Increasing Compliance With the Residency Review Committee Requirements for Follow-up in Academic Emergency Departments☆☆☆★

Abstract 

Study Objectives: The purpose of this study was to assess patient follow-up activities and changes in compliance with the Residency Review Committee follow-up requirements among emergency medicine residency training programs over a 12-year period. Methods: A cross-sectional survey of residency directors of all accredited programs in emergency medicine listed in the Graduate Medical Education Directory was performed in 1996. Program director responses were matched with the results of our study group’s previous surveys performed in 1984, 1988, and 1992. The survey requested information regarding the mechanism for follow-up on patients admitted to the hospital, as well as those treated and released from the emergency department. Results: All residency programs responded to the survey. Seventy-four percent of the residency programs surveyed reported a formal system of follow-up for admitted patients, and 51% had a formal system in place for discharged patients. Inpatient follow-up mechanisms included follow-up case conferences (56%), discharge summaries (55%), follow-up book/cards (47%), or follow-up rounds (11%). Outpatient follow-up mechanisms included routine telephone follow-up (86%), follow-up document (37%), ED follow-up clinic (24%), or home visits (<1%). During the past 12 years, compliance with the Residency Review Committee requirements for follow-up activity has improved from 38% to 78% for inpatients and from 33% to 52% for outpatients. Conclusion: Emergency medicine residency training programs report an increasing compliance with residency requirements for ED patient follow-up. However, a significant number of programs still lack a formal mechanism. Compliance continues to be much better for patients admitted to the hospital than those treated and released. Specific suggestions and model follow-up mechanisms are described.[Gaeta TJ, Osborn HH, Emergency Medicine Follow-up Study Group: Increasing compliance with the Residency Review Committee requirements for follow-up in academic emergency departments. Ann Emerg Med May 1999;33:510-515.]