691 - Acuity Scoring to Evaluate Efficacy of Care Management Interventions

Publication Number: 691.4014

Adriana Martinez, Primary Children's Hospital, Herriman, UT, United States; Erin Avondet, University of Utah School of Medicine, Salt Lake City, UT, United States; Karine Romero, Primary Children's Hospital, SLC, UT, United States; Laura Holden, University of Utah School of Medicine, South Jordan, UT, United States; Carolyn Reynolds, Intermountain Healthcare, Salt Lake City, UT, United States

Background: To mitigate the outsized impacts of unmet social needs on children with medical complexity and their families, Intermountain Primary Children’s Hospital developed an intensive care management program called the Connector Service (CS) to partner with families to address social determinants of health (SDOH) and care access issues via intensive care management. To better understand patient and family needs, team time and resource allotment, and progression through the program, the team developed a score to evaluate and track patient acuity during enrollment.

Objective: Utilize the Acuity Score (AS) as a resource to identify medical and social needs of CS patients and track the progression of their medical management.

Design/Methods: Patients enrolled on CS are scored using an AS. The AS includes 14 categories evaluating medical and SDOH concerns (Table 1). Apart from “Other Psychosocial Needs,” each category is scored as a 0, 1, or 2. With a score of 0 indicating low needs, 1 indicating mild to moderate needs, and 2 indicating high needs. “Other Psychosocial Needs” is scored by summing 1 point per identified need. Tabulated scores are categorized into High, Medium, or Low Risk categories with higher risk indicating higher team focus. Patients are re-evaluated on a regular basis depending on the patient’s acuity level. The AS is utilized to understand medical and social needs and team resource allocation. Furthermore, scoring directs focus toward unaddressed issues and helps the team to evaluate impacts and progression toward discharge.

Results: A majority of patients enrolled during 2018-2023 scored in the High or Medium category at admission. 46% of patients with a High AS at admit had progressed to Medium at discharge and 44% to Low and 66% of patients with a Medium AS at admit had progressed to Low by the time of discharge. Very few patients crossed from a lower acuity level to higher levels, with only 1 Low patient increasing to Medium and 3 Medium patients increasing to High (Table 2).

Conclusion(s): The AS reflects the broad impacts of high intensity care management. AS decreases and movement from higher acuity levels to lower acuity levels demonstrates improved medical management of chronic medical conditions, decreased social needs, or a combination of both. The AS could be useful in medical settings that provide care for children with medical complexity to understand patient medical and social needs and track these needs over the course of intervention periods. Further research is needed to better understand areas of greatest impact, gaps in scoring, and other implications of utilizing the AS.

Acuity Score Table
Acuity Score PAS1.pdfAcuity Score (AS) Table

Acuity Score (AS) categories with description of reason for inclusion in score
Table 1 AS categories .pdfAcuity Score (AS) categories with description of reason for inclusion in score

Table 2. Acuity Scoring comparison from enrollment to discharge
Table 2. Acuity Scoring comparison from enrollment to discharge.pdfTable 2. Acuity Scoring comparison from enrollment to discharge