Establishing learning collaboratives to facilitate quality improvement: Insights from a learning community to reduce non-urgent use of emergency services

A promising approach to translating evidence-based strategies into community settings is to establish learning collaboratives. Accordingly, the Health Care Innovations Exchange, sponsored by the U.S. Agency for Healthcare Research and Quality, established the Reducing Non-Urgent Emergency Services Learning Community (ESLC).

Many patients seek treatment at the emergency department for non-urgent or chronic conditions that are best cared for in other settings. The most common diagnoses for high utilizers are behavioral health conditions (Jiang, et. al., 2014). This results in unnecessarily high costs of care and has significant consequences for both patients and the health care system. Patients may receive fragmented care and inadequate management of underlying medical, behavioral, and psychosocial needs, while emergency services are overburdened and struggling with allocating limited resources. To address this issue, the ESLC, located in the Detroit metropolitan area, adapted a cluster of evidence-based practices for the local context to identify individuals who frequently misuse emergency services and to connect them to more appropriate outpatient care settings. The ESLC consisted of private and public organizations in the community that deliver emergency medical services, behavioral and primary health care, and support services. Participants received technical assistance and support from nationally recognized experts.

This presentation will share the theoretical framework used to develop the learning community, as well as lessons learned from using the ESLC to implement this quality improvement initiative in the Detroit community.