Does a Provider Contact Wristband Reduce Emergency Department Visit Rates Following Hip or Knee Arthroplasty?

Abstract

Background

Reducing unnecessary emergency department (ED) visits following joint arthroplasty is an important goal. Literature suggests 30-day visit rates range between 4% and 15%, with only 20%-25% of these admitted for care. Low admissions suggest an opportunity to reduce unnecessary postarthroplasty ED visits. This study examined whether a wristband would encourage patients to call the care team with concerns prior to going to the ED.

Methods

A wristband displaying a contact phone number was placed on patients at discharge. ED visit rates (30 and 90 days) and readmissions (90 days) were tabulated for 2 years prior to and up to 3 years after the implementation of the wristband program. Residents who responded to calls and call logs were also reviewed.

Results

At 2 years after implementation, a total of 1023 joint replacements produced 273 calls or 1 call per 3.75 patients. Nearly half (48.1%) of the calls were received during weekday work hours when the patients had been directed to call the office. While ED visits declined after the implementation of the wristband at both 2 and 3 years, these reductions were not statistically significant (30 days: 5.1% before, 4.1% after; 90 days: 8.1% before, 7.1% after). There was a significant reduction in 90-day readmissions (6.4% before, 4.0% after).

Conclusions

Patients utilized the wristband number, but this did not significantly reduce the number of ED visits within 3 years. Future studies should track ED visits and identify decision-making factors behind ED use in order to find ways to improve the intervention.