Comparison of Three Coordination Methods to Increase Outpatient Follow Up Among Older Adults Discharged From the Emergency Department: A Pilot Study.

Abstract

Purpose: Older adults are among the highest users of the emergency department (ED), comprising over 50% of those discharged home from the ED. The Geriatric Emergency Department (GED) guidelines recommend addressing transitions of care that connect older adults with timely outpatient services to decrease adverse events. The purpose of outpatient follow up is to evaluate and adjust patient treatment, if necessary, following an ED visit to prevent adverse events.

Methods: A prospective, descriptive pilot study was conducted to gather preliminary data on the potential impact of follow-up outpatient appointment coordination types (standard care, point-of-care scheduling, and portal reminder message). Older adults 65 years and over, who were discharged from six accredited GEDs within one healthcare system from October 2023 to May 2024, were included. The primary outcomes were follow up on outpatient appointment within 30 days. Secondary outcomes were 30-day ED revisit and 30-day unplanned hospitalization.

Results: The point-of-care method/scheduling the outpatient appointment prior to GED discharge resulted in the highest outpatient follow up (63%) within 30 days of GED discharge compared to standard care (44%) and portal reminder message (35%). None of the coordination follow-up methods impacted 30-day GED revisits or hospital admission statistically.

Conclusions: This study provided important preliminary data about the benefit of point-of-care scheduling for older adults. More research is needed to determine which older adults could benefit from point-of-care scheduling and the impact on healthcare utilization.