Follow-up Phone Calls After an Emergency Department Visit

PEDIATRICS ◽  
1994 ◽  
Vol 93 (3) ◽  
pp. 513-514 ◽  
Author(s):  
Vidya T. Chande ◽  
Vanessa Exum
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Severe Illness ◽  
Improve Patient Compliance ◽  
Discharge Instructions ◽  
Parental Compliance ◽  
Phone Calls ◽  
Viral Illness ◽  
Improve Patient

Follow-up care of patients treated in an emergency department (ED) is an important component of patient care. Previous studies suggest that follow-up phone calls may improve patient compliance with discharge instructions.1-4 Most of these studies have used nurses to contact the families of children with relatively mild illnesses, such as otitis media or nonspecific viral illness. The families who received follow-up phone calls were more likely to keep their scheduled follow-up appointments than those who did not. We studied patients discharged from the Pediatric Emergency Department (PED) with moderate to severe illness for whom close follow-up is essential. We hypothesized that physician-initiated follow-up phone calls to parents of moderately ill children seen in the PED would improve parental compliance with primary care follow-up.

scholarly journals Nurse-Led Call Back Program to Improve Patient Follow-Up With Providers After Discharge From the Emergency Department

2020 ◽  
Vol 7 (6) ◽  
pp. 1349-1356
Author(s):  
Ines Luciani-McGillivray ◽  
Julie Cushing ◽  
Rebecca Klug ◽  
Hang Lee ◽  
Jennifer E Cahill
Keyword(s):  
Emergency Department ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Patient Compliance ◽  
Phone Call ◽  
Discharge Instructions ◽  
Phone Calls ◽  
Improve Patient ◽  
Hospital Volunteers

Phone calls to patients after discharge from the emergency department (ED) serve as reminders to schedule medical follow-up, support adherence to discharge instructions, and reduce revisits to already-crowded EDs. An existing, nurse-administered, call-back program contacted randomly selected ED patients 24 to 48 hours following discharge. This program did not improve patient follow-up (48.68%) nor reduce the ED revisit rate (6.7% baseline vs 6.0% postimplementation). Plan-Do-Study-Act methodology tested a modification to the existing program consisting of a second, scripted phone call from a trained volunteer at 72 to 96 hours postdischarge. Volunteers utilized a patient list and script, and nurses provided expertise to eliminate identified barriers to follow-up. Follow-up rate and ED revisit were monitored through the electronic medical record. A total of 894 patients participated between October 2017 and June 2018. Follow-up increased from 48.68% to 65.5% ( P < .0001) and ED revisit decreased significantly (4.5% vs 8.6%, P < .001). This innovative nurse-led, systematic postdischarge call-back program utilizing hospital volunteers increased patient compliance with post-ED medical follow-up while significantly reducing the rate of patient revisit to the ED within 7 days of discharge.

scholarly journals 688 Rapid Implementation of Virtual Fracture Clinic During COVID 19 Reduces Both Face-To-Face Appointments and Facilitates Rapid Feedback and Education to Be Delivered to The Emergency Department

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Havenhand ◽  
L Hoggett ◽  
A Bhutta
Keyword(s):  
Emergency Department ◽  
Patient Flow ◽  
Prospective Data ◽  
Fracture Clinic ◽  
Face To Face ◽  
Return Rates ◽  
Acute Hospitals ◽  
Virtual Fracture Clinic ◽  
Improve Patient

Abstract Introduction COVID-19 has dictated a shift towards virtual clinics. Pennine Acute Hospitals NHS Trust serves over a million patients with a significant number of face-to-face fracture clinics. Introduction of a Virtual Fracture Clinic (VFC) reduces hospital return rates and improves patient experience. The referral data can be used to give immediate monthly feedback to the referring department to further improving patient flow. Method Prospective data was collected for all referrals to VFC during March 2020. Data included referral diagnosis, actual diagnosis, referrers grade, and final outcome. Results 630 referrals were made to VFC. 347 (55%) of those referrals were directly discharged without the need for physical consultation. Of these 114 (32%) were injuries which can be discharged by the Emergency Department with an advice leaflet using existing pathways. Of the remaining discharges 102 (29%) were query fractures or sprains; and 135 (39%) were minor fractures; which needed only advice via a letter and no face to face follow up. Conclusions Implementation of VFC leads to a decrease in physical appointments by 55% saving 347 face to face appointments. The new system has also facilitated effective audit of referrals in order to further improve patient flow from the Emergency Department via feedback mechanisms and education.

