<< Back to the abstract archive
The Impact of a Designated Emergency Room Follow-Up Clinic on Continuity of Care
Emily Wirtz, Matthew Brown MD, Hooman Soltanian MD
University Hospital Department of Plastic Surgery, Case Medical Center
2014-02-28
Presenter: Emily Wirtz
Affidavit:
All of the work, including literature review, data collection and analysis, is the original work of Matthew Brown (resident) and Emily Wirtz (medical student) under the direction of Hooman Soltainian.
Director Name: Hooman Soltanian, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Objective:
A low follow-up rate is commonly reported for patients seen as Emergency Room (ER) consultations. We changed our follow-up strategy to have a standardized once a week designated follow-up clinic for all ER consultations. Retrospective review was performed to assess follow-up and outcomes both before and after establishment of the clinic.
Methods:
Plastic surgery ER consultations from the electronic medical records were reviewed from July 2012 to May 2013. Patients with acute injuries that were seen in the emergency room and discharged were included in the study. Charts were reviewed for patient age, injury, length of stay, follow-up, and surgical intervention. Binary logistic regression was performed to evaluate significance.
Results:
276 consultations met inclusion criteria for being new patients evaluated in the ER. The follow-up rate before ER clinic establishment (BC) was 46.9%, and 75.4% after establishment (AC) (P < .0001). The location of the injury was found to be a significant predictor of follow-up BC (95% CI). The location of the injury and length of stay in the ER were significant AC (95% CI). Holding other variables constant, patients were 2.50 times more likely to successfully follow-up AC (95% CI).
Conclusions:
Establishing a designated ER follow-up clinic appears to have improved follow-up by 63%. A standardized day and ER-adjacent location for follow-up that can be given at the time of ER visit may be the major factors improving follow-up. Patients with longer ER visits and boney injuries may require other interventions to increase follow-up in clinic.
