Launching the ED After Care Clinic has provided our Emergency Medicine providers with perspective on the complexity of navigating patient care after the ED visit has ended. Outcomes from the clinic provide insight into several opportunities for improving patient transitions after ED discharge. Several themes arose that warrant further investigation. The “transitional” period following discharge from the Emergency Department (ED) is high-risk. Published studies estimate only 40% of Medicare beneficiaries can secure outpatient follow-up within 7 days of ED discharge. Without adequate follow-up, ED patients are at risk for adverse drug events, treatment non-compliance, increased costs, medical complications, ED revisits, and hospital readmissions. To extend the convenience of rapid access to ED care beyond the initial visit and decrease potentially avoidable ED return visits, a Virtual ED After-Care Clinic was launched. This Quality Improvement project will retrospectively describe initial patient, demographics, quality metrics, and clinic use characteristics.
Problem: The “transitional” period following discharge from the Emergency Department (ED) is a high risk for patients. To extend the convenience of rapid access to ED care beyond the initial visit and to decrease potentially avoidable 72-hour ED return visits, a Virtual ED After-Care Clinic was launched in March 2022
Measurement: This project aimed to develop a virtual clinic to provide rapid follow-up services to adult patients discharged from the ED with the goal of mitigating unnecessary 72-hour ED returns. Clinic encounters were manually abstracted by quality nurses to measure utilization, interventions provided, and 72-hour ED returns for the pilot population
Analysis: All data were extracted from the electronic health record and analyzed in Excell. Clinic and patient characteristics were analyzed to identify themes regarding utilization patterns, interventions needed, and relationships with primary care. Rates for 72-hour returns were retrospectively gathered and compared to return rates within the general ED population
Implementation: The Virtual ED After-Care Clinic was launched and integrated into the health system’s primary electronic health platform. This allowed for improved transparency of patient care. Emergency Medicine clinicians are well-suited to provide follow-up care for ED patients. In the first six months, over 183 patients scheduled services within the clinic