Consultation and referral patterns from a teaching hospital emergency department.
The objective of this study was to describe consultation and referral patterns from a military emergency department (ED). The design of the study consisted of a prospective analysis of consultations and referrals from Madigan Army Medical Center ED during April 1990, an Army Medical Center with multiple residencies, including emergency medicine (EM). Patient population included active and retired military personnel, their families, and civilian emergency medical system-transported patients. ED visits averaged 60,000 per year. The overall rate of consultation and referral was 39.9%; 10.7% were consultations, whereas 29.2% were referrals. PGY-2 and -3 EM residents consultation rates were higher than average. Of all ED visits, 19.7% resulted in consultations or referrals to surgical services, 13.6% to medical services, and 2.8% to pediatrics. ED patients frequently are referred to or result in consultations with non-EM physicians. Differences in consultation by level of training and the impact of consultation on consulting services both deserve further investigation. Review of EM resident use of consultation and referral may focus evaluation of ED care in teaching hospitals.
Department of Emergency Medicine, St Francis Community Hospital, Federal Way, WA.
J M
JM
Cortazzo
A T
AT
Guertler
M M
MM
Rice
D000208:Acute Disease; D000328:Adult; D000359:Aftercare; D003142:Communication; D004635:Emergency Medicine / Q000193:education; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005568:Forms and Records Control; D006302:Health Services Research; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006772:Hospitals, Military / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D008499:Medical Records / Q000592:standards; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014218:Triage / Q000458:organization & administration*; D014861:Washington