Estratégias para o gerenciamento de casos no cuidado transicional em serviços de emergência: <i>scoping review</i>

Braz, Priscilla Gonçalves de Castro Gomes; Vila, Vanessa da Silva Carvalho; Neves, Heliny Carneiro Cunha

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

REVISÃO • Rev. bras. enferm. 73 (Suppl 5) • 2020 • https://doi.org/10.1590/0034-7167-2019-0506 copiar

Estratégias para o gerenciamento de casos no cuidado transicional em serviços de emergência: scoping review

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

mapear e sintetizar as estratégias implementadas para o gerenciamento de caso no cuidado transicional de pacientes com necessidades complexas nos serviços de emergência.

Método:

scoping review conduzido segundo os pressupostos metodológicos do Instituto Joanna Briggs. Foram analisados 23 estudos, com diferentes delineamentos metodológicos, sobre as estratégias empregadas no gerenciamento de casos envolvendo populações adultas e idosas, no contexto dos serviços de emergência.

Resultados:

as principais estratégias empregadas foram: rastreamento/identificação e estratificação de risco do paciente; plano de gerenciamento do cuidado; coordenação do cuidado por meio da atuação multiprofissional; apoio ao processo de transição; monitoramento e seguimento contínuo do paciente.

Considerações finais:

essas estratégias utilizaram abordagens estruturadas do cuidado nos serviços de emergência, para promover o apoio ao autogerenciamento e o efetivo cuidado transicional de pessoas com necessidades complexas, garantindo a integralidade, coordenação e continuidade do cuidado.

Descritores:
Administração de Caso; Assistência Centrada no Paciente; Cuidado Transicional; Revisão; Serviços Médicos de Emergência

Critérios de inclusão

Critérios de exclusão

Participantes - pessoas adultas (18 anos ou mais) e idosas (maiores de 60 anos); independentemente do sexo; com necessidades complexas.
Conceito - estratégias para o gerenciamento de caso no cuidado transicional.
Contexto - serviços de emergência.
Tipo de estudo - Estudos quantitativos (ensaios clínicos; estudos quase experimentais; observacionais prospectivos e retrospectivos; estudos caso-controle e transversais analíticos). Estudos qualitativos (descritivos, fenomenológicos, etnográficos, pesquisa-ação e teoria fundamentada nos dados). Revisões sistemáticas (com ou sem meta-análise) e metassínteses. Literatura cinzenta (documentos e livros publicados por organizações focadas em gerenciamento de caso).

• Não apresentar as etapas descritivas das estratégias para o gerenciamento de casos no cuidado transicional.

• Editoriais, protocolos de pesquisa, comentários, teses e dissertações.

