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

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.