Date of Award
8-16-2015
Document Type
Thesis
Degree Name
Doctor of Nursing (ND)
First Advisor
Dr. Rebecca Pequeno
Second Advisor
Dr. Cheryl Fuller
Third Advisor
Dr. Brenda Hage
Abstract
Background: A large percentage of serious medical errors involve miscommunication during the hand-off of patients between medical providers. In addition, care providers do not effectively or completely communicate important information among themselves, to the patient, or to those taking care of the patient at home in a timely fashion. The communication method whether verbal, recorded, or written has proven to be ineffective. As healthcare disparities increase with healthcare complexity, it is important to extrapolate the best evidence based practice and bring these practices to the front line.
Literature Search: A comprehensive literature search using the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE was performed. Medical Subject Headings (MeSH) were used in various combinations including key terms: emergency department, care coordination, and follow-up compliance. The search was limited to dates from 2004 to present, English language, Evidenced Based Medicine (EBM) reviews, Systematic Review (SR), Randomized Controlled Trials (RCT), and Human related. Selected studies demonstrated that scheduling patients’ follow-up prior to emergency department discharge has shown to be an effective method in increasing patient follow- up compliance. Several other beneficial outcomes including: increased patient satisfaction, decreased unscheduled visits to the emergency departments, possible avoidable costly hospital admissions, and an overall decrease in unnecessary health care expenditures have also been noted.
Methodology: Patients who need follow-up within 30 days of emergency department discharge may be selected for enrollment. The intervention group will have follow-up scheduled for them prior to emergency department departure. The standard group will be given the hospital’s standard discharge instructions and make their own follow-up appointment. Outpatient provider offices will be contacted at 30 days following departure to ascertain if patients followed up. Selected descriptive and inferential statistics will be used as appropriate to examine follow-up compliance between groups, as well as sociodemographic factors that may impact follow-up compliance.
Objective: The purpose of this research is to contribute to the growing body of knowledge supporting the transition of patient care. The project will evaluate the effects of scheduling patients for follow-up prior to emergency department discharge on followup compliance. There has been a continual growth of high level evidence that needs to be further developed and applied to the discharge of the emergency department patient.
Recommended Citation
Hansen, Jens, "Closing the Loop: The Effects of Scheduling Patients' Follow-up Prior to Emergency Department Discharge" (2015). Doctor of Nursing Practice (DNP) Program. 2.
https://digitalcommons.misericordia.edu/dnp_etd/2