Contacting Patients After an Emergency Department Visit to Influence their Follow-Up Care Preferences

Abstract

CONTEXT Emergency Departments (ED) have faced increasing challenges in providing quality, cost-effective patient care. In addition, healthcare administrators have sought specific techniques to improve patient perceptions of care and satisfaction as a component of Medicare reimbursement and physician contract retention. This five-month study sought to examine whether contacting patients per phone or leaving them a voicemail message after an ED visit might influence their perceptions of care and subsequent follow-up care preferences. METHODS A sample of 95 discharged ED patients were contacted by phone and mailed surveys rating their likelihood of return directly for future ED as well as scheduling office-based visits. Patients were stratified by whether they were: a) directly spoken to over the phone, b) left a voicemail message, or c) never successfully contacted. Mailed patient surveys utilized a five-point Likert-type scale items concerning future follow-up care preferences. Sample patients were also monitored in the electronic health record to correlate self-reported intentions with whether they actually returned to the same ED for the same chief complaint within 30 days of their initial visit. RESULTS Those patients who were directly contacted after ED discharge tended to be more likely to report they would return to the same ED, although not significantly (p = 0.060). Patients who were left a voicemail message were not more likely to return to the ED (p = 0.230). However, patients who were contacted directly indicated that they were more likely to adhere to received discharge instructions (p = 0.010). Neither did phoning patients significantly influence whether they followed-up with clinic providers (p = 0.999) or return to the same ED within 30 days (p = 0.999). CONCLUSIONS Although there are often many complex factors influencing patients' post-ED care decisions, the results from this smaller project indicated that contacting patients after ED discharge may help influence their perceptions of care and influence some follow-up care preferences.