“Bounces”: An analysis of short-term return visits to a public hospital emergency department

Pierce, John; Kellerman, Arthur L.; Oster, Catherine

doi:10.1016/s0196-0644(05)81698-1

Cited by 128 publications

(140 citation statements)

References 14 publications

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“…They found that 39.6% of preventable readmissions result from treatment defects, 14.6% from improper prescription, 20.8% from presenting insufficient patient education, and 36.5% from patient incompatibility (9). In another study, they remarked that 15% of RAEP cases could be preventable through comprehensive patient education (10). In two different studies, it was found that 1/3 of the patient-and disease-related unexpected returns were preventable returns and the patients who were admitted for the second time due to preventable causes were discharged after reevaluation (3,9).…”

Section: Discussionmentioning

confidence: 98%

“…In some studies, it was stated that the ratio of RAEP to ED could be a marker of quality (9,10). However, there is no precise data about which level of RAEP ratios are ideal or an indicator of high quality.…”

Section: Discussionmentioning

confidence: 99%

“…It was shown that RAEP rates are between 8.2% and 26% due to errors in medical care in the first admission (1,5,10,(19)(20)(21). In the studies of Wu, early discharges constituted most of the doctor-related factors, and false diagnosis constituted 3.7% of them (1).…”

Section: Discussionmentioning

confidence: 99%

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Evaluating Unscheduled Readmission to Emergency Department in the Early Period

et al. 2016

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Background:The readmission in the early period (RAEP) is defined as the admission of a patient to emergency department (ED) for the second time within 72 hours after discharge from the ED. Aims: The aim of this study was to determine the disease, patient, doctor, and system related causes of RAEP. Study Design: Descriptive study. Methods: This study is a two-stage study that was conducted at Department of Emergency, Gazi University Faculty of Medicine. The causes of RAEP were defined as disease, patient, doctor, and system related causes. Results: A total of 46,800 adult patients admitted to ED during the study period and 779 (1.66%) patients required RAEP. After the exclusion criteria, 429 of these patients were included the study. The most common reasons for RAEP were renal colic in 46 (10.7%) patients. It was detected that 60.4% of the causes of RAEP were related to disease, 20.0% were related to the doctor, 12.1% were related to the patient, and 7.5% were related to the hospital management system. Conclusion: This study revealed that there are patient-, doctor-, and system-related preventable reasons for RAEP and the patients requiring RAEP constitute the high risk group.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Evaluating Unscheduled Readmission to Emergency Department in the Early Period

et al. 2016

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“…Pierce et al, using a two-day criterion, found a 3% return rate from 17,000 visits. 67 Ten percent of returns were deemed due to error in diagnosis, treatment, or disposition. Patients returning for one of these three reasons were more likely than other returnees to require hospitalization.…”

Section: System-level Approachesmentioning

confidence: 99%

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Schenkel

2000

Academic Emergency Medicine

135

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Abstract. An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are, individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the likelihood of reduction of error in EM practice.

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“…The age distribution of all patients attending the ED was studied in the week from [1][2][3][4][5][6][7] December 1991 and is also shown in Fig. 1 Patient-related factors were the second most important and accounted for 13% of reattendances (Fig.…”

mentioning

confidence: 99%

Reattendance audit in an inner-city emergency department.

Wong

Lam²

1994

Emergency Medicine Journal

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SUMMARYA study was carried out in an inner-city emergency department (ED) of patients returning for related complaints within 48 h of discharge. The incidence was around 0.7% and the majority (82%) of patients presented with persistence or progression of the original symptoms. Patient-related factors accounted for 13% of returns and only 5% were found to be the result of doctor-related factors. Of the returnees, 54% were discharged and 36% were admitted. The most common initial complaint was pain (31 %) which, in 23% of patients, was localized to the abdomen. Injury (14%) and febrile illnesses (13%) came second and third. Asthma and chronic obstructive airway diseases (COAD) also accounted for 8% of cases. Children of less than 10 years of age were more likely to return within 48 h. About 18% of cases were thought to be potentially avoidable. Better patient education and an improvment in primary health care services were thought to be important in decreasing such avoidable reattendance. Reattendance audit was a useful tool in the continuous quality improvement programme of emergency department.

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“Bounces”: An analysis of short-term return visits to a public hospital emergency department

Cited by 128 publications

References 14 publications

Evaluating Unscheduled Readmission to Emergency Department in the Early Period

Evaluating Unscheduled Readmission to Emergency Department in the Early Period

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Reattendance audit in an inner-city emergency department.

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