College
School of Nursing
Graduate Level
Doctoral
Graduate Program/Concentration
Nurse Executive
Presentation Type
Poster Presentation
Abstract
PROBLEM: Emergency department (ED) utilization is a measure the effectiveness of the department and an indication of the availability of primary care in the community. The ED of a given healthcare system can be overwhelmed with patients seeking both urgent and non-urgent care, especially in rural and underserved communities. Non-urgent care accounts for over a half of all visits in most EDs. Much of this non-urgent care in the ED is caused by several socioeconomic factors including access to care around working schedules, no requirement for payment when services are rendered, and a lack of a primary care provider. Mobile clinics have been employed to increase access to care for non-urgent care outside of the ED while being conscience of the socioeconomic factors of a community. The Old Dominion University (ODU) Mobile Medical Clinic (MMC) is a nurse run clinic that began operating in Southampton County, Virginia in the Summer of 2023 to support access to care and provide care in an underserved community.
OBJECTIVE: The purpose of this study is to explore whether there is a reduction in the proportion of non-urgent care, the total volume of care, left without being seen, and post-admission volume at the ED at Southampton Medical Center when the MMC is deployed in the community.
RESEARCH METHODS: A longitudinal study looked at the casual ED visits for all adult patients for approximately six months. The proportion of non-urgent visits, overall ED volume of care, and the proportion of left without being seen and post-admission patients were calculated and compared via independent t-test and chi-square analysis to determine if there are any statistically reductions when the mobile clinic is available.
IMPLEMENTATION METHODS: The MMC is fully staffed by board certified nurse practitioners and supported by nurse practitioner students from ODU. Over the study period, the availability of the MMC increased and the locations of care adjusted to allow for maximum visibility and ease of access. Cost free services were initiated and increased over this time. A casual review of administrative level ED metrics were reviewed and compared between days the MMC is and is not available in the community.
RESULTS: There were no significant reduction non-urgent visits, the proportion of left without being seen, or the proportion of post-admissions identified when the mobile clinic is available. There was an unexpected increase in the total volume of care in the ED when the MMC was deployed.
SIGNIFICANCE: The average cost of emergency care in the Commonwealth of Virginia $1,941 in 2024 for approximately 3.7 million annual visits. The reduction in the volume of non-urgent care, plus the increase in access to primary care offered by a mature MMC program could lead to a significant cost savings for the entire community health system while increasing the increasing preventative and primary care to an underserved population. These early results are inconclusive simply because of the youth of the program and the relatively short study period.
Keywords
Mobile Clinic, Access to Care, Nonurgent Care, Nurse run clinic, Healthcare Administration, Community Care
Included in
Mobile Clinic Effects on a Rural Emergency Department
PROBLEM: Emergency department (ED) utilization is a measure the effectiveness of the department and an indication of the availability of primary care in the community. The ED of a given healthcare system can be overwhelmed with patients seeking both urgent and non-urgent care, especially in rural and underserved communities. Non-urgent care accounts for over a half of all visits in most EDs. Much of this non-urgent care in the ED is caused by several socioeconomic factors including access to care around working schedules, no requirement for payment when services are rendered, and a lack of a primary care provider. Mobile clinics have been employed to increase access to care for non-urgent care outside of the ED while being conscience of the socioeconomic factors of a community. The Old Dominion University (ODU) Mobile Medical Clinic (MMC) is a nurse run clinic that began operating in Southampton County, Virginia in the Summer of 2023 to support access to care and provide care in an underserved community.
OBJECTIVE: The purpose of this study is to explore whether there is a reduction in the proportion of non-urgent care, the total volume of care, left without being seen, and post-admission volume at the ED at Southampton Medical Center when the MMC is deployed in the community.
RESEARCH METHODS: A longitudinal study looked at the casual ED visits for all adult patients for approximately six months. The proportion of non-urgent visits, overall ED volume of care, and the proportion of left without being seen and post-admission patients were calculated and compared via independent t-test and chi-square analysis to determine if there are any statistically reductions when the mobile clinic is available.
IMPLEMENTATION METHODS: The MMC is fully staffed by board certified nurse practitioners and supported by nurse practitioner students from ODU. Over the study period, the availability of the MMC increased and the locations of care adjusted to allow for maximum visibility and ease of access. Cost free services were initiated and increased over this time. A casual review of administrative level ED metrics were reviewed and compared between days the MMC is and is not available in the community.
RESULTS: There were no significant reduction non-urgent visits, the proportion of left without being seen, or the proportion of post-admissions identified when the mobile clinic is available. There was an unexpected increase in the total volume of care in the ED when the MMC was deployed.
SIGNIFICANCE: The average cost of emergency care in the Commonwealth of Virginia $1,941 in 2024 for approximately 3.7 million annual visits. The reduction in the volume of non-urgent care, plus the increase in access to primary care offered by a mature MMC program could lead to a significant cost savings for the entire community health system while increasing the increasing preventative and primary care to an underserved population. These early results are inconclusive simply because of the youth of the program and the relatively short study period.