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Follow-up: who needs it?

C L Carraccio1, J M Chamberlain

  • 1Department of Pediatrics, University of Maryland, Baltimore.

Pediatric Emergency Care
|August 1, 1991
PubMed
Summary
This summary is machine-generated.

Pediatric residents often miss appropriate patient follow-ups. Young age and respiratory issues were key factors in missed pediatric emergency department (ED) follow-up assignments.

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Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Quality Improvement

Background:

  • The appropriate assignment of follow-up care for pediatric patients discharged from the emergency department (ED) is crucial for continuity of care.
  • Previous studies have not specifically evaluated the accuracy of pediatric resident decisions regarding outpatient follow-up assignments.

Purpose of the Study:

  • To assess the accuracy of pediatric resident decisions in assigning follow-up care for patients seen in the pediatric ED.
  • To identify factors associated with missed follow-up assignments.

Main Methods:

  • A retrospective chart review of 1693 consecutive patients presenting to a pediatric ED was conducted.
  • Two independent reviewers assessed the appropriateness of resident-assigned follow-up care.
  • Discrepancies were analyzed to identify missed follow-ups and associated patient characteristics.

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Main Results:

  • The authors agreed with 60 out of 82 (73%) resident-assigned follow-ups.
  • 99 patients (approximately 5.8% of the total reviewed) were identified as needing follow-up but were not assigned.
  • Missed follow-ups were more common in younger patients and those with respiratory difficulties, lower mean temperatures, and less consistent access to a routine healthcare provider.

Conclusions:

  • Pediatric residents demonstrate variability in appropriately assigning follow-up care.
  • Younger age and respiratory symptoms are significant predictors of missed follow-up assignments.
  • Integrating formal training on outpatient follow-up protocols into pediatric residency curricula is recommended to improve care quality.