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

Area of Science:

• Health Services Research
• Rural Health
• Quality Improvement

Background:

• Rural populations face healthcare access barriers, leading to higher emergency department (ED) use and readmissions.
• Effective outpatient follow-up is crucial for successful transitions from the ED to home care.
• Post-discharge phone calls are evidence-based interventions to enhance follow-up adherence and mitigate adverse outcomes.

Purpose of the Study:

• To evaluate the impact of post-discharge phone calls on outpatient follow-up rates in a rural ED setting.
• To assess whether these calls reduce unplanned ED revisits.
• To identify and address barriers to timely follow-up care.

Main Methods:

• A quality improvement project involving patients (≥18 years) discharged from a rural ED with recommended outpatient follow-up.
• Two scripted phone calls: one within 72 hours and another 7–10 days post-discharge.
• Provision of resources during calls to overcome identified follow-up barriers.

Main Results:

• Post-discharge phone calls significantly increased adherence to outpatient follow-up appointments.
• The intervention showed no significant effect on unplanned ED revisits.
• Barriers to follow-up were identified and addressed through provided resources.

Conclusions:

• Post-discharge phone calls are effective in overcoming barriers and improving outpatient follow-up rates.
• Implementing these calls is recommended to enhance primary care and specialist follow-up post-ED discharge.
• Ongoing monitoring of follow-up appointments and ED revisits is necessary to refine interventions.