Our EMR lets us generate reports of our 72-hour returns – and it’s a fun toy, but, reading through it is rarely illuminating. On a rare occasion you see a “true miss”, where one of your colleagues finds something through another line of thinking. But, mostly, it’s wound checks, admissions for failed outpatient antibiotic therapy for cellulitis, or the town drunk coming back in again. It is a valuable tool, at least, in the sense that our ED is the only one for 40 miles and is the only tertiary center for 90 miles, so we should get most of our own bouncebacks.
And, this study essentially confirms my anecdotal observations – most people who come back return for non-emergent conditions, do not require significant additional testing, and are no more likely to be admitted. Their conclusion, then, is that 72-hour returns are of limited utility as a quality measure – something of which I tend to agree…although, if it were, the unintended consequence of discouraging that 2-day wound check/abscess repacking might finally put abscess packing to rest….