This report, from the National Center for Health Statistics, shows that rates of Emergency Department (ED) visits for any mental health disorder were highest among non-Hispanic Black adults (96.8) compared with non-Hispanic White (53.4) and Hispanic (36.0) adults. Adults made an average of 774,508 mental health-related ED visits per year from 2018 to 2020, accounting for 12.3% of all ED visits made by adults.

Download this list of interventions you and your hospital staff can use to help to decrease hospital use for Medicare beneficiaries who are identified as super utilizers.

On Jan. 25, TMF QIN-QIO specialists discuss strategies for reducing readmissions and increasing patient and family engagement. Also addressed: care transitions, the TMF Patient and Family Engagement Network and the Partnership for Community Health Network.

Work with your department leadership team to complete the following assessment. Each item relates to care transition elements that should be in place for a program to improve care transitions within your facility. This Care Transitions Implementation Assessment is supported by published evidence and best practices.

Work with your department leadership team to complete the following assessment. Each item relates to care transition elements that should be in place for a program to improve care transitions within your facility. This Care Transitions Implementation Assessment is supported by published evidence and best practices.

The TMF Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services, designed this change package to provide strategies to improve the quality of care transitions.

The purpose of this video is to highlight health care quality improvement interventions hospitals can implement to help manage super utilizers in the health care system.

This one-page document the Where for Care campaign developed helps guide the reader through developing a care plan before an actual medical emergency takes place.

The American Academy of Family Physicians created this handout to help care teams understand social determinants of health and how to develop a team-based care approach to identify specific patient needs and how to address those needs.

The American Academy of Family Physicians created this two-page fillable PDF document to allow a care team member to work directly with a patient to document the social determinants that may influence their health needs.

The AAMC created this five-page checklist for care team members to use to help prompt patients to provide more information about themselves, which can help identify areas of need that have historically not been addressed in the traditional clinical setting.

Download this infographic to view what The Joint Commission considers are the eight tips for high-quality patient hand offs.

Download this PDF of a PowerPoint presentation developed by the Denver Health Alliance that explores different care models to address super utilizers’ needs.

Download this one-page list of interventions you and your hospital staff can use to help reduce 30-day hospital readmissions.

Download this list of case examples from the New York State Department of Health to learn how to manage super utilizers in various care settings and/or with other service providers and nonprofit organizations.

Trauma-informed care acknowledges that understanding a patient’s life experiences is key to potentially improving engagement and outcomes while lowering unnecessary utilization.

Internists/primary care physicians and nurses: Provide this document to your patients, which includes more information to help them ascertain when to call your office for help or when to go to the emergency room for a range of conditions, including shortness of breath, heart failure, complications with diabetes and more. Patients: Use this document to help determine when to call your physician for help or when to go to the emergency department for assistance.

Internists/primary care physicians and nurses: Provide this document to your patients, which includes more information to help them ascertain when to call your office for help or when to go to the emergency room for a range of conditions, including shortness of breath, heart failure, complications with diabetes and more. Patients: Use this document to help determine when to call your physician for help or when to go to the emergency department for assistance.