Primary care follow-up after an emergency department (ED) visit is an important component of comprehensive healthcare, contributing to both improved patient outcomes and reduced readmissions to emergency care. In alignment with the Clinical Nurse Leader (CNL) roles of risk anticipator and lateral integrator of care, this project aimed to support improvement in care continuity for patients at a large primary care clinic in London. At this clinic, a team of physicians, nurses, and support staff care for a diverse population of adult and pediatric patients who account for nearly 3,000 ED visits annually. Assessment of the clinical review process used to coordinate post-emergency follow-up revealed that less than 22% of patients receive timely care and the process to initiate care takes an average 15 days to complete. To address this gap in quality and efficiency, an interprofessional team utilized root-cause analyses, process optimization, and small tests of change to develop an optimized clinical review process for post- emergency department follow-up care. Implementation of the process resulted in an 81.3% decrease in clinical review time and a 34.5% increase in on-time follow-up care. Process optimization is an effective framework through which rapid improvements in care processes can be implemented to enhance care quality and efficiency.
","abstract_html":"<p>Primary care follow-up after an emergency department (ED) visit is an important component of comprehensive healthcare, contributing to both improved patient outcomes and reduced readmissions to emergency care. In alignment with the Clinical Nurse Leader (CNL) roles of risk anticipator and lateral integrator of care, this project aimed to support improvement in care continuity for patients at a large primary care clinic in London. At this clinic, a team of physicians, nurses, and support staff care for a diverse population of adult and pediatric patients who account for nearly 3,000 ED visits annually. Assessment of the clinical review process used to coordinate post-emergency follow-up revealed that less than 22% of patients receive timely care and the process to initiate care takes an average 15 days to complete. To address this gap in quality and efficiency, an interprofessional team utilized root-cause analyses, process optimization, and small tests of change to develop an optimized clinical review process for post- emergency department follow-up care. Implementation of the process resulted in an 81.3% decrease in clinical review time and a 34.5% increase in on-time follow-up care. Process optimization is an effective framework through which rapid improvements in care processes can be implemented to enhance care quality and efficiency.</p>","abstract_has_math":false,"creators":["Malpass, Liam"],"institution":null,"degree_name":"Master of Science in Nursing (MSN)","degree_level":"Project/Capstone - Global access","degree_discipline":null,"degree_department":null,"school":null,"contributors":["Elena Capella, EdD, MSN, MPA, RN, CNL, CPHQ, LNCC"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2017,"date_issued":"2017-12-15T08:00:00Z","date_published":"2017-12-15T08:00:00Z","updated_at":"2026-07-24T05:44:13Z","subjects":["care delays","clinical process efficiency","primary care follow-up after emergency department","process optimization","Family Practice Nursing","Nursing","Other Nursing"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://repository.usfca.edu/capstone/641","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Elena Capella, EdD, MSN, MPA, RN, CNL, CPHQ, LNCC"]},{"key":"dc:creator","label":"Author","values":["Malpass, Liam"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2017-12-02T08:00:00Z"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Project/Capstone - Global access"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Master of Science in Nursing (MSN)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["care delays","clinical process efficiency","primary care follow-up after emergency department","process optimization","Family Practice Nursing","Nursing","Other Nursing"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://repository.usfca.edu/capstone/641"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Primary care follow-up after an emergency department (ED) visit is an important component of comprehensive healthcare, contributing to both improved patient outcomes and reduced readmissions to emergency care. In alignment with the Clinical Nurse Leader (CNL) roles of risk anticipator and lateral integrator of care, this project aimed to support improvement in care continuity for patients at a large primary care clinic in London. At this clinic, a team of physicians, nurses, and support staff care for a diverse population of adult and pediatric patients who account for nearly 3,000 ED visits annually. Assessment of the clinical review process used to coordinate post-emergency follow-up revealed that less than 22% of patients receive timely care and the process to initiate care takes an average 15 days to complete. To address this gap in quality and efficiency, an interprofessional team utilized root-cause analyses, process optimization, and small tests of change to develop an optimized clinical review process for post- emergency department follow-up care. Implementation of the process resulted in an 81.3% decrease in clinical review time and a 34.5% increase in on-time follow-up care. Process optimization is an effective framework through which rapid improvements in care processes can be implemented to enhance care quality and efficiency.
"]},{"key":"dc:title","label":"Title","values":["Reducing Delays in Follow-up Care through Process Optimization"]}]}],"canonical_facts":{"dc:contributor":["Elena Capella, EdD, MSN, MPA, RN, CNL, CPHQ, LNCC"],"dc:creator":["Malpass, Liam"],"dc:date.available":["2017-12-02T08:00:00Z"],"dc:description.abstract":["Primary care follow-up after an emergency department (ED) visit is an important component of comprehensive healthcare, contributing to both improved patient outcomes and reduced readmissions to emergency care. In alignment with the Clinical Nurse Leader (CNL) roles of risk anticipator and lateral integrator of care, this project aimed to support improvement in care continuity for patients at a large primary care clinic in London. At this clinic, a team of physicians, nurses, and support staff care for a diverse population of adult and pediatric patients who account for nearly 3,000 ED visits annually. Assessment of the clinical review process used to coordinate post-emergency follow-up revealed that less than 22% of patients receive timely care and the process to initiate care takes an average 15 days to complete. To address this gap in quality and efficiency, an interprofessional team utilized root-cause analyses, process optimization, and small tests of change to develop an optimized clinical review process for post- emergency department follow-up care. Implementation of the process resulted in an 81.3% decrease in clinical review time and a 34.5% increase in on-time follow-up care. Process optimization is an effective framework through which rapid improvements in care processes can be implemented to enhance care quality and efficiency.
"],"dc:identifier":["https://repository.usfca.edu/capstone/641"],"dc:subject":["care delays","clinical process efficiency","primary care follow-up after emergency department","process optimization","Family Practice Nursing","Nursing","Other Nursing"],"dc:title":["Reducing Delays in Follow-up Care through Process Optimization"],"thesis:degree_level":["Project/Capstone - Global access"],"thesis:degree_name":["Master of Science in Nursing (MSN)"]},"updated_at":"2026-07-24T05:44:13Z"}