A conceptual framework for improved analyses of 72-hour return cases.

Area of Science:

• Emergency Medicine
• Healthcare Quality Improvement
• Patient Safety

Background:

• 72-hour return visits have been used for over 25 years in emergency medicine.
• These revisits are often viewed as indicators of high-risk patients and surrogate markers for quality of care.
• Emergency departments commonly employ 72-hour returns as a screening tool to detect care deficits, though reviews can be resource-intensive.

Purpose of the Study:

• To discuss the limited published data supporting 72-hour return frequency as an overall performance measure.
• To examine the validity of using 72-hour return frequency as a performance metric.
• To propose a conceptual framework for reviewing 72-hour return cases as a screening tool for quality assurance.

Main Methods:

• Literature review and conceptual analysis regarding the use of 72-hour return visits.
• Examination of the existing evidence and rationale for using return visit frequency as a performance indicator.
• Development of a framework for quality assurance reviews of patients returning to the emergency department within 72 hours.

Main Results:

• There is a lack of published data to support the use of 72-hour return frequency as a comprehensive performance measure.
• The use of 72-hour return frequency as an overall performance metric is not considered valid.
• A conceptual framework for reviewing these cases as a screening tool has been described.

Conclusions:

• The validity of using 72-hour return visits as a universal performance metric in emergency medicine is questionable.
• A structured approach is needed to effectively utilize 72-hour return visits for quality assurance.
• Further research is required to test and validate different models for quality assurance reviews of 72-hour emergency department return cases.