Characteristics of an Urban Emergency Department Callback System for the Treatment of Sexually Transmitted Infections.

Abstract

Introduction: Patient callbacks after discharge from the emergency department are critical for communicating diagnostic test results, especially for sexually transmitted infections such as gonorrhea and chlamydia. Although these callbacks are essential for timely treatment and patient education, they can be time consuming and administratively burdensome. This quality improvement initiative evaluates the volume, success rate, and primary reasons for emergency department callbacks over 6 years, focusing on patient notification, education, and treatment during their emergency department visit.

Methods: A retrospective analysis was conducted using an administrative data set of 3615 visits that required a callback to patients treated at an urban community emergency department in southeast Washington, DC, between March 2018 and June 2024. Data on callback attempts, reasons for callbacks, and patient follow-ups were extracted and analyzed. Descriptive statistics characterized the frequency and outcomes of these callbacks.

Results: Of the 3615 visits with at least 1 callback attempt, 21.2% of initial attempts failed to reach patients. Chlamydia and gonorrhea were the primary reasons for callbacks, accounting for 46.4% and 45.1% of ED cases requiring a callback, respectively. A notable 9.5% of visits requiring a callback required at least 3 attempts to reach the patient. In addition to gonorrhea and chlamydia, reasons for callbacks included positive results for herpes simplex virus, Trichomonas vaginalis, and various cultures. Limitations included missing data and free-text entries.

Discussion: The high volume of callbacks and the failure rate of initial attempts highlight inefficiencies in the current system. These findings suggest a need for improved technology and workflows to enhance timely treatment and reduce the burden on nursing and physician staff. Future studies should examine the impact of such interventions on treatment outcomes and workflow efficiencies.

Conclusions: Improving callback systems and incorporating rapid sexually transmitted infection testing could streamline ED operations, ensure timely patient treatment, and mitigate the spread of sexually transmitted infections. Further research is needed to validate these approaches and explore their broader implications for public health and clinical practice.