A sample lesson learned: All-too-frequent users

(Editor’s note: This lesson was submitted by San Francisco VAMC, Dec. 1, 2000.)

A small number of patients were using the urgent care clinic in an excessive and inappropriate manner. A computer review identified patients who had made three or more visits to the urgent care clinic. They were invited to participate in a monthly group clinic for high users of the medical practice urgent care clinic. The health education curriculum emphasized resources available through the VA Medical Center as well as overall health promotion.

Of the 60 high users identified, 18 participated in the group clinic. The mean number of sessions attended by these participants was 4.4. Before the intervention, the mean number of participants’ visits to the urgent care clinic was 5.7; this decreased to 1.8 visits in the year during which the group clinic was instituted.

This decrease was statistically significant, with a p value less than .0001. All patients who completed an evaluation form at the end agreed that the group clinic was a useful way to spend their time and that the sessions helped them understand better how to access VAMC services.

[For further information, contact:

Sharad Jain, MD, Assistant Chief of the Medical Service, San Francisco VAMC. Telephone: (415) 221-4810, ext. 3739.

View the full lesson on the Virtual Learning Center web site at www.va.gov/med/osp/cgi-bin/browse.asp?lesson=1387.]