Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug:94:166-172.
doi: 10.1016/j.ajem.2025.04.054. Epub 2025 Apr 25.

Expanding acute care treatment and disposition options: Creating a post-ED rapid clinic follow-up program

Doug Wallace  1 , Chetan Aher  2 , Patty Wright  3 , Justin Young  4 , Mitchell Sexton  5 , C Blayke Gibson  6 , Stephan Russ  7 , Schiara Gonzalez Parker  8 , Nathaniel Miller  9 , H Gerard Colmer 4th  10 , Tyler W Barrett  11
Affiliations
Free article

Expanding acute care treatment and disposition options: Creating a post-ED rapid clinic follow-up program

Doug Wallace et al. Am J Emerg Med. 2025 Aug.
Free article

Abstract

Background: Emergency department (ED) arrivals are surging in hospitals across the United States, with many systems facing significant capacity challenges. Identifying effective and safe alternative dispositions for patients is one solution to the capacity and boarding crises.

Methods: Our health system created a rapid post-ED evaluation follow-up process through enterprise-wide collaboration among multiple service lines. This system allowed for real-time payer agnostic scheduling of rapid subspecialty and primary care outpatient follow-up appointments for ED patients as a safe alternative to hospital admission.

Results: During the first 12 months of the program, 735 referrals were ordered by the ED physicians with 551 (75 %) of appointments identified to have safely averted a hospital admission on retrospective review by a physician oversight leader. Program safety was measured by appointment completion and return ED visits within 1 week. More than 80 % of patients attended their appointments, 74 patients had one or more repeat visits to the ED within seven days with 26 patients (3.5 %) admitted on the subsequent visit. No patients required an escalation of inpatient care to an intensive care or intermediate care unit.

Conclusions: The post-ED rapid clinic follow-up program has been successful and provided a safe alternative to hundreds of patients who would otherwise have been admitted and often boarding in our ED for hours to days. Health systems dealing with capacity challenges may consider implementing an individualized version of this program.

Keywords: Alternative disposition; Boarding; Capacity; ED administration; ED operations; Follow up; Overcrowding.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Dr. Barrett is supported in part by a Tennessee Department of Health Statewide Cooperative Agreement for Emergency Response supporting the development and dissemination of opioid use disorder education.

LinkOut - more resources