Why do patients seek unplanned follow up after treatment in the emergency department?

• Main Author: Hoskins, R.
• Published: University of the West of England, Bristol 2014
• Subjects: 362.18
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.596053

Aims: This study explored why patients seek unplanned follow up after treatment in an emergency department, if participants could identify the healthcare professional they were treated by, and whether the patient’s perception of, and confidence in, the healthcare professional had an impact on their subsequent decision to seek follow up. Methods: A mixed method pragmatic approach was used in order to quantify and explore the aims of the study. Participants were followed up two weeks later by telephone and finally invited to take part in a focus group to explore their experience and perceptions of their visit to the emergency department. Results: 18% of patients sought unplanned follow up in the 2 weeks following their initial visit, with no statistically significant difference between healthcare professional groups. 19% of patients incorrectly identified the healthcare professional treating them, with evidence of a gender bias. Discussion: The qualitative elements of the study explored the quantitative results. Participants were more likely to believe the healthcare professional was a doctor if they were male and had effective communication skills. A number of practical issues were identified in reducing unplanned follow up rates. The most common were issuing fitness to work certificates, explaining the trajectory of an illness or injury and addressing specific pain management issues. A change in policy would be required for non –medical health care professionals to be able to issue fitness to work certificates but in this study it was found to be the single most effective strategy to reduce reconsultantion rates. Conclusion: Patients seek unplanned follow up for a variety of reasons. This study shows that non-medical HCPs do not have a higher planned or unplanned follow-up rate, and they may have some advantages over junior medical staff in terms of effective consultation skills, high patient satisfaction and reduced reconsultation rates.