Survey of Follow‐up Systems in Emergency Medicine Residencies: Analysis and Proposal

Objective:For educational purposes, the Residency Review Committee for Emergency Medicine requires that emergency medicine residencies “provide a mechanism for each resident to obtain information on outcomes of patients the resident has evaluated in the emergency department.” The authors analyzed the current patient follow‐up systems of emergency medicine residencies and, based upon survey results, propose a comprehensive organized system of follow‐up. Methods:The 84 emergency medicine residency directors listed in the 1991 Society for Academic Emergency Medicine Handbook were polled regarding the current follow‐up systems at all hospitals affiliated with their residencies. The survey contained 11 items, including two five‐point Likert scales for rating system effectiveness and satisfaction. A description of each hospital's follow‐up system was requested, and other comments were reviewed. Results:The 72 (86%) respondents represented residencies with a total of 138 affiliated hospitals, of which 89 (64.5%) had formal follow‐up systems. Of those 89 hospitals, 39% (n= 80) residency directors reported that fewer than half of their residents used the systems, 63% (n= 87) had mandatory compliance policies; 53% had the capability for residents to obtain discharge summaries on admitted patients; and 66% (n= 83) had mechanisms for follow‐up of patients released from the emergency department. Twenty‐three percent of the systems were considered effective, with ratings of 4 or higher, and only 31% received satisfaction ratings of 4 or more. Conclusion:Most emergency medicine residency‐affiliated hospitals in our survey had follow‐up systems in place. Of existing systems, only a minority were rated by residency directors as effective or satisfactory. A model for a comprehensive system of patient follow‐up is proposed.