Health systems around the world struggle to handle super utilizers. Super utilizers are people who continue to activate the 911 system excessively. These patients are often encountered by EMS, hospital staff, and police departments. In this article we give ways to address 911 super utilization.
There are times when a patient initiates excessive contact with the emergency system; however, there are also times when the patient needs to be treated more directly. A super utilizer usually requires a more holistic, nuanced approach to their care, which is a difficult bridge to walk in the fast-paced world of public health and safety.
This article outlines why community partnerships can lead to a breakthrough in reducing 911 activation. Also, we’ll discuss how different community health organizations have something unique to offer regarding reducing 911 calls.
The Secret to Successfully Adressing 911 Utilization Reduction Program
Many areas have some form of a super utilizer reduction program. So if someone truly misuses the 911 system, there is often some avenue that allows the issue to be corrected. However, this can be a time-consuming process and often may seem more trouble than it’s worth.
As anyone working in public health knows, whether it’s the ER, the police, EMS, or a mental health professional, one person overusing the system can lead to a considerable expense and time commitment.
One of the secrets to successfully reducing super utilizers is to treat “super-utilization” as any other health problem – be it someone struggling with substance abuse, mental health problems, or a medical emergency.
What does this mean? When a super-utilizer is identified, there should be a swift, coordinated, and cohesive response. The key is identifying the inciting reason the patient is calling 911 and then properly addressing those concerns.
But there’s an issue.
Why It’s so Difficult to Address 911 Super Utilization
As anyone who has tried to address 911 super utilization knows, it can be challenging for a single organization to correct these problems. Why is this?
Often, the 911 calls keep coming from the same patient because the root cause isn’t being addressed. For example, it could be that the patient has a medical problem, or perhaps the patient needs mental health care or is lonely. In all these cases, there are solutions, but not all public health organizations are equipped to deal with them.
This can lead to a perpetuating cycle that frustrates everyone involved.
Let’s look at an example.
Imagine a 60-year-old man. He’s been calling the ambulance every day for the last month. Every time the paramedics check him out, they find his blood sugar either too low or too high. They continue telling the patient to take his medications and follow up on his physicians’ instructions, but the patient keeps calling. The patient and the physicians are frustrated, and the paramedic is frustrated. What’s the issue?
Many things could be happening, and it would undoubtedly be foolish to presume anything; however, it could be that the patient is severely depressed and is not motivated to keep his meds organized or to take them regularly – he’s caught in a cycle, and he’s reaching out for help. The issue is that EMS and the ER can only solve part of his problem. He likely needs to see a mental health professional who may be able to help him overcome some depression.
If the EMS crew had a working relationship with the mental health institution, they could have referred the patient for a psychiatric evaluation.
And that’s the key – having a relationship with other professionals in the area.
Why Building Partnerships is Essential to Addressing 911 Super Utilization
In the last section, we discussed the importance of collaboration to address 911 super utilization and overuse of the 911 system. Now, let’s dive into the importance of having a broad lens when addressing super-utilizers.
In the following sections, we’ll review several public health and safety branches and discuss why they can’t address super utilizers without each other’s help.
Here are the branches we’ll cover
- Mental health
- Police
- Emergency Medical Services (EMS)
Let’s look at these branches in more depth.
How Partnerships within Mental Healthcare Can Address 911 Super Utilization
Some areas may have a critical incidence team that responds to mental health patients. These are great programs, and they give communities another way to reach out for mental healthcare.
However, it’s not just 911 callers who can begin to use the healthcare system excessively. Even in a mental healthcare program, some patients may seem to be constantly in need and never getting better.
As discussed in the previous sections, when mental health professionals encounter super-utilizers, they should ask themselves if there is more to the story. Of course, the mental health provider is there to address psychological concerns, but is there another reason the patient could be calling so much?
For example, we could just flip the script of the 60-year-old man we mentioned. Perhaps the mental health team has been going to his house every day, only to find that, after trial and error, he needs a medical provider to help him control his diabetes!
These types of things happen often and can occur in any branch of public health.
How Police Can Help Reduce 911 Super Utilizers
Generally, the public safety realm is trying to reduce the number of police officers called to a mental health incident. This is better for the patients and the police officer, who doesn’t need to be tied up with medical calls.
However, the police are an essential aspect of public safety, and the astute healthcare provider will carefully consider whether law enforcement could play a key role in patient health.
For example, maybe the reason the 60-year-old male is calling is not due to his diabetes or due to his mental health. Instead, perhaps the man received threats of violence from a neighbor or has been the victim of domestic violence. In this case, it may be prudent to contact law enforcement, as they may be able to correct the issue and help the patient feel safer in their own home.
Finally, when it comes to police officers and how they address 911 super utilization, it could be that the officers have been running on the same belligerent patient for weeks, but maybe the patient has an uncorrected drug problem. If the officers have a partnership with a local rehab facility, this person may be able to receive some real help.
How EMS Can Help Reduce 911 Super Utilizers
EMS can also become overly fixated on one issue. For example, they may believe that a patient repeatedly has chest pain and cardiac problems. Still, it could be that the patient is having unchecked anxiety and could use a consult with a primary care physician or mental health professional.
Unfortunately, the opposite can also occur – the patient has called for anxiety so many times that when the patient is having a cardiac event, the EMS crew doesn’t take them seriously.
Having a cohesive community response can make a difference in all these cases. Why? Because it gives each provider more tools in their bag. As the saying goes, to a hammer, everything is a nail.
To a police officer, everything can look like a crime. To a paramedic, everything looks like a medical emergency – this is a common struggle. Still, when a good partnership develops, it helps each provider take a more holistic approach when they contact a super utilizer.
Let’s talk about how to build a partnership that lasts.
How Partnerships Can Help Reduce 911 Super Utilizers
How can a public health or safety organization form these partnerships? It comes down to communicating with nearby departments and discussing the issues. Perhaps you can help each other.
The second thing you can do is have a unified communication network. When you begin to establish partnerships within the community, you are forming a cohesive unit. Communication is the key.
A platform like Julota allows everyone to communicate. Julota has a simple, cloud-based system that lets separate organizations connect. There is no need for cumbersome hardware upgrades. In addition, Julota is designed for mobile integrated healthcare, respects privacy policies, and allows for a consistent record.
Now for our conclusion.
Final Thoughts on How Collaborative Partnerships Can Reduce 911 Super-Utilizers
When one organization tries to solve super-utilization, the results can be mixed and unpredictable. Building a community-wide partnership allows organizations to address why a person frequently calls 911. Each public discipline, be it EMS, fire, police, hospital, or mental health professionals, brings a different skill set to the table.
Contact Julota to see how their software can help you form good partnerships so that you can reduce 911 super-utilizers in your area. The team at Julota would be happy to answer any questions and provide a free demonstration.