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

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.