ED Community Placement Project (EDCPP): “Right Service-Right Venue”

Background:San Diego has the 3rd largest homeless population in the United States, second only to New York and Los Angeles. Nearly one-third of all visits to the emergency room are made by people who struggle with chronic homelessness coupled with co-occurring disorders. Emergency departments (ED) are not equipped to meet the psychosocial needs of homeless community members and do not have the capacity to assist them with housing, substance abuse treatment, and mental health care.

Goal Statement: The goal for this project was to identify the costliest and in need patients, then provide resources to address their substance abuse, homelessness and mental health issues and to reduce recidivism among this population by 20%.  

Description of Innovation: The “Emergency Department Community Placement Project” (EDCPP) is designed to bridge the highest ED users into community based homeless prevention services, substance abuse treatment, and intensive case management. Upon discharge patients meeting inclusion criteria are screened, refereed and placed upon discharge into contracted community partners to receive unique services fitted to meet their psychosocial needs.  

Participants: Nurse-Led multi collaborative project between hospital and community.

• ED Outreach Manager

• Community Partners: St Vincent de Paul, San Diego Rescue Mission, and Volunteers of America

• ED Social workers

• ED Staff

Outcomes: Phase II of project has shown a continued downward trend in reduction of ED revisits and inpatient visits.

Implications: Cost benefits savings of $168,231 (based on program expenses, of $38,234 (6mos) = 4 .4 (ROI)). Among EDCPP placed patients a 78% reduction in recidivism was seen.  Press-Ganey patient satisfaction scores increased by 3.8%.

Recommendations for future projects: Acquire additional community partners and expand project throughout the UC System.

Outcomes: Phase II of project has shown a continued downward trend in reduction of ED revisits and inpatient visits.

Implications: Cost benefits savings of $168,231 (based on program expenses, of $38,234 (6mos) = 4 .4 (ROI)). Among EDCPP placed patients a 78% reduction in recidivism was seen.  Press-Ganey patient satisfaction scores increased by 3.8%.

Recommendations for future projects: Acquire additional community partners and expand project throughout the UC System.