Healthcare News & Insights

Avoid repeat emergency department visits for patients with this strategy

To curb healthcare spending, the feds want to crack down on emergency department “repeat offenders,” or those who make multiple visits to the ED in a short time period. And they’re enlisting help from hospitals themselves.

emergency patient entranceFindings from a new study may offer some insight into how hospitals can help solve this problem.

In the study, published in the Annals of Emergency Medicine, researchers interviewed patients at two Philadelphia hospitals who had returned to the emergency department to seek further treatment within a few days of being discharged.

Patients were asked about exactly what factors led them to return – and why they sought additional care at the hospital instead of from a primary care office, clinic or other outpatient setting.

The number one reason why patients came back to the ED so quickly? Fear.

Patients reported feeling frightened after discharge because they often still weren’t sure what was causing their illness, even after being evaluated and treated. Their symptoms weren’t improving, and they didn’t feel they had any other options outside of the ED.

Repeat visitors also reported issues with obtaining care outside of a hospital setting, including difficulty in scheduling appointments and long wait times to see doctors.

Easing patients’ minds

So how can hospitals ensure patients don’t end up right back in the ED with the same symptoms?

To quell any lingering fears patients may have, researchers suggested that emergency department providers should make sure all patient concerns are addressed before discharge, specifically by:

  • telling patients about their clinical reasoning/rationale for treatment
  • communicating test results clearly, and
  • discussing any uncertainty patients may feel if providers can’t make a clear diagnosis.

Hospitals can also be more proactive by doing more to boost the continuum of care, including reaching out to patients’ other primary care providers or specialists post discharge to help with scheduling follow-up appointments. The use of telemedicine may help make this easier down the line, as will collaborative healthcare efforts like accountable care organizations.

While most patients interviewed didn’t mention having any specific issues with the discharge process, encouraging providers to take more time during discharge to address patients’ fears and set them up with appropriate post-hospital care would likely go a long way toward keeping these patients from making multiple unnecessary ED visits.

As lead study author Dr. Kristin Rising noted in a press release, “The medical community must learn to meet our patients when and where they need us. Sometimes, they may just need reassurance, especially when there is no clear explanation for what is causing their symptoms.”

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