Outpatient Follow-Up After Rural Emergency Department Discharge: A Quality Improvement Initiative

Introduction

Patients residing in rural communities experience a gap in health care access, leading to increased emergency department usage and returns. Outpatient follow-up with primary care providers or specialists is instrumental in transitioning from the emergency department to home. Evidence supports the use of post-discharge phone calls to increase adherence with follow-up outpatient appointments and potentially reduce negative sequelae for health care systems and patients.

Methods

This quality improvement project used a convenience sample of patients aged 18 years and older presenting to a critical-access rural emergency department and discharged home with recommended outpatient follow-up. Two scripted post-discharge phone calls were conducted: initial contact within 72 hours of discharge and second contact between 7 and 10 days after discharge. Resources were provided during phone calls if barriers to timely follow-up were identified.

Results

Implementation of post-discharge phone calls significantly increased outpatient follow-up but had no impact on unplanned emergency department revisits.

Discussion

Post-discharge phone calls addressed potential barriers and effectively increased outpatient follow-up. Implementation of post-emergency department discharge phone calls is recommended to improve primary care or specialist follow-up. Continued tracking of follow-up appointments and emergency department revisits are required.