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Project Helps High-Risk Patients Connect with Community Resources


By Michelle Brubaker   |   February 25, 2013

Brian Anziano, 38, was a heavy drinker for nearly 20 years.  He was living on the streets and had been picked up intoxicated by police several times. 

“I was drinking 12 to 18 beers a day,” said Anziano.  “At one point, I had gone about five months without showering because all I cared about was the next drink.”

 Brian Anziano
Once a successful manager in the hotel business, Anziano’s struggle with substance abuse isolated him from friends and family and eventually ruined his career.  He became a regular emergency room patient at UC San Diego Health where he eventually met Karen Elizabeth Mitchell, RN, MSN, CMCN.

Mitchell is a clinical nurse educator and outreach manager with the Department of Emergency Medicine. Her goal is to strive for an overall better level of care for all patients, including patients who battle multiple health issues such as diabetes and high blood pressure, compounded by issues such as mental illness, substance abuse or homelessness.

Mitchell is the driving force behind UC San Diego Health’s Emergency Department Community Placement Project (EDCPP) made up of a multidisciplinary team, including Christian Tomaszewski, MD, emergency department physician, Beverly Kress, RN, BSN, director of the Department of Emergency Care and Marina Baroff, FACHE, associate administrator.  The project is designed to decrease emergency department readmissions by establishing a reliable bridge for high-risk patients to established community services in San Diego. 

Karen Mitchell

“We are a safety-net for the health care needs of many patients who are homeless and suffer from mental illness,” said Mitchell.  “Many of these patients use the emergency department as their primary source of care, and visits range anywhere from four to five times per month. A community placement project can help these patients connect to resources that address their complex needs beyond health care.”

UC San Diego Health is the first hospital to partner with Volunteers of America, a national non-profit organization that provides housing and rehabilitation to high-risk patients. The partnership has already had a positive impact on patients like Anziano, who is now off the streets, sober, has a roof over his head and is currently looking for employment.

“I see first-hand the need for this project.  The emergency department staff works hard to treat and safely discharge a high-risk patient, but an hour after leaving the hospital, that same patient may return to the emergency department - it’s disheartening,” said Mitchell. 

Anziano said during one visit to the ED he was introduced to Volunteers of America through EDCPP.

“I finally came to the conclusion that I needed to turn my life around,” said Anziano.  “Thanks to EDCPP, I was able to make one phone call and connect to Volunteers of America.  I had all the necessary resources in front of me.”

“Through EDCPP, high risk patients gain the confidence needed to positively change their lives.  It’s rewarding to see the significant improvement in such a short amount of time when given the appropriate resources,” said Mitchell.

Anziano has been sober for several months now and is working to rebuild his career, as well as doing outreach to the homeless.

“Facing my issues head on has led to a much more balanced life.  I work hard every day to continue my sobriety.  EDCPP truly saved my life,” said Anziano.  “I now share my story with high-risk patients and hope they find it inspiring enough to reach out to the supportive resources available in the community.”

UC San Diego Health will also work with St. Vincent de Paul during the first phase of the project and is actively searching for more community program connections.

“We are hopeful that the program will not only help patients, but decrease stress levels for staff and faculty.  The EDCPP will measure staff morale by conducting a pre-and-post-intervention survey to identify the results of the project on job satisfaction,” said Mitchell. 

The EDCPP team is part of UC San Diego Health’s vision of community involvement and looking at the best way to serve high-risk patients with strong and ample connections.

“It’s time to be part of a national movement that will address this issue of readmissions and find cost-effective solutions that will improve lives,” said Mitchell.  “I am grateful to have the opportunity to participate on a team that is dedicated to seeking an innovative, community collaboration.  It’s part of the organization’s true commitment to strive for patient care excellence.” 

Related Specialties

Emergency Care Services