CHOICES
A program of the University of Michigan Health Center under the auspices of Michigan Visiting Nurses and the Department of Social Work.
The purpose of the CHOICES program is to provide next day medical and psychosocial care to patients who might otherwise have been admitted to the hospital. These patients may have acute needs but may not need hospitalization. CHOICES acts as bridge between acute and follow- up care and may be called upon to help facilitate an ED discharge plan. The Nurse Practitioners and Social Workers of the CHOICES program, in consultation with the medical director, are available to consult with the ED staff 24/7. The CHOICES program is available to pediatric and adult patients who live within southeast Michigan. There are no insurance restrictions to accessing this care.
The Nurse Practitioners can:
- Work with the ED or hospital staff to set up treatment options and plans for discharge to home
- Assess the treatment plan, patient response to treatment, and modify as needed
- Order tests, prescribe medication, start IV’s, provide EKG monitoring, and generally provide a higher level of care than traditional home nursing services
- Along with CHOICES Medical Director, the NP can provide direct feedback to the follow up physician
- Assure that appropriate and timely follow up is arranged.
The Social Workers can:
- Assist in discussions with patients and families about social, financial and psychological needs
- Assist in making arrangements for follow up care in the community
- Assess patient adherence to treatment plans and identify barriers to compliance
- Work on developing resources to help patients avoid unnecessary admissions in the future
- Coordinate care with other medical social workers as needed.
Target Patients:
- Those with uncertain social support – elderly patients living alone, behavioral or functional problems with family members or other caregivers
- Those who might be admitted for observation of a treatment effect when the diagnosis is clear
- Those with exacerbations of chronic conditions who are appropriate for close outpatient observation when treatment is temporarily augmented
- Those who have frequent ED or hospital admissions who might benefit from care coordination with other departments or community resources
