Survey of follow-up systems in emergency medicine residencies: analysis and proposal.
OBJECTIVE
For educational purposes, the Residency Review Committee for Emergency Medicine requires that emergency medicine residencies "provide a mechanism for each resident to obtain information on outcomes of patients the resident has evaluated in the emergency department." The authors analyzed the current patient follow-up systems of emergency medicine residencies and, based upon survey results propose a comprehensive organized system of follow-up.


METHODS
The 84 emergency medicine residency directors listed in the 1991 Society for Academic Emergency Medicine Handbook were polled regarding the current follow- up systems at all hospitals affiliated with their residencies. The survey contained 11 items, including two five-point Likert scales for rating system effectiveness and satisfaction. A description of each hospital's follow-up system was requested, and other comments were reviewed.


RESULTS
The 72 (86%) respondents represented residencies with a total of 138 affiliated hospitals, of which 89 (64.5%) had formal follow-up systems. Of those 89 hospitals, 39% (n = 80) residency directors reported that fewer than half of their residents used the systems, 63% (n = 87) had mandatory compliance policies; 53% had the capability for residents to obtain discharge summaries on admitted patients; and 66% (n = 83) had mechanisms for follow-up of patients released from the emergency department. Twenty-three percent of the systems were considered effective, with ratings of 4 or higher and only 31% received satisfaction ratings of 4 or more.


CONCLUSIONS
Most emergency residency-affiliated hospitals in our survey had follow-up systems in place. Of existing systems, only a minority were rated by residency directors as effective or satisfactory. A model for a comprehensive system of patient follow-up is proposed.
Bentley
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Department of Emergency Medicine Medical College of Wisconsin, Milwaukee 53226, USA.
DeBehnke
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Ma
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D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care / Q000592:standards; D016896:Treatment Outcome