Huber says the hospital placed social workers in the ER full time. It then identified 313 so-called frequent fliers who visited Aurora Sinai's ER at least five times in four months. Those patients alone accounted for 1,827 emergency room visits in that time.
The social workers chose 39 people out of the 313 and spent the next eight months trying to change their habits so that when they get sick, they go to a primary care doctor or clinic rather than the ER.
"These are people who are in crisis all the time," Huber says. "They don't know where they're going to sleep or whether they can get groceries. They can't think about making appointments and planning ahead."
The social workers developed a plan for each patient that included finding transportation to a doctor and securing child care for the appointment. Then they helped the patient make a first appointment. They even sometimes accompanied them to the visit.