Effectiveness of an organized follow-up system for elder patients released from the emergency department.
OBJECTIVE
To determine whether an effective telephone callback system can be successfully implemented in a busy ED and to quantify the benefits that can be obtained related to the follow-up care of elder patients.


METHODS
This was a prospective, cohort study conducted at a community teaching hospital during a 6-month period. Consecutive patients > or = 60 years old and released from the ED were selected for telephone follow-up. Calls were made by a research nurse within 72 hours after the patient's ED visit. Follow-up information included current medical status, problems encountered during the ED visit, compliance, and impact of the illness on self-care capabilities.


RESULTS
Seventy-nine percent (831/1,048) of the patients selected for telephone follow-up were successfully contacted. The calls lasted an average of 4 +/- 2.5 minutes. Although 94% (778/831) of these patients had a regular physician, 14% failed to make their recommended follow-up arrangements. Compliance was significantly improved when a follow-up physician was contacted during the patient's ED visit. Approximately 96% of the patients were either satisfied or very satisfied with their ED care. However, 13% (109/831) had moderate deterioration in their ability to care for themselves. Of the patients contacted, 333 (40%) required further clarification of their home care instructions, 31 were advised to return to the ED for reevaluation, and 26 were referred to a medical social worker for psychosocial concerns.


CONCLUSIONS
A telephone callback system is a feasible and effective method to improve follow-up care of elder patients released from the ED.
Jones
J S
JS
Department of Emergency Medicine, Butterworth Hospital, Grand Rapids, MI 49503, USA. 70602.706@compuserve.com
Young
M S
MS
LaFleur
R A
RA
Brown
M D
MD
D000203:Activities of Daily Living; D000359:Aftercare / Q000458:organization & administration*; D000368:Aged; D003266:Continuity of Patient Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006302:Health Services Research; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D015397:Program Evaluation; D011446:Prospective Studies; D013689:Telephone; D013997:Time Factors