Compliance with emergency department referral: The effect of computerized discharge instructions

Abstract

Study objective: To examine the effect of computerized discharge instructions on emergency department patient referral recommendations. Design: Prospective, descriptive analysis and clinical trial. Setting: Emergency medicine residency-affiliated urban hospital with 568 beds and 29,000 annual visits. Type of participants: One thousand ED patients discharged to an outpatient referral network during a six-week period. Intervention: Mandatory referral was provided in written or computerized (Logicare Corp, Eau Claire, Wisconsin) format for each 500-patient group. Demographic data and compliance, measured as appointment completion within 30 days, were analyzed using χ2 with Yates' correction, Fisher's exact, and odds ratio comparisons (P < .05, 95% confidence interval). Measurements and main results: The institution of computerized discharge instructions resulted in increased overall patient compliance from 26.2% to 36.2% (P < .001). Conclusion: Computerized discharge instructions were associated with improved compliance with ED referral recommendations, based on historic and contemporary controls. © 1993 American College of Emergency Physicians. All Rights Reserved.