Decreasing Preventable Emergency Department Visits Using the Patient Activation Measure

Abstract

Problem: Chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) are chronic conditions and common causes of death and disability in the United States that lead to emergency department (ED) overutilization. In individuals with these conditions, unnecessary use of the ED can adversely affect health outcomes, significantly increase healthcare expenditures, and result in poor quality of care (Soril et al., 2015). Emergency Department overutilization occurs for a variety of reasons, however, poor education on disease self-management is a major contributor (Cerisier, 2019). Purpose: This project sought to determine if administering the short-form Patient Activation Measure (PAM-13) survey in the ED and providing additional educational resources decreases unnecessary 30-day ED return visits among patients with COPD and CHF who score an activation level of 2 or less, when compared to the standard care. Methods: A hospital-based, quality improvement project was implemented using a convenience sample of patients ≥ 18 years old presenting to the ED with a chief complaint related to their diagnosis. The PAM-13 survey was used to determine each participant’s level of activation in their own healthcare prior to the educational intervention. Results: The average PAM-13 score indicated a need for improvement in disease self-management among this population. A significant difference was found in the number of 30-day return visits among participants that received the educational intervention. No correlation was found between low PAM-13 scores and frequent ED visits among the participants. Significance: This project supports the need for improved education in the ED for COPD and CHF patients to improve self-disease management, thus decreasing unnecessary ED visits and poor outcomes.