Nursing Student Coaches for Emergency Department Super Utilizers

Della Anderson
Enedina Patch
Brooke Oxandale
Amy Kincade
Angie Gamber
Ruth Ohm
Journal Article
January 2017

This resource describes the Super Utilizer Project, a collaboration between an integrated health care organization and a baccalaureate school of nursing.


  • The goal was to help patients with complex needs through the use of a student coach model, helping patients to improve follow-up with primary care physicians and reduce inappropriate ED use.
  • Coaching involves providing feedback to help guide individuals to develop skills and self-confidence. The student coaches provide clients with disease prevention and health promotion education and assistance specific to the clients’ unique health care needs.
  • The project was grounded in the theoretical frameworks of servant leadership, caring theory, and transtheoretical model of behavior change. These theories gave the students a foundation for showing the patients that someone cared about their health outcomes and their needs.
  • First-year outcomes for the project were encouraging, with the total number of emergency department visits for 23 patients decreasing from 710 annually to a projected 510 annually. The total costs incurred decreased from $2.45 million annually to a projected $1.5 million annually.
  • Ideas for improvement include addressing the termination process of the coaching relationship to avoid causing emotional distress.
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Population Addressed
Adults Under 65 with Disabilities
People with Advanced Illness
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
  • What does the “student coach model” involve, and what are its benefits?
  • What’s an example of a project that used this model with promising results?
Level of Evidence
What does this mean?