Etapa	Finalidade
1° etapa Rastreamento/identificação e estratificação de risco	- Identificar (classificação de risco) a situação de saúde (aspectos clínicos e psicossociais) dos pacientes, assim como os serviços requeridos para atender às necessidades de saúde e que possam afetar o progresso do cuidado; avaliação do risco de readmissão; e recursos na comunidade e potenciais parceiros no cuidado⁽²⁶26 National Case Management Network (CA). Canadian standards of practice in case management. [Internet] Ottawa: National Case Management Network; 2009 [cited 2017 Mar 08]. [about 18 p.]. Available from: http://www.ncmn.ca/standards http://www.ncmn.ca/standards... ^,²⁸28 Tahan HM, Treiger TM. CMSA core curriculum for case management. 3rd ed. Philadelphia: Williams & Wilkins. 2017. 738 p.^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾.
2° etapa Avaliação das necessidades dos pacientes	- Avaliar e identificar as necessidades do paciente e da família: 1. Histórico de saúde e medicações utilizadas; 2. Dados sobre família e cuidador; 3. Verificar se possui médico da família ou da atenção primária; 4. Análise dos registros clínicos hospitalares, incluindo antigos e atuais dos serviços de emergência, equipes de saúde auxiliares, empregadores; 5. Medicamentos em uso; 6. Outros documentos administrativos e serviços de cuidados domiciliares; 7. Identificar necessidades de intervenções que deverão ser incorporadas no plano de cuidado; 8. Identificar os recursos necessários para direcionar os problemas levantados⁽²⁶26 National Case Management Network (CA). Canadian standards of practice in case management. [Internet] Ottawa: National Case Management Network; 2009 [cited 2017 Mar 08]. [about 18 p.]. Available from: http://www.ncmn.ca/standards http://www.ncmn.ca/standards... ^,²⁸28 Tahan HM, Treiger TM. CMSA core curriculum for case management. 3rd ed. Philadelphia: Williams & Wilkins. 2017. 738 p.^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾.
3° etapa Desenvolvimento de um plano de gerenciamento do cuidado	- Desenvolver um plano de cuidado individualizado fundamentado nas necessidades clínicas e psicossociais, em colaboração com toda equipe envolvida na gestão de casos, para garantir a transferência segura do atendimento no continuum do cuidado⁽²⁶26 National Case Management Network (CA). Canadian standards of practice in case management. [Internet] Ottawa: National Case Management Network; 2009 [cited 2017 Mar 08]. [about 18 p.]. Available from: http://www.ncmn.ca/standards http://www.ncmn.ca/standards... ^,²⁸28 Tahan HM, Treiger TM. CMSA core curriculum for case management. 3rd ed. Philadelphia: Williams & Wilkins. 2017. 738 p.^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾.
4° etapa Implementação do plano com coordenação do cuidado	- Implementar o plano de cuidados contemplando todas as intervenções necessárias para garantir e manter a continuidade dos cuidados do indivíduo em todos os níveis de atenção à saúde⁽²⁶26 National Case Management Network (CA). Canadian standards of practice in case management. [Internet] Ottawa: National Case Management Network; 2009 [cited 2017 Mar 08]. [about 18 p.]. Available from: http://www.ncmn.ca/standards http://www.ncmn.ca/standards... ^,²⁸28 Tahan HM, Treiger TM. CMSA core curriculum for case management. 3rd ed. Philadelphia: Williams & Wilkins. 2017. 738 p.^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾.
5° etapa Avaliação e Seguimento do Plano de Cuidados	- Revisar, acompanhar, avaliar e monitorar as respostas do paciente ao plano de cuidado implementado, além de monitoramento e reavaliação das condições de saúde do paciente⁽²⁶26 National Case Management Network (CA). Canadian standards of practice in case management. [Internet] Ottawa: National Case Management Network; 2009 [cited 2017 Mar 08]. [about 18 p.]. Available from: http://www.ncmn.ca/standards http://www.ncmn.ca/standards... ^,²⁸28 Tahan HM, Treiger TM. CMSA core curriculum for case management. 3rd ed. Philadelphia: Williams & Wilkins. 2017. 738 p.⁾. - Reunir informações e compartilhá-las entre os profissionais; avaliar a eficácia, necessidade de adequações no plano de cuidado e seus efeitos sobre o estado de saúde do paciente; e recomendar novas intervenções; verificar se o paciente e a família estão satisfeitos com o cuidado e com os serviços pós-alta⁽²⁶26 National Case Management Network (CA). Canadian standards of practice in case management. [Internet] Ottawa: National Case Management Network; 2009 [cited 2017 Mar 08]. [about 18 p.]. Available from: http://www.ncmn.ca/standards http://www.ncmn.ca/standards... ^,²⁸28 Tahan HM, Treiger TM. CMSA core curriculum for case management. 3rd ed. Philadelphia: Williams & Wilkins. 2017. 738 p.^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾.
6° etapa Apoio no processo de transição	- Facilitar o progresso do cuidado por meio do avanço do plano de cuidados, com o objetivo de alcançar os resultados desejados e integrar o trabalho da equipe de cuidado em saúde para o alcance das metas definidas; identificar, comunicar e resolver as barreiras que impedem o progresso do cuidado; e otimizar resultados ao longo do continuum⁽³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾.
7° etapa Comunicação pós- transição	- Comunicar e compartilhar informações entre paciente, equipe multidisciplinar, provedor de cuidado primário e sistemas de apoio⁽²⁶26 National Case Management Network (CA). Canadian standards of practice in case management. [Internet] Ottawa: National Case Management Network; 2009 [cited 2017 Mar 08]. [about 18 p.]. Available from: http://www.ncmn.ca/standards http://www.ncmn.ca/standards... ^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾. - Verificar a implementação do plano de cuidados: conforto do paciente; adesão medicamentosa; disponibilidade de serviços de pós-transição; solicitação de feedback sobre a experiência e satisfação do paciente com os serviços prestados durante o processo; verificação dos problemas e busca de resolução; e transferência de informações adquiridas com prestadores de serviços⁽²⁸28 Tahan HM, Treiger TM. CMSA core curriculum for case management. 3rd ed. Philadelphia: Williams & Wilkins. 2017. 738 p.^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾.
8° etapa Reavaliação periódica	- Examinar a adesão e verificar as respostas do paciente ao plano de cuidados, a necessidade de adequações; esclarecer dúvidas do paciente, da família ou do cuidador; e verificar a satisfação do paciente⁽²⁶26 National Case Management Network (CA). Canadian standards of practice in case management. [Internet] Ottawa: National Case Management Network; 2009 [cited 2017 Mar 08]. [about 18 p.]. Available from: http://www.ncmn.ca/standards http://www.ncmn.ca/standards... ^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾. - Confirmar o acesso aos serviços pós-alta, determinar a necessidade de intervenções para evitar readmissões do departamento de emergência, assegurar o seguimento na atenção primária e concluir o processo de gerenciamento de casos baseado nas condições do paciente e da família⁽²⁸28 Tahan HM, Treiger TM. CMSA core curriculum for case management. 3rd ed. Philadelphia: Williams & Wilkins. 2017. 738 p.^,³⁸38 American Case Management Association. Standards of practice and scope of services for health care delivery system case management and transitions of care professionals [Internet] Little Rock; 2013 [cited 2018 Aug 21]. Available from: https://www.acmaweb.org/forms/Case_Management_SoP_SoS.pdf. https://www.acmaweb.org/forms/Case_Manag... ⁾.

Autor (es), Título	Ano/ País	Periódico/ Livro	Método	Estratégia^* * Estratégia empregada: 1. Rastreamento/identificação e avaliação; 2. Plano de cuidado individualizado; 3. Apoio e comunicação no processo de transição do cuidado; 4. Coordenação do cuidado por meio de equipe multiprofissional; 5. Monitoramento e seguimento do paciente.
Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J.⁽²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ⁾ Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review.	2017 Canadá	British Medical Journal Open.	Revisão de análise temática	1-5
Grover CA, Crawford E, Close RJ.⁽⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ⁾ The efficacy of case management on emergency department frequent users: an eight-year observational study.	2016 Estados Unidos	The Journal of Emergency Medicine	Estudo observacional	1-5
Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al.⁽³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ⁾ A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial.	2016 Suécia	European Journal of Emergency Medicine	Ensaio clínico randomizado controlado	1-3,5
Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al.⁽³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ⁾ Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial.	2017 Suíça	Journal of General Internal Medicine	Ensaio clínico randomizado controlado	1-5
Soril LJ, Leggett LE, Lorenzetti DL, Noseworthy TW, Clement FM.⁽²⁹29 Soril LJ, Leggett LE, Lorenzetti DL, Noseworthy TW, Clement FM. Reducing frequent visits to the emergency department: a systematic review of interventions. PloS One. 2015;10(4):e0123660. doi: 10.1371/journal.pone.0123660 https://doi.org/10.1371/journal.pone.012... ⁾ Reducing frequent visits to the emergency department: a systematic review of interventions.	2015 Canadá	PloS one.	Revisão Sistemática	1,2
McCarty RL, Zarn J, Fenn R, Collins RD.⁽³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ⁾ Frequent ED utilizers: A case management program to address patient needs.	2015 Estados Unidos	Nursing management	Estudo quase experimental do tipo antes e depois	1-4
Walsh K, Z.⁽³¹31 Walsh K, Z. Emergency Department Case Management: the compendium of best practices [Internet] 2nd ed. Danvers (MA): HCPro; 2014 [cited 2018 Aug 21]. Available from: https://hcmarketplace.com/aitdownloadablefiles/download/aitfile/aitfile_id/1616.pdf https://hcmarketplace.com/aitdownloadabl... ⁾ Emergency Department Case Management: the compendium of best practices	2014 Estados Unidos	Emergency Department Case Management: the compendium of best practices	-----	2
Kumar GS, Klein R.⁽⁶6 Kumar GS, Klein R. Effectiveness of case management strategies in reducing emergency department visits in frequent user patient populations: a systematic review. J Emerg Med. 2013;44(3):717-29. doi: 10.1016/j.jemermed.2012.08.035 https://doi.org/10.1016/j.jemermed.2012.... ⁾ Effectiveness of case management strategies in reducing emergency department visits in frequent user patient populations: a systematic review.	2013 Estados Unidos	The Journal of Emergency Medicine	Revisão sistemática	2-5
Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G.⁽³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ⁾ A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors.	2013 Suécia	European Journal of Emergency Medicine	Ensaio clínico randomizado controlado	1-3,5
Pillow MT, Doctor S, Brown S, Carter K, Mulliken R.⁽⁴²42 Pillow MT, Doctor S, Brown S, Carter K, Mulliken R. An emergency department-initiated, web-based, multidisciplinary approach to decreasing emergency department visits by the top frequent visitors using patient care plans. J Emerg Med. 2013;44(4):853-60. doi: 10.1016/j.jemermed.2012.08.020 https://doi.org/10.1016/j.jemermed.2012.... ⁾ An emergency department-initiated, web-based, multidisciplinary approach to decreasing emergency department visits by the top frequent visitors using patient care plans.	2013 Estados Unidos	The Journal of Emergency Medicine	Estudo de coorte retrospectivo	1,2,4
Rinke ML, Dietrich E, Kodeck T, Westcoat K.⁽⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ⁾ Operation care: a pilot case management intervention for frequent emergency medical system users.	2012 Estados Unidos	The American Journal of Emergency Medicine	Estudo quase experimental do tipo antes e depois	2-5
Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al.⁽²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ⁾ Effectiveness of interventions targeting frequent users of emergency departments: a systematic review.	2011 Canadá	Annals of Emergency of Medicine	Revisão sistemática	2,4
Grover CA, Close RJ, Villarreal K, Goldman LM.⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ⁾ Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography.	2010 Estados Unidos	The Western Journal of Emergency Medicine	Estudo observacional retrospectivo	1-5
Skinner J, Carter L, Haxton C.⁽¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ⁾ Case management of patients who frequently present to a Scottish emergency department.	2009 Reino Unido	Emergency Medicine Journal	Estudo observacional prospectivo	1,2,4
Shumway M, Boccellari A, O'brien K, Okin RL.⁽¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ⁾ Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial.	2008 Estados Unidos	The American Journal of Emergency Medicine	Ensaio clínico randomizado controlado	1,2,5
Phillips GA, Brophy DS, Weiland TJ, Chenhall AJ, Dent AW.⁽⁸8 Phillips GA, Brophy DS, Weiland TJ, Chenhall AJ, Dent AW. The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department. Med J Aust. 2006;184(12):602-6. doi: 10.5694/j.1326-5377.2006.tb00412.x https://doi.org/10.5694/j.1326-5377.2006... ⁾ The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department.	2006 Austrália	The Medical Journal of Australia	Estudo de coorte retrospectivo	1,2,4
Lee K-H, Davenport L.⁽⁴⁰40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... ⁾ Can case management interventions reduce the number of emergency department visits by frequent users?	2006 Estados Unidos	The Health Care Manager	Estudo do tipo antes e depois	1-5
Walsh KT, Moran P, Greenwood C.⁽⁴⁵45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ⁾ A successful emergency department case management practice model.	2003 Estados Unidos	Case Manager	---------	1,2,5
Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al.⁽⁷7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... ⁾ The effects of clinical case management on hospital service use among ED frequent users.	2000 Estados Unidos	The American Journal of Emergency Medicine	Estudo prospectivo	1,2,4,5
Bristow DP, Herrick CA.⁽⁴⁴44 Bristow DP, Herrick CA. Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review. Lippincotts Case Manag. [Internet]. 2002 [cited 2018 May 2];7(6):243-51. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12048342 https://www.ncbi.nlm.nih.gov/pubmed/1204... ⁾ Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review.	2002 Estados Unidos	Lippincotts Case Management	Revisão de literatura	1,4,5
Pope D, Fernandes CM, Bouthillette F, Etherington J.⁽⁹9 Pope D, Fernandes CM, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Cmaj [Internet]. 2000 [cited 2018 Sep 12];162(7):1017-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10763402 https://www.ncbi.nlm.nih.gov/pubmed/1076... ⁾ Frequent users of the emergency department: a program to improve care and reduce visits.	2000 Canadá	Canadian Medical Association Journal	Estudo do tipo antes e depois	1,2,4,5
Walsh KM.⁽⁴⁶46 Walsh KM. ED case managers: one large teaching hospital's experience. J Emerg Nurs [Internet]. 1999 [cited 2018 Sep 5];25(1):17-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9925673 https://www.ncbi.nlm.nih.gov/pubmed/9925... ⁾ ED case managers: One large teaching hospital's experience.	1999 Estados Unidos	Journal of Emergency Nursing	Relato de experiência	1,3,4,5
Brewer BB, Jackson L.⁽⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ⁾ A case management model for the emergency department.	1997	Journal of Emergency Nursing	Relato de experiência	1-5

ESTRATÉGIA	SÍNTESE DAS ESTRATÉGIAS IMPLEMENTADAS
Rastreamento/identificação estratificação de risco	- Utilização de sistemas de registros eletrônicos do departamento de emergência para inserir o plano de cuidados individual⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^-⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^,⁸8 Phillips GA, Brophy DS, Weiland TJ, Chenhall AJ, Dent AW. The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department. Med J Aust. 2006;184(12):602-6. doi: 10.5694/j.1326-5377.2006.tb00412.x https://doi.org/10.5694/j.1326-5377.2006... ^,¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ^-¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,32-33^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ^,⁴²42 Pillow MT, Doctor S, Brown S, Carter K, Mulliken R. An emergency department-initiated, web-based, multidisciplinary approach to decreasing emergency department visits by the top frequent visitors using patient care plans. J Emerg Med. 2013;44(4):853-60. doi: 10.1016/j.jemermed.2012.08.020 https://doi.org/10.1016/j.jemermed.2012.... ⁾ e sistemas de informação para rastreamento de usuários frequentes⁽⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^,¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ^,²¹21 Brewster LR, Rudell LS, Lesser CS. Emergency room diversions: a symptom of hospitals under stress. Issue Brief Cent Stud Health Syst Change [Internet]. 2001 [cited 2017 May 15];(38):1-4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11603406 https://www.ncbi.nlm.nih.gov/pubmed/1160... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ⁾; recrutamento de pacientes com necessidades de cuidados complexos⁽²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ⁾. - Revisão sistemática de prontuários para identificação sistemática e precoce dos pacientes de alto risco elegíveis para o gerenciamento de casos⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^-⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^,⁷7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... ^,¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,32-33^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ^-⁴⁰40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... ^,⁴⁶46 Walsh KM. ED case managers: one large teaching hospital's experience. J Emerg Nurs [Internet]. 1999 [cited 2018 Sep 5];25(1):17-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9925673 https://www.ncbi.nlm.nih.gov/pubmed/9925... ⁾. - Avaliação do paciente face a face após o contato telefônico⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^-³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ⁾. - Envio de uma carta ao médico da atenção primária para convidar o paciente a participar do processo de gerenciamento de caso, desde que seja usuário frequente do serviço de emergência⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ⁾. - Entrevista para avaliação inicial completa das necessidades clínicas e psicossociais do paciente⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,⁷7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... ^,⁹9 Pope D, Fernandes CM, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Cmaj [Internet]. 2000 [cited 2018 Sep 12];162(7):1017-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10763402 https://www.ncbi.nlm.nih.gov/pubmed/1076... ^,11-12^,²⁹29 Soril LJ, Leggett LE, Lorenzetti DL, Noseworthy TW, Clement FM. Reducing frequent visits to the emergency department: a systematic review of interventions. PloS One. 2015;10(4):e0123660. doi: 10.1371/journal.pone.0123660 https://doi.org/10.1371/journal.pone.012... ^-³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^-³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... 40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... 41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... 42 Pillow MT, Doctor S, Brown S, Carter K, Mulliken R. An emergency department-initiated, web-based, multidisciplinary approach to decreasing emergency department visits by the top frequent visitors using patient care plans. J Emerg Med. 2013;44(4):853-60. doi: 10.1016/j.jemermed.2012.08.020 https://doi.org/10.1016/j.jemermed.2012.... 43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... 44 Bristow DP, Herrick CA. Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review. Lippincotts Case Manag. [Internet]. 2002 [cited 2018 May 2];7(6):243-51. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12048342 https://www.ncbi.nlm.nih.gov/pubmed/1204... 45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ^-⁴⁶46 Walsh KM. ED case managers: one large teaching hospital's experience. J Emerg Nurs [Internet]. 1999 [cited 2018 Sep 5];25(1):17-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9925673 https://www.ncbi.nlm.nih.gov/pubmed/9925... ⁾. - Diálogo entre o gestor de caso e o médico do departamento de emergência para compreensão do caso e discussão a respeito do tratamento esperado e nível de admissão adequado⁽⁴⁵45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ⁾. - Identificação da motivação do indivíduo para procurar atendimento no departamento de emergência e das barreiras por ele encontradas para o atendimento no contexto comunitário; identificação de qual caminho de cuidado pode ser fornecido⁽⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^,¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ^,²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,⁴⁰40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... ^,⁴⁶46 Walsh KM. ED case managers: one large teaching hospital's experience. J Emerg Nurs [Internet]. 1999 [cited 2018 Sep 5];25(1):17-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9925673 https://www.ncbi.nlm.nih.gov/pubmed/9925... ⁾; e investigação dos fatores relacionados ao uso excessivo dos serviços de saúde⁽²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ⁾. - Identificação dos serviços de cuidados em saúde que podem ser fornecidos com sucesso e de forma eficaz⁽¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ⁾; avaliação dos níveis de cuidado e coleta de informações necessárias para elaborar o planejamento⁽⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ^,⁴⁵45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ⁾.
Plano de gerenciamento do cuidado	- Plano de cuidado individualizado elaborado pelo gestor de caso juntamente com a equipe multiprofissional, para coordenar os serviços que o paciente necessita⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... 5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... 6 Kumar GS, Klein R. Effectiveness of case management strategies in reducing emergency department visits in frequent user patient populations: a systematic review. J Emerg Med. 2013;44(3):717-29. doi: 10.1016/j.jemermed.2012.08.035 https://doi.org/10.1016/j.jemermed.2012.... 7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... 8 Phillips GA, Brophy DS, Weiland TJ, Chenhall AJ, Dent AW. The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department. Med J Aust. 2006;184(12):602-6. doi: 10.5694/j.1326-5377.2006.tb00412.x https://doi.org/10.5694/j.1326-5377.2006... ^-⁹9 Pope D, Fernandes CM, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Cmaj [Internet]. 2000 [cited 2018 Sep 12];162(7):1017-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10763402 https://www.ncbi.nlm.nih.gov/pubmed/1076... ^,¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,32-33^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... 40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... 41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ^-⁴²42 Pillow MT, Doctor S, Brown S, Carter K, Mulliken R. An emergency department-initiated, web-based, multidisciplinary approach to decreasing emergency department visits by the top frequent visitors using patient care plans. J Emerg Med. 2013;44(4):853-60. doi: 10.1016/j.jemermed.2012.08.020 https://doi.org/10.1016/j.jemermed.2012.... ⁾; para compreender as necessidades clínicas do paciente; fornecer recomendações para o plano de cuidado, evitar internações inapropriadas e diminuir o número de visitas ao departamento de emergência⁽²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,²⁹29 Soril LJ, Leggett LE, Lorenzetti DL, Noseworthy TW, Clement FM. Reducing frequent visits to the emergency department: a systematic review of interventions. PloS One. 2015;10(4):e0123660. doi: 10.1371/journal.pone.0123660 https://doi.org/10.1371/journal.pone.012... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ⁾. - Deve envolver melhores práticas relacionadas a: planejamento da transição de pacientes com necessidades psicossociais complexas pelo assistente social; planejamento de transferência simples executado por um gestor de caso do departamento de emergência; e planejamento de alta após a admissão de pacientes no departamento de emergência executado por um gestor de caso domiciliar e/ou assistente social⁽³¹31 Walsh K, Z. Emergency Department Case Management: the compendium of best practices [Internet] 2nd ed. Danvers (MA): HCPro; 2014 [cited 2018 Aug 21]. Available from: https://hcmarketplace.com/aitdownloadablefiles/download/aitfile/aitfile_id/1616.pdf https://hcmarketplace.com/aitdownloadabl... ⁾. - Direcionado para as necessidades clínicas e sociais do paciente e da família⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,11-12^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,32-33^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... 40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... ^-⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ⁾. - Foco no estabelecimento de metas e objetivos terapêuticos que promovam o autogerenciamento da saúde e o aconselhamento em busca de soluções para os problemas psicossociais e definição do melhor seguimento do cuidado nos demais níveis de atenção à saúde⁽⁸8 Phillips GA, Brophy DS, Weiland TJ, Chenhall AJ, Dent AW. The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department. Med J Aust. 2006;184(12):602-6. doi: 10.5694/j.1326-5377.2006.tb00412.x https://doi.org/10.5694/j.1326-5377.2006... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ⁾. - Engajamento de toda a equipe de cuidado na elaboração de um plano de cuidado abrangente, com intervenções e reavaliações contínuas dos problemas do paciente⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^-⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^,⁷7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^-³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... 40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... 41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ^-⁴²42 Pillow MT, Doctor S, Brown S, Carter K, Mulliken R. An emergency department-initiated, web-based, multidisciplinary approach to decreasing emergency department visits by the top frequent visitors using patient care plans. J Emerg Med. 2013;44(4):853-60. doi: 10.1016/j.jemermed.2012.08.020 https://doi.org/10.1016/j.jemermed.2012.... ⁾. - Convite e envolvimento ativo do paciente na revisão do seu caso (autogerenciamento) e participação na elaboração do seu plano de cuidado individualizado e na busca de soluções para os seus problemas⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,⁹9 Pope D, Fernandes CM, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Cmaj [Internet]. 2000 [cited 2018 Sep 12];162(7):1017-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10763402 https://www.ncbi.nlm.nih.gov/pubmed/1076... ^,¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ⁾ e diálogo com a equipe e família sobre a necessidade de encaminhamentos, planos de cuidados e metas a serem atingidas⁽⁴⁵45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ⁾. - Realização de um planejamento de transições complexas para coordenar o cuidado clínico no departamento de emergência⁽⁹9 Pope D, Fernandes CM, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Cmaj [Internet]. 2000 [cited 2018 Sep 12];162(7):1017-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10763402 https://www.ncbi.nlm.nih.gov/pubmed/1076... ^,⁴⁶46 Walsh KM. ED case managers: one large teaching hospital's experience. J Emerg Nurs [Internet]. 1999 [cited 2018 Sep 5];25(1):17-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9925673 https://www.ncbi.nlm.nih.gov/pubmed/9925... ⁾; plano de alta planejado⁽⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ⁾; Elaboração de um plano abrangente de cuidados pós-alta, incluindo coordenação do cuidado nas seguintes vertentes: seguro, transporte, moradia e atendimento às necessidades clínicas e psicossociais⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,6-7^,¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ^,²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,29-30^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ^,⁴⁵45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ⁾. - Promoção de ações que envolvem educação em saúde, empoderamento na tomada de decisão e incentivo ao autogerenciamento do cuidado e à participação do paciente na elaboração do plano de cuidado⁽²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,⁴⁵45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ⁾. - O plano de cuidados deverá ser atualizado, revisado e compartilhado considerando-se as necessidades dos pacientes e o risco futuro de admissão hospitalar, de acordo com a classificação⁽¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ⁾. - Alto risco (plano de cuidados revisado a cada 3 meses, gestão de caso intensiva e advocacia); - Médio risco (plano de cuidados revisado em 6 meses e contato telefônico para monitorar e implementar o plano de cuidado e direcionar problemas emergentes); - Baixo risco (plano de cuidados revisado em 12 meses).
Apoio e comunicação no pós-transição	- Educação e orientação do paciente quanto ao uso adequado do sistema de saúde e dos serviços clínicos e sociais disponíveis na comunidade⁽⁶6 Kumar GS, Klein R. Effectiveness of case management strategies in reducing emergency department visits in frequent user patient populations: a systematic review. J Emerg Med. 2013;44(3):717-29. doi: 10.1016/j.jemermed.2012.08.035 https://doi.org/10.1016/j.jemermed.2012.... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,32-33^,39-41^,⁴⁶46 Walsh KM. ED case managers: one large teaching hospital's experience. J Emerg Nurs [Internet]. 1999 [cited 2018 Sep 5];25(1):17-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9925673 https://www.ncbi.nlm.nih.gov/pubmed/9925... ⁾; ajudar o paciente a encontrar soluções para seus problemas⁽⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ⁾; - Orientação do paciente quanto ao autogerenciamento do cuidado, oferecendo opções de cuidado e ajudando-o a fazer escolhas adequadas⁽³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^-³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ⁾; aconselhamento do paciente sobre comportamentos de risco (por exemplo, uso abusivo de substâncias) e quanto ao uso dos serviços clínicos⁽²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ⁾. - Comunicação com toda a equipe e com diferentes provedores e níveis de cuidado⁽³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^,⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ⁾; Ligação com outras agências comunitárias⁽⁷7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... ^,²²22 Freitas LFC, Moreira DA, Brito MJM. The continuity of care from the perspective of the being cared for. 2014;19(4):636-42. doi: 10.5380/ce.v19i4.35993 https://doi.org/10.5380/ce.v19i4.35993... ^,⁴⁰40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... ⁾; comunicação com os demais níveis de cuidado⁽³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ^,⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ⁾; informar ao médico da Atenção Primária à Saúde sobre consultas agendadas e necessidade de acompanhamento⁽³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ⁾.
Coordenação do cuidado	- A atuação multiprofissional inclui médico, enfermeiro, assistente social⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^-⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^,⁷7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... 8 Phillips GA, Brophy DS, Weiland TJ, Chenhall AJ, Dent AW. The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department. Med J Aust. 2006;184(12):602-6. doi: 10.5694/j.1326-5377.2006.tb00412.x https://doi.org/10.5694/j.1326-5377.2006... ^-⁹9 Pope D, Fernandes CM, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Cmaj [Internet]. 2000 [cited 2018 Sep 12];162(7):1017-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10763402 https://www.ncbi.nlm.nih.gov/pubmed/1076... ^,¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^,⁴⁰40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... 41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... 42 Pillow MT, Doctor S, Brown S, Carter K, Mulliken R. An emergency department-initiated, web-based, multidisciplinary approach to decreasing emergency department visits by the top frequent visitors using patient care plans. J Emerg Med. 2013;44(4):853-60. doi: 10.1016/j.jemermed.2012.08.020 https://doi.org/10.1016/j.jemermed.2012.... 43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ^-⁴⁴44 Bristow DP, Herrick CA. Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review. Lippincotts Case Manag. [Internet]. 2002 [cited 2018 May 2];7(6):243-51. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12048342 https://www.ncbi.nlm.nih.gov/pubmed/1204... ⁾, profissionais da atenção primária, nutricionista, terapeuta ocupacional, fisioterapeuta, entre outros⁽⁸8 Phillips GA, Brophy DS, Weiland TJ, Chenhall AJ, Dent AW. The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department. Med J Aust. 2006;184(12):602-6. doi: 10.5694/j.1326-5377.2006.tb00412.x https://doi.org/10.5694/j.1326-5377.2006... ^,⁴⁶46 Walsh KM. ED case managers: one large teaching hospital's experience. J Emerg Nurs [Internet]. 1999 [cited 2018 Sep 5];25(1):17-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9925673 https://www.ncbi.nlm.nih.gov/pubmed/9925... ⁾; - Trabalho colaborativo com a equipe multidisciplinar para apoiar o gerenciamento de casos⁽²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,⁴⁰40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... ⁾ e elaborar recomendações quanto ao uso deste serviço e tratamentos que deveriam ser fornecidos neste contexto⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ⁾; - Reuniões periódicas da equipe multidisciplinar (multidisciplinary case conference) para discussão dos casos⁽⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^-⁶6 Kumar GS, Klein R. Effectiveness of case management strategies in reducing emergency department visits in frequent user patient populations: a systematic review. J Emerg Med. 2013;44(3):717-29. doi: 10.1016/j.jemermed.2012.08.035 https://doi.org/10.1016/j.jemermed.2012.... ^,⁹9 Pope D, Fernandes CM, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Cmaj [Internet]. 2000 [cited 2018 Sep 12];162(7):1017-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10763402 https://www.ncbi.nlm.nih.gov/pubmed/1076... ^,¹²12 Skinner J, Carter L, Haxton C. Case management of patients who frequently present to a Scottish emergency department. Emerg Med J. 2009;26(2):103-5. doi: 10.1136/emj.2008.063081 https://doi.org/10.1136/emj.2008.063081... ^,²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ^-⁴²42 Pillow MT, Doctor S, Brown S, Carter K, Mulliken R. An emergency department-initiated, web-based, multidisciplinary approach to decreasing emergency department visits by the top frequent visitors using patient care plans. J Emerg Med. 2013;44(4):853-60. doi: 10.1016/j.jemermed.2012.08.020 https://doi.org/10.1016/j.jemermed.2012.... ⁾;
Seguimento, avaliação e reavaliação periódica das necessidades do paciente e do seu progresso	- Contato proativo e estreito entre pacientes e provedores de cuidados por meio de chamadas telefônicas ou visitas⁽³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ⁾; Acesso telefônico a um gestor caso, para esclarecer dúvidas⁽³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ^,⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ⁾; - Seguimento telefônico agendado com base nos riscos de admissão hospitalar⁽¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^-³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ⁾; e visitas domiciliares ou contato telefônico para verificar adesão e adequar o plano de cuidados⁽⁶6 Kumar GS, Klein R. Effectiveness of case management strategies in reducing emergency department visits in frequent user patient populations: a systematic review. J Emerg Med. 2013;44(3):717-29. doi: 10.1016/j.jemermed.2012.08.035 https://doi.org/10.1016/j.jemermed.2012.... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ^,⁴⁵45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ⁾ e/ou reavaliá-lo caso o paciente retorne para atendimento, a fim de checar se ele está recebendo os serviços coordenados apropriados para diminuir o uso do serviço de emergência⁽²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ⁾; - Fornecer um e-mail ou telefone para o paciente entrar em contato caso haja problemas na alta. Deve-se garantir que as chamadas serão retornadas pelo gestor de caso no mesmo dia⁽²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ⁾; - Reuniões regulares com um gestor de caso e visitas de um gestor de caso para avaliar as respostas do paciente ao plano de cuidado individualizado e, se necessário, revisá-lo⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ^,⁴¹41 Rinke ML, Dietrich E, Kodeck T, Westcoat K. Operation care: a pilot case management intervention for frequent emergency medical system users. Am J Emerg Med. 2012;30(2):352-7 doi: 10.1016/j.ajem.2010.12.012 https://doi.org/10.1016/j.ajem.2010.12.0... ⁾; - Assistência domiciliar⁽⁸8 Phillips GA, Brophy DS, Weiland TJ, Chenhall AJ, Dent AW. The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department. Med J Aust. 2006;184(12):602-6. doi: 10.5694/j.1326-5377.2006.tb00412.x https://doi.org/10.5694/j.1326-5377.2006... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ⁾; acompanhamento contínuo monitorado eletronicamente por enfermeiros com ações de acompanhamento e feedback dos progressos do paciente⁽⁵5 Grover CA, Crawford E, Close RJ. The efficacy of case management on emergency department frequent users: an eight-year observational study. J Emerg Med. 2016;51(5):595-604. doi: 10.1016/j.jemermed.2016.06.002 https://doi.org/10.1016/j.jemermed.2016.... ^,³³33 Edgren G, Anderson J, Dolk A, Torgerson J, Nyberg S, Skau T, et al. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial. Eur J Emerg Med. 2016;23(5):344-50. doi: 10.1097/mej.0000000000000280 https://doi.org/10.1097/mej.000000000000... ^,³⁹39 Reinius P, Johansson M, Fjellner A, Werr J, Öhlén G, Edgren G. A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors. Eur J Emerg Med. 2013;20(5):327-34. doi: 10.1097/MEJ.0b013e328358bf5a https://doi.org/10.1097/MEJ.0b013e328358... ⁾; definição dos padrões de procura por cuidados em saúde e qualidade de vida; e verificar a necessidade de nova internação do paciente⁽⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ⁾; - Implementação do tratamento comunitário assertivo que envolve a abordagem proativa e assertiva, enfatizando a promoção e prevenção em saúde e o tratamento agudo. Consiste em visitas domiciliares para discussão do caso, acompanhamento em consultas, rastreamento e identificação de pacientes, especialmente usuários frequentes dos serviços de emergência com comprometimento da saúde mental⁽⁷7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... ^,⁹9 Pope D, Fernandes CM, Bouthillette F, Etherington J. Frequent users of the emergency department: a program to improve care and reduce visits. Cmaj [Internet]. 2000 [cited 2018 Sep 12];162(7):1017-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10763402 https://www.ncbi.nlm.nih.gov/pubmed/1076... ^,¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ^,²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ^,³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ⁾; - Referência do paciente para outra configuração de cuidado, de modo a garantir a continuidade do cuidado em curto e longo prazo⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,⁷7 Okin RL, Boccellari A, Azocar F, Shumway M, O'brien K, Gelb A, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med. 2000;18(5):603-8. doi: 10.1053/ajem.2000.9292 https://doi.org/10.1053/ajem.2000.9292... ^,¹¹11 Shumway M, Boccellari A, O'brien K, Okin RL. Cost-effectiveness of clinical case management for ED frequent users: results of a randomized trial. Am J Emerg Med. 2008;26(2):155-64. doi: 10.1016/j.ajem.2007.04.021 https://doi.org/10.1016/j.ajem.2007.04.0... ^,²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... 44 Bristow DP, Herrick CA. Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review. Lippincotts Case Manag. [Internet]. 2002 [cited 2018 May 2];7(6):243-51. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12048342 https://www.ncbi.nlm.nih.gov/pubmed/1204... ^-⁴⁵45 Walsh KT, Moran P, Greenwood C. A successful emergency department case management practice model. Case Manager [Internet]. 2003[cited 2018 Sep 5];14(6):54-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14618150 https://www.ncbi.nlm.nih.gov/pubmed/1461... ⁾; referência para cuidados de saúde primários, serviços comunitários⁽⁴4 Grover CA, Close RJ, Villarreal K, Goldman LM. Emergency department frequent user: pilot study of intensive case management to reduce visits and computed tomography. West J Emerg Med[Internet]. 2010 [cited 2017 Sep 18];11(4):336-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21079705 https://www.ncbi.nlm.nih.gov/pubmed/2107... ^,⁶6 Kumar GS, Klein R. Effectiveness of case management strategies in reducing emergency department visits in frequent user patient populations: a systematic review. J Emerg Med. 2013;44(3):717-29. doi: 10.1016/j.jemermed.2012.08.035 https://doi.org/10.1016/j.jemermed.2012.... ^,²⁰20 Althaus F, Paroz S, Hugli O, Ghali WA, Daeppen J-B, Peytremann-Bridevaux I, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41-52. e42. doi: 10.1016/j.annemergmed.2011.03.007 https://doi.org/10.1016/j.annemergmed.20... ^,²³23 Hudon C, Chouinard M-C, Lambert M, Diadiou F, Bouliane D, Beaudin J. Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review. BMJ Open. 2017;7(10):e017762. doi: 10.1136/bmjopen-2017-017762 https://doi.org/10.1136/bmjopen-2017-017... ^,²⁹29 Soril LJ, Leggett LE, Lorenzetti DL, Noseworthy TW, Clement FM. Reducing frequent visits to the emergency department: a systematic review of interventions. PloS One. 2015;10(4):e0123660. doi: 10.1371/journal.pone.0123660 https://doi.org/10.1371/journal.pone.012... ^-³⁰30 McCarty RL, Zarn J, Fenn R, Collins RD. Frequent ED utilizers: A case management program to address patient needs. Nurs Manage. 2015;46(9):24-31. doi: 10.1097/01.NUMA.0000470771.17731.3d https://doi.org/10.1097/01.NUMA.00004707... ^,³²32 Bodenmann P, Velonaki V-S, Griffin JL, Baggio S, Iglesias K, Moschetti K, et al. Case management may reduce emergency department frequent use in a universal health coverage system: a randomized controlled trial. J Gen Intern Med [Internet]. 2017 [cited 2018 Nov 12];32(5):508-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27400922 https://www.ncbi.nlm.nih.gov/pubmed/2740... ^,⁴⁰40 Lee K-H, Davenport L. Can case management interventions reduce the number of emergency department visits by frequent users? Health Care Manag (Frederick) [Internet]. 2006 [cited 2018 Sep 20];25(2):155-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16699330 https://www.ncbi.nlm.nih.gov/pubmed/1669... ^,⁴³43 Brewer BB, Jackson L. A case management model for the emergency department. J Emerg Nurs. 1997;23(6):618-21. doi: 10.1016/s0099-1767(97)90280-4 https://doi.org/10.1016/s0099-1767(97)90... ^-⁴⁴44 Bristow DP, Herrick CA. Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review. Lippincotts Case Manag. 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[1] Autor Correspondente: Priscilla Gonçalves de Castro Gomes Braz. E-mail: priscillagoncalves_enf@yahoo.com.br