Abstract
Purpose :
Emergency Department (ED) and hospital inpatients seen by ophthalmology residents are typically provided a follow-up appointment in the clinic. However, some patients fail to show up and go back to the ED when their condition recurs or does not resolve. The aim of this study is to investigate the prevalence of the bounce-back and develop strategies to reduce it.
Methods :
A log of all ophthalmology consults seen in ED or inpatient setting is maintained in this academic, University-based center. Data on all consults between April 2020 and November 2023 were analyzed to look at the 'repeat' consults.
Results :
Of 1279 consults during this period, 55 (4%) patients were seen as consults more than once: 47 were seen twice and 8 were seen 3 times. Analyzing the 55 bounce-back patients, 36 (65%) had an appointment scheduled and 20 (36%) showed up in the clinic. Of these 55 patients, 34 were initially seen in ED and 21 seen as inpatients. Of the 34 initially seen in the ED, 24 (71%) had a clinic appointment scheduled but only 12 (50%) showed up. Of the 21 seen as inpatients, 12 (57%) had an appointment scheduled, of which only 4 (33%) showed up. The average age of these 55 patients was 50 years (range 18-85 yrs; 31 males and 24 females). 12 out of 55 patients were uninsured.
Conclusions :
The prevalence of 'repeat' consults in patients seen in ED or inpatient setting was low (4%). Of all the bounce-back patients (n=55), only 65% (36/55) that were seen as consults initially had a follow up appointment scheduled and only 29% (16/55) were actually seen in the clinic. Consults that were seen as inpatients had less follow up appointments scheduled and a higher no-show rate compared to patients who were seen in the ED. This was likely due to the unpredictability of the hospital course and discharge date. Ensuring all consultations have a clinic follow up scheduled is one strategy to reduce the bounce-back rate. For inpatients, follow-up can be scheduled based on predicted discharge date and rescheduled if they are still in the hospital on the day of appointment. It is also important to educate the patient at the time of consult of the importance of compliance with the appointment date. These strategies have been implemented with the aim of lowering the bounce-back rate of patients seen as consults.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.