients per day 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 (ED). Medical services were again made available for patients in Ellijay and surrounding areas.
- Results: After one year of being open, the freestanding ED continues to average 30 patients per day and has reached over 11,000 emergency room visits.
For examples from other sources, see: