Contingency Planning

“A child is in respiratory distress. Mom panics and calls an ambulance. On their way to an ED, she remembers their doctor shared her personal number.”

Collaborating with families to better understand how to prevent an emergency department (ED) visit provided input that strengthened strategies for avoiding future ED use. Care plans were designed for each child with medical complexity (CMC) to not only include family-centered goals, but action steps for families to use after-hours or in emergencies. One essential component of the care plan was contingency plans, which offers instructions for parent action when the child experiences a change in condition that describes how and when to contact the appropriate clinical provider for health care issues. These plans are developed from scenarios, suggested by families, that are likely to result in an ED visit.

Mike Aubin, CEO, Wolfson Children’s Hospital, talked about the importance of contingency plans with a story involving one of their patients. “After Mom made the call, our physician, Dr. Komatz, then asked to speak to the paramedic, and requested they take the child to one of our satellite pediatric emergency centers instead. Dr. Komatz then called ahead to the satellite center and let them know they needed to just do one thing to resolve the problem, which prevented unnecessary testing and avoided a hospital admission.”


Reducing Medical Spend for CMC

To effectively manage costs for CMC, hospitals in the CARE Award focused on building alternative payment models that support and sustain care delivery transformation.


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