Hospitals in pursuit of excellence

Identify and Intervene with Emergency Department Super-Users

At Brigham and Women’s Hospital, a small group of challenging patients account for a disproportionate share of emergency department visits. Between March 2013 and February 2014, 50 patients accounted for 1,083 visits, or 1.7 percent of the total volume. We designated these patients ED super-users. This level of ED overuse is associated with non-ideal care that is often targeted toward solving acute issues and unsuccessful in addressing chronic care needs or social issues underpinning the frequent ED use. For the hospital, ED super-use increases costs and frustrates provider staff.