# Assessing Feasibility of Measuring Veterans’ Experiences and Receipt of Follow-Up Care after VA Emergency Department Treat-and-Release Visits

> **NIH VA I21** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2020 · —

## Abstract

Multiple studies have documented that poor communication across care transitions leads to
medical errors, adverse clinical outcomes, inefficient care, and less favorable patient
experiences. However, relatively little attention has been given to the transition between
emergency department (ED) and follow-up care for patients discharged directly from the ED.
Patients discharged from EDs may have one or more urgent follow-up care needs, such as
repeat laboratory assessments, specialty care consultations, and specialized diagnostic testing.
Available literature suggests that failures to receive follow-up care after being sent home from
ED visits are a crucial patient safety issue. Inadequate communication and coordination of
follow-up care recommendations may be leading to such failures.
Veterans make approximately 2 million visits to VA EDs each year, and are discharged from the
ED nearly 80% of the time. Patients presenting to VA EDs generally have complex medical
histories, and therefore are at particularly high risk for experiencing adverse outcomes. Among
a cohort of 942 Veterans 65 years of age or older discharged from the Durham VA ED in 2003,
34% had a return ED visit, were hospitalized and/or died within 90 days.
Despite this vulnerability, knowledge is scant and outdated about whether Veterans receive the
post-ED care they need to prevent these adverse outcomes, and no assessments have been
done regarding Veterans’ experiences obtaining this care. Tools for assessing Veterans’
experiences with this care transition are needed. Further, VA operations and QUERI-funded
projects have been initiated targeting this transition in VA, and tools are needed to enable
rigorous assessment of their effectiveness.
This project will develop and test a patient survey to measure the quality of communication and
care coordination for this transition. Since ambulatory care can prevent initial chronic disease
exacerbations needing ED visits, it is a reasonable extrapolation that ambulatory care follow-up
after ED visits could prevent re-exacerbations and ED re-visits. Therefore, this work will focus
on Veterans with ED visits for chronic ambulatory care sensitive conditions (ACSCs): 1) asthma,
2) congestive heart failure, 3) chronic obstructive pulmonary disease, 4) diabetes mellitus, and
5) hypertension, since we postulate that these patients are most likely to have follow-up care
needs. Given that there is also scant literature on the ED follow-up care needs of patients with
ACSCs, the work will begin with characterizing the specific follow-up care needs of these
patients using record review. Then, semi-structured interviews will be conducted to investigate
patient-centered perspectives on critical components of post-ED care, asking Veterans about
their communication and care coordination experiences. Interviews will be analyzed to assess
which aspects of communication and coordination are most important for Veterans’ post-ED
experiences as well as other fac...

## Key facts

- **NIH application ID:** 9833338
- **Project number:** 1I21HX002799-01A1
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Kristina Marie Cordasco
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-02-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9833338

## Citation

> US National Institutes of Health, RePORTER application 9833338, Assessing Feasibility of Measuring Veterans’ Experiences and Receipt of Follow-Up Care after VA Emergency Department Treat-and-Release Visits (1I21HX002799-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9833338. Licensed CC0.

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