Red flag findings in children with headaches: Prevalence and association with emergency department neuroimaging

Cephalalgia ◽  
2018 ◽  
Vol 39 (2) ◽  
pp. 185-196 ◽  
Author(s):  
Daniel S Tsze ◽  
Julie B Ochs ◽  
Ariana E Gonzalez ◽  
Peter S Dayan
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Healthy Children ◽  
High Prevalence ◽  
Associated Symptoms ◽  
Neurological Exam ◽  
Red Flag

Background Clinicians appear to obtain emergent neuroimaging for children with headaches based on the presence of red flag findings. However, little data exists regarding the prevalence of these findings in emergency department populations, and whether the identification of red flag findings is associated with potentially unnecessary emergency department neuroimaging. Objectives We aimed to determine the prevalence of red flag findings and their association with neuroimaging in otherwise healthy children presenting with headaches to the emergency department. Our secondary aim was to determine the prevalence of emergent intracranial abnormalities in this population. Methods A prospective cohort study of otherwise healthy children 2–17 years of age presenting to an urban pediatric emergency department with non-traumatic headaches was undertaken. Emergency department physicians completed a standardized form to document headache descriptors and characteristics, associated symptoms, and physical and neurological exam findings. Children who did not receive emergency department neuroimaging received 4-month telephone follow-up. Outcomes included emergency department neuroimaging and the presence of emergent intracranial abnormalities. Results We enrolled 224 patients; 197 (87.9%) had at least one red flag finding on history. Several red flag findings were reported by more than a third of children, including: Headache waking from sleep (34.8%); headache present with or soon after waking (39.7%); or headaches increasing in frequency, duration and severity (40%, 33.1%, and 46.3%). Thirty-three percent of children received emergency department neuroimaging. The prevalence of emergent intracranial abnormalities was 1% (95% CI 0.1, 3.6). Abnormal neurological exam, extreme pain intensity of presenting headache, vomiting, and positional symptoms were independently associated with emergency department neuroimaging. Conclusions Red flag findings are common in children presenting with headaches to the emergency department. The presence of red flag findings is associated with emergency department neuroimaging, although the risk of emergent intracranial abnormalities is low. Many children with headaches may be receiving unnecessary neuroimaging due to the high prevalence of non-specific red flag findings.

scholarly journals Tele-Follow-Up of Older Adult Patients from the Geriatric Emergency Department Innovation (GEDI) Program

Geriatrics ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 18 ◽  
Author(s):  
Lucy Morse ◽  
Linda Xiong ◽  
Vanessa Ramirez-Zohfeld ◽  
Scott Dresden ◽  
Lee Lindquist
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Social Services ◽  
Care Coordination ◽  
Symptom Management ◽  
Comparative Method ◽  
Patient Needs ◽  
Time Points ◽  
Phone Calls

The objective of this study was to characterize the content and interventions performed during follow-up phone calls made to patients discharged from the Geriatrics Emergency Department Innovation (GEDI) Program and to demonstrate the benefit of these calls in the care of older adults discharged from the emergency department (ED). This study utilizes retrospective chart review with qualitative analysis. It was set in a large, urban, academic hospital emergency department utilizing the Geriatric Emergency Department Innovations (GEDI) Program. The subjects were adults aged 65 and over who visited the emergency department for acute care. Follow-up telephone calls were made by geriatric nurse liaisons (GNLs) at 24–72 h and 10–14 days post-discharge from the ED. The GNLs documented the content of the phone calls, and these notes were analyzed through a constant comparative method to identify emergent themes. The results showed that the most commonly arising themes in the patients’ questions and nurses’ responses across time-points included symptom management, medications, and care coordination (physician appointments, social services, therapy, and medical equipment). Early follow-up presented the opportunity for nurses to address needs in symptom management and care coordination that directly related to the ED admission; later follow-up presented a unique opportunity to resolve sub-acute issues that were not addressed by the initial discharge plan and to manage newly arising symptoms and patient needs. Thus, telephone follow-up after emergency department discharge presents an opportunity to better connect older adults with appropriate outpatient care and to address needs arising shortly after discharge that may not have otherwise been detected. By following up at two discrete time-points, this intervention identifies and addresses distinct patient needs.

scholarly journals Process Mapping in a Pediatric Emergency Department to Minimize Missed Urinary Tract Infections

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Morgan Black ◽  
Valene Singh ◽  
Vladimir Belostotsky ◽  
Madan Roy ◽  
Deborah Yamamura ◽  
...  
Keyword(s):  
Emergency Department ◽  
Urinary Tract ◽  
Chart Review ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Process Mapping ◽  
Number Of Children ◽  
Positive Urine ◽  
Tract Infections

Urinary tract infections (UTIs) are common in young children and are seen in emergency departments (EDs) frequently. Left untreated, UTIs can lead to more severe conditions. Our goal was to undertake a quality improvement (QI) initiative to help minimize the number of children with missed UTIs in a newly established tertiary care pediatric emergency department (PED). A retrospective chart review was undertaken to identify missed UTIs in children < 3 years old who presented to a children’s hospital’s ED with positive urine cultures. It was found that there was no treatment or follow-up in 12% of positive urine cultures, indicating a missed or possible missed UTI in a significant number of children. Key stakeholders were then gathered and process mapping (PM) was completed, where gaps and barriers were identified and interventions were subsequently implemented. A follow-up chart review was completed to assess the impact of PM in reducing the number of missed UTIs. Following PM and its implementation within the ED, there was no treatment or follow-up in only 1% of cases. Based on our results, the number of potentially missed UTIs in the ED decreased dramatically, indicating that PM can be a successful QI tool in an acute care pediatric setting.

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