Improving Emergency-Room Patient Follow-up in a Metropolitan Teaching Hospital

Abstract A randomized controlled study was conducted to determine whether addition of a Follow-up Clerk to the emergency-room staff would improve compliance among emergency-room patients requiring follow-up observation for nonurgent conditions. Two hundred and ninety-one patients scheduled either for x-ray studies with follow-up clinic visits or for follow-up clinic visits because of hypertension were randomized into Intervention and Control Groups. For the Intervention Group, the Clerk reminded patients of scheduled appointments, offered assistance and followed them to ensure completion of x-ray examination or return to clinic (or both). Eighty per cent of the Intervention Group and 58 per cent of the Control Group returned to the clinic (p<0.001). Thirty-seven per cent of the Intervention Group required assistance beyond routine reminders. Intervention was associated with higher compliance regardless of age, race, sex, marital or employment status. Thus, addition of a Follow-up Clerk in the emergency room may significantly improve patient return for follow-up care. (N Engl J Med 291:385–388, 1974)