Racial Disparities in Emergency Department Return After Orthopaedic Surgery (2023-2024)
Unplanned returns to the emergency department (ED) and readmission rates following orthopaedic surgery are important markers for quality of care. A quality improvement project at Duke Health revealed that Black patients were more likely to present to the ED after orthopaedic surgery without a difference in readmission rates compared to white patients.
This project team analyzed the factors associated with emergency department return after orthopaedic trauma surgery, expanding the patient cohort from the pilot study and finding that both race and public insurance status are independent predictors of return to the ED.
The team held focus groups with orthopaedic trauma patients to better understand the issues that they faced upon discharge from the hospital with the goal of improving the discharge counseling process.
Finally, team members began a pilot study exploring the use of a large language model-based check-in system that will automatically follow up with patients at predetermined intervals after surgery. The goal of this effort is to provide patients with continuous support and attention after discharge from the hospital and prevent unnecessary ED visits.
In 2024-2025, the team will quantify the impact of the interventions and publish their findings.
Timing
Summer 2023 – Spring 2024
Team Outputs
Improved guidance for patients discharged from orthopaedic surgery
Focus groups with orthopaedic trauma patients
Intervention implementation
Conference presentations
Racial Disparities in Emergency Department Return After Orthopaedic Surgery (Poster presented at Fortin Foundation Bass Connections Showcase, April 17, 2024)
Race and Government-Funded Insurance are Independent Predictors of Return to the Emergency Department after Orthopaedic Trauma Surgery Within the Global Period (Abstract accepted for Orthopaedic Trauma Association 2024 Annual Meeting, Montreal, Canada, October 2024)
See related team, Racial Disparities in Emergency Department Return After Orthopaedic Surgery (2024-2025).
Image: Foot and Ankle Orthopaedic Surgeon Andrew Hanselman, MD, examines a patient’s achilles during an appointment at Duke Orthopaedics Heritage, by Erin Hull/Duke Health