Targeting Top 911 Callers Trims Cost and Improves Patient Care

Repeated unnecessary 911 calls are a common drain on the manpower and finances of emergency medical services, but a pilot program that identified Baltimore City’s top 911 callers and coupled them with a case worker has succeeded in drastically cutting the number of such calls while helping callers get proper care.

The program, called Operation Care, was conceived and implemented by the non-profit agency Baltimore HealthCare Access and ran as a 3-month pilot in 2008. Now, a newly published report of its results appearing in The American Journal of Emergency Medicine can help illuminate strategies for other emergency medical services (EMS) departments around the country that may be plagued by the same problem, according to the report’s lead author.

“The original idea was to help these frequent callers get better access to medical and other care and in doing so, Baltimore City ended up saving money and resources — a welcome side-effect,” Michael Rinke, MD, pediatrician and a quality and safety expert, Johns Hopkins Children’s Center and lead author of the report, stated in a press release.

In 2007, two Baltimore City residents were responsible for more than 60 emergency calls, another resident made 110 calls to 911 and yet another one made 147 such calls, the investigators stated. Each 911 call requires EMS to dispatch an ambulance to the caller.

Examining a year’s worth of 911 call logs, the researchers identified Baltimore City’s 25 most frequent 911 callers, 10 of whom enrolled in the 3-month program for weekly sessions with a case worker who assessed their medical needs, taught them how to navigate the health care system, put them in touch with primary care physicians and specialists, referred them to various support programs and educated them on ways to limit 911 calls to true emergencies.

In 3 months, the program generated savings of more than $14,300 — more than $6,300 of which was for the city fire department. The real savings are probably greater, as this number did not factor in any money saved from unnecessary trips to the ER and freeing up ambulances for other callers.

“This program highlights the importance of simple interventions that can yield powerful results,” Kathleen Westcoat, MPH, Baltimore HealthCare Access and co-investigator, stated. “For example, making sure that a diabetic patient does not run out of strips for the glucose monitor can prevent a frantic 911 call for a non-emergency.”

The Baltimore City Fire Department, which responds to nearly 150,000 emergency calls each year, has continued to fund the program, providing a nurse and a case manager for repeat 911 callers.

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