Improve Community Health  through Cross-Referrals

Emergency Departments around the country do a great job diagnosing patients and treating them for specific injury and illness. But how often do they consider the overall health of the patient before discharging them into the community? While most hospitals' missions include a commitment to improving community health or advocating preventative health, we often are so focused on symptoms, disease, illness, and injury that we miss this opportunity to be proactive. Cross referrals for health care screening and preventative services improve community health through early intervention. They also raise patient satisfaction and reduce marketing/advertising expense. This is because patients are captured within the organization when they visit the ED or an inpatient facility. Volume and market share increase. A few examples...

Three Ways to Capture Cross-Referrals:
1. Review patient records in the Women's Services Department.
One hospital set a goal of increasing volume 30 percent in bone density scans and mammography. When the director of Women's Services pulled patient records, she learned that staff were not tracking and reminding past patients about appropriate follow-up visits. Hardwiring follow-up increased volume from 2 to 30 percent annually.

2. Identify all prior hospital patients who are age forty.
Once the IT department has pulled these patient records, send them a reminder postcard about the importance of getting a mammogram, bone density scan, colonoscopy, or other age-appropriate diagnostic tests.

3. Ensure ED patients know about health screenings and other services the hospital provides.
One hospital uses the outside of the envelope that contains discharge instructions to list contact information for their physician directory, health screenings, seminars and classes. Another ED gives each of its patients a simple age and gender-based checklist of recommended tests and screenings at triage to assist them in considering preventative care.

"...we often are so focused on symptoms, disease,
illness, and injury that we miss this opportunity to
be proactive."

If, for example, a 40 year old female is seen in the ED for a fractured wrist, the checklist might remind her she is due for a mammogram. This gives physicians and staff the opportunity to say, "Here at St. Mary's Hospital, we are committed to your total health and I notice you have never had a mammogram. Mammograms have proven to be so effective at early detection of cancer that I'd like for you to set up an appointment with your family physician at your soonest convenience. Is it okay if Annie, our registrar, makes an appointment for you now?”

What about the indigent? If we don't help them proactively, we will see them in our Emergency Departments anyway for services that are more expensive to provide. By increasing volume through cross-referral of medically approved protocol services, we also find a way to pay for the indigent care we often already provide.