• Soo Hoon Lee, Kyuseok Kim, Hooyoung Kim, Jin Hee Jeong, Changwoo Kang, Joong Eui Rhee, Young Im Byeon, Yeon Sook Im, Chanjong Park, Joonghee Kim, and Seung Sik Hwang.
• Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
• Emerg Med Australas. 2015 Oct 1; 27 (5): 431-9.

ObjectiveThe objective of the present study is to develop new multifaceted interventions to reduce return visits (RVs) based on identified risk factors related to RVs in the ED and to compare the RV rate before and after the implementation of the intervention.MethodsThe present study was a controlled before and after study that was conducted in the ED of a 900-bed tertiary hospital in an urban area. The primary outcome was the rate of unplanned RVs to the ED and hospital admission after RV. The risk and predictive factors of RVs were identified by a retrospective study of all unscheduled RVs to the ED within 72 h in 2011. We developed five new multifaceted interventions based on the results: (i) daily RV feedback; (ii) prescription set of drugs; (iii) creation of a discharge instruction sheet; (iv) early follow-up appointments of outpatient department (OPD); and (v) enhancement of referral system. A prospective interventional study in which the interventions were implemented was then conducted over 10 months, from 1 June 2012 to 31 March 2013.ResultsThe five new multifaceted interventions significantly reduced the mean early RV rate and RV admission rate after ED discharge by an average of approximately 25%, with a maximum of approximately 55% and 47%, respectively, compared with the pre-intervention period (RV rate: P < 0.001, RV admission rate: P < 0.001).ConclusionsMultifaceted interventions based on identified risk factors for early RV after ED discharge had a positive effect on reducing RVs and the admission rate after RVs for adult patients within 72 h of non-traumatic ED visits.© 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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