Related Experiment Video
Updated: Dec 4, 2025
09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
17.5K
Emergency Department "Bounce-Back" Rates as a Function of Emergency Medicine Training Year.
Janine Curcio1, Andrew Little1, Chelsea Bolyard2
1Emergency Medicine, OhioHealth Doctors Hospital, Columbus, USA.
Cureus
|October 23, 2020
Summary
Emergency department (ED) unscheduled return visits (URVs) were not significantly impacted by resident training year. Patients with substance abuse or chronic pain showed higher URV rates, highlighting specific patient populations for targeted interventions.
Area of Science:
- Emergency Medicine
- Healthcare Quality Improvement
- Medical Education
Background:
- Unscheduled return visits (URVs), or "bounce-backs," are a key metric for emergency department (ED) quality of care.
- Historically, resident training and supervision, particularly for second-year residents, have undergone scrutiny.
- Limited research concurrently examines residency supervision and ED bounce-back rates, despite evidence suggesting equivalent performance with adequate attending supervision.
Purpose of the Study:
- To determine the rate of ED bounce-back visits within 72 hours.
- To evaluate the impact of resident training level (residents vs. attending physicians) on ED bounce-back rates.
- To describe patient characteristics associated with bounce-back visits, including primary complaint, age, comorbidities, and compliance.
Main Methods:
- A retrospective chart review of 732 randomly selected patient charts from September 2015 to September 2017.
- Inclusion criteria: patients aged 18+, treated by an Emergency Medicine (EM) resident during their initial visit, with a 'discharge' disposition.
- Logistic regression modeling was used to analyze factors influencing bounce-back visits.
Main Results:
- The overall URV rate within 72 hours was 4.65%.
- No statistically significant difference in bounce-back rates was observed across residency years (PGY1-4).
- Patients with a history of tobacco abuse (current smokers 6.5x more likely) and chronic pain (2.5x more likely) were significantly more likely to have a bounce-back visit.
Conclusions:
- Emergency Medicine residency training year does not significantly increase the frequency of ED bounce-back visits.
- Specific patient populations, including those with substance abuse and chronic pain, are at higher risk for bounce-back visits.
- Findings suggest a need for targeted interventions for high-risk patient groups rather than solely focusing on resident training level.
Related Concept Videos
01:23Cardiopulmonary Resuscitation III: AED Use
328
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
328
01:20Actuarial Approach
217
The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
217
01:52Regression Toward the Mean
6.7K
Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...
6.7K
01:21Cardiopulmonary Resuscitation I: Adult
370
Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
370
01:11Hazard Rate
310
The hazard rate, also known as the hazard function or failure rate, is a statistical measure used to describe the instantaneous rate at which an event occurs, given that the event has not yet happened. From a probabilistic perspective, it represents the likelihood that a subject will experience the event in a very small time interval, conditional on surviving up to the beginning of that interval. In terms of frequency, the hazard rate can be viewed as the ratio of the number of events to the...
310
01:30Methods of Documentation VII: EMR
1.3K
Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare...
1.3K