Managing the needs of frequent attenders of urgent care services: a case management approach
evidence and practice    

Managing the needs of frequent attenders of urgent care services: a case management approach

Julie Hedayioglu Health Psychologist Researcher, Kent Community Health NHS Foundation Trust, Ashford, England and University of Kent, Canterbury, England
Jill Whibley Frequent Service User Manager, Kent Community Health NHS Foundation Trust, Ashford, England
Laura Bottle Commissioning Manager, NHS West Kent Clinical Commissioning Group, Tonbridge, England
Amy Sackree Undergraduate Student, Canterbury Christ Church University, Canterbury, England

Why you should read this article:
  • To understand the effects of frequent emergency department (ED) attendance on healthcare services

  • To familiarise yourself with the core components of case management approaches

  • To gain knowledge of the potential benefits of high-intensity user (HIU) programmes, including how they can address the needs of frequent service users

Background Frequent service users, frequent attenders and high intensity users comprise a small proportion of emergency department (ED) visits but have a significant effect on cost and workload and are often ineffectively managed in healthcare settings. A new frequent service user manager (FSUM) service was set up in west Kent. This service used a case management approach to address the issue of frequent ED attendance and to support the well-being of these patients.

Aim To evaluate a pilot FSUM service designed to address the frequent use of urgent care services.

Method Service data on demographics, loneliness, anxiety, quality of life and urgent care service use were obtained for 24 frequent service users in one west Kent ED. Interviews were also undertaken with a sample of these patients (n=4) to capture their experiences of using the FSUM service.

Results The main presenting symptoms for attending the ED were pain and alcohol-related issues. After 12 months of the FSUM service, loneliness, anxiety and use of urgent care services had reduced. The participants’ quality of life improved from baseline to four months, but then stabilised at 12 months.

Conclusion This evaluation demonstrated the value of taking a case management approach to address the needs of frequent service users. Healthcare services must encourage the appropriate use of urgent care services to reduce system pressures, but also to improve the well-being of patients.

Emergency Nurse. doi: 10.7748/en.2020.e1998

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software

Correspondence

julie.hedayioglu@nhs.net

Conflict of interest

None declared

Hedayioglu J, Whibley J, Bottle L et al (2020) Managing the needs of frequent attenders of urgent care services: a case management approach. Emergency Nurse. doi: 10.7748/en.2020.e1998

Published online: 21 April 2020

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