title: Medical Trainee Continuity of Care Following Emergency Department Consultations in a Pediatric Hospital.
abstract: BACKGROUND
  The importance of continuity of care in training is widely recognized; however, a broad-spectrum assessment across all specialties has not been performed.
  
  
  OBJECTIVE
  We assessed the continuity of care provided by trainees, following patient consultations in the emergency department (ED) across all specialties at a large pediatric tertiary care center.
  
  
  METHODS
  Medical records were reviewed to identify patients seen in consultation by a resident or fellow trainee in the ED over a 1-year period, and to determine if the patient followed up with the same trainee for the same condition during the next 6 months.
  
  
  RESULTS
  Resident and fellow trainees from 33 specialties participated in 3400 ED consultations. Approximately 50% (1718 of 3400) of the patients seen in consultation by a trainee in the ED followed up with the same specialty within 6 months, but only 4.1% (70 of 1718) followed up with the same trainee for the same condition. Trainee continuity of care ranged from 0% to 21% among specialties, where specialties with resident clinics (14.4%) have a greater continuity of care than specialties without resident clinics (2.7%, P < .001). Continuity of care did not differ between fellows (4.2%) and residents (4.0%, P = .87), but did differ between postgraduate years for residents (P < .001).
  
  
  CONCLUSIONS
  Trainee continuity of care for ED consultations was low across all specialties and levels of training. If continuity of care is important for patient well-being and trainee education, efforts to improve continuity for trainees must be undertaken.
authors.forename: Kim
authors.initials: K
authors.lastname: Bjorklund
authors.forename: Emily A
authors.initials: EA
authors.lastname: Eismann
authors.forename: Roger
authors.initials: R
authors.lastname: Cornwall
mesh_terms: D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital; D006776:Hospitals, Pediatric; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010372:Pediatrics / Q000193:education*; D010820:Physicians; D012017:Referral and Consultation