Hospital Admissions, Emergency Department Visits Decline Following Sickle Cell Education

A Centers for Medicare & Medicaid Services (CMS) special innovation project to improve acute pain management in Sickle Cell Disease (SCD) patients that originated in Memphis, TN will be is being expanded to a national scale. The project which is a collaborative effort between the Qsource, the Sickle Cell Foundation of Tennessee, specialized sickle cell centers and hospitals, emphasizes:

  • education of the Emergency Department (ED) staff,
  • increasing the availability and use of care plans in the ED,
  • improved care coordination between hospitals and sickle cell centers or healthcare providers, and
  • addressing cultural stigmas around the disease.

Sickle cell disease is an inherited genetic blood disorder that causes red blood cells to be sickle-shaped instead of round. This can lead to acute and chronic pain, pain crisis, progressive organ damage, and death. Pain drives the majority of patient interactions with the healthcare system, particularly the EDs. Because the disease is rare in the United States, there is a lack of training about appropriate treatment guidelines among those who provide care in the ED which can result in insufficient care.

In Memphis, Qsource sponsored events that provided education to approximately 300 clinicians and healthcare navigators through face-to-face meetings and on-demand learning webinars. These educational events featured nationally recognized leaders including prominent patient advocate Dominique Friend and Dr. Patricia Kavanagh, a physician and quality improvement expert who has worked with more than 30 hospitals across the country to improve the way SCD patients are cared for in their EDs. Over the course of two days, Kavanagh and Friend worked closely with ED physicians, nurses and hospital leadership from seven acute care hospitals in Memphis to share information about the disease and its unpredictability and current National Heart, Lung and Blood Institute guidelines for acute pain crisis. She will return to Memphis this month to train additional healthcare providers.

Qsource also offered a monthly learning series for people with SCD in partnership with the Sickle Cell Foundation of Tennessee. Topics included: proper hydration and stress management; care coordination between various providers; emergency room engagement and visit preparation and self-advocacy. Education to consumers intentionally stressed the benefits of aligning with a medical home and often included information related to resources available through the local SCD centers. The work over the past two years has been focused on connecting patients with SCD Centers that deliver high-quality, comprehensive care designed specifically for individuals with SCD. These centers provide patients with more timely pain management services than can typically be given in the ED which has been associated with a decrease in ED visits and inpatient admissions that originate from the ED.

In the coming months, Qsource will spread lessons learned locally to hospitals across the country, amplifying the voices of those living with this disease. The Alliance has partnered with the American College of Emergency Physicians (ACEP), which has a current reach of over 37,000 members, and Paula Tanabe, PhD, RN, FAEN, FAAN, Professor of Nursing and Medicine, Duke University. They will conduct educational events emphasizing current treatments, best practices, patient perspectives and innovations in the management of SCD.