Emergency department frequent visitors receiving proactive support to relieve ED pressure

Group of five people smiling to camera
Members of the HIUS team (L-R): Claire Jones, Royce Zanetic, Linley Speijers, Chris Waters and Dan Kelsey-Wilkinson
September 27, 2022

According to the Sustainable Health Review, five per cent of people who present to emergency departments (EDs) in Western Australia account for 20 per cent of all presentations. Furthermore, 164 people came to the Fiona Stanley Hospital (FSH) ED ten or more times in a twelve-month period, accounting for more than 2,270 presentations totaling a staggering 702 days spent in the ED.

To help address this issue, the Kaartdijin Innovation team and FSFHG Mental Health Services have turned their sights to the highly successful NHS model called High Intensity Use Service (HIUS). In partnership with the UK-based founder of HIUS, project co-leads Sarah Rooney and Claire Jones adapted the model for our community and recently kicked off the HIUS trial at Fiona Stanley Fremantle Hospital Group (FSFHG).

Project co-lead Claire Jones said that much of the time people who present frequently to EDs have underlying unmet psychosocial needs and the HIUS model looks at what other supports and services are available outside of EDs, to provide a better patient experience and improved patient outcomes.

“HIUS takes a humanistic approach to determine the root cause for their visits to the ED,” Claire said.

“The frequent visitors are engaged by our HIUS team, that includes a senior social work, senior occupational therapist and peer support workers, outside of the ED via face-to-face community visits and telehealth.

“We use an individualised approach to help empower each person to maintain their own health and wellbeing, and also connect them to their community and the resources available to them.”

Project co-lead Sarah Rooney said while the HIUS team is only weeks into the trial, they are already seeing great outcomes for the participants.

“The focus of the trial is embedding the model of service and delivery of care, learning as a team, collaborating with community and hospital service providers, and building the cohort of people we are working with,” Sarah said.

“We’re only weeks into the trial and have started to see some great results in terms of redirecting care away from our busy ED to services already established in the community.

“Following the trial’s completion in December, we hope to scale HIUS up to best support more Western Australians and further relieve the pressure on our State’s EDs.”

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