72-hour discharge calls
Symptom trajectory, wound checks, whether the analgesia is working, whether the safety-net advice was understood. Deterioration routes straight back to the department with the index visit attached.
Specialty · Emergency Medicine
The calls around the department, so the department can work.
Post-discharge follow-up, results callbacks, ambulatory pathway coordination and the endless 'should I come in' calls — handled with emergency thresholds and an unambiguous bias toward being seen.
- 100%
- 72-hour discharge follow-ups attempted
- < 60s
- To emergency advice on a red flag
- 38%
- Fewer avoidable re-presentations
In the product
ED follow-up — discharge 22108
ReturningOutbound 09:30 · 72h post-discharge · Liam N. · 34 · left leg cellulitis · flucloxacillin
Primum
You were seen on Sunday for the leg. Has the redness stayed inside the pen line they drew on it?
Caller
No, it's gone past it, up towards the knee. And I was shivering last night.
Primum
Are you able to take fluids and keep them down?
Caller
Yes, but I feel rotten.
Spreading margin + new rigors on oral therapy → failed outpatient treatment · return advised
Primum
I need you to come back to the department today. I've flagged your record so they know you're coming and why — bring the antibiotics with you.
Follow-up record
- Index visit
- Sun 21:40 · cellulitis
- Margin
- Extended beyond marking
- Systemic
- Rigors overnight
- Oral intake
- Maintained
- Decision
- Return today
- Department
- Pre-notified 09:34
Episode kept open · index visit linked · IV pathway flagged
Overview
Emergency medicine's phone problem starts when the patient leaves.
- Uncertainty always resolves toward attendance — never toward reassurance.
- Every discharge gets a follow-up attempt, not just the ones somebody remembered.
- Positive cultures and incidental findings chased until the patient is actually reached.
A department is built to see people, not to ring them. But the work that determines whether a discharge holds happens afterwards: the follow-up call at 72 hours, the culture result that came back positive, the patient who was told to return if something changed and cannot decide whether it has.
Primum takes that work with emergency thresholds applied throughout. The bias is always toward being seen: anything ambiguous produces advice to attend, not reassurance. Post-discharge calls are made on every single discharge, positive cultures are chased until the patient is reached, and ambulatory pathways are coordinated so the follow-up appointment exists before the patient asks about it.
Capabilities
The four jobs that fall off the end of a shift
Each of these is real clinical work, and each of them is the first casualty of a full department.
Culture and result callbacks
Positive cultures, discordant antibiotics, radiology addenda and incidental findings. Chased across channels until the patient is reached, with escalation if they are not.
Pre-arrival advice, erring toward coming in
'Should I come back?' is answered against emergency thresholds. Anything that could be serious produces clear instructions to attend, with what to bring and where to present.
Ambulatory pathways coordinated
Same-day clinic slots, DVT and cellulitis pathways, fracture clinic and hot clinic appointments booked at discharge rather than left to a letter.
How it works
From discharge to a closed episode
The department's clock stops when the patient leaves. This one does not.
- Arrives
- Decided
- Done
- Returned
01
Discharge registered
Diagnosis, safety-net advice, prescriptions and pending investigations captured from the record as the patient leaves.
Index visit linked
02
Follow-up made
Contact at the interval the pathway sets, checking trajectory, adherence and understanding of the advice given.
72h protocol
03
Assessed against thresholds
Answers evaluated against emergency criteria, with ambiguity always resolving toward attendance rather than reassurance.
ED threshold set
04
Returned or closed
Re-attendance arranged with the index visit attached, or the episode closed and written back with the outcome recorded.
Chart write-back
01
Discharge registered
Diagnosis, safety-net advice, prescriptions and pending investigations captured from the record as the patient leaves.
Index visit linked
02
Follow-up made
Contact at the interval the pathway sets, checking trajectory, adherence and understanding of the advice given.
72h protocol
03
Assessed against thresholds
Answers evaluated against emergency criteria, with ambiguity always resolving toward attendance rather than reassurance.
ED threshold set
04
Returned or closed
Re-attendance arranged with the index visit attached, or the episode closed and written back with the outcome recorded.
Chart write-back
Benefits
Safer discharges, fewer avoidable returns
Both at once, because the calls sort which is which.
Pending results stop going missing
A positive culture chased until the patient answers is the difference between a course of the right antibiotic and a re-presentation five days later.
Triage nurses stay in the department
The follow-up list stops being something a senior nurse works between patients.
Re-presentations become visible
Every follow-up contact is coded, so which discharges bounce back — and why — becomes a report rather than an impression.
In practice
Four calls after the doors closed behind them
The same protocol, four very different trajectories.
Cellulitis, 72 hours on
Returned same dayThe margin has extended past the marked line and there is new fever. Advised to return, and the department is told they are coming.
Urine culture, resistant organism
Reached on attempt 3The prescribed antibiotic does not cover the organism. The patient is reached on the third attempt, the prescription is changed and the pharmacy is notified.
Head injury, day 2
Reassured, safety-nettedNo red flags on questioning. Advice repeated, written instructions re-sent, and the episode kept open for a further 24 hours.
'Is this worth coming in for?'
Advised to attendNew unilateral weakness described in passing. Emergency advice given immediately and an ambulance recommended.
Read next
- Intelligent Triage & RoutingClinical triage against your own protocol, applied to every inbound contact — phone, portal message or web form — and routed to the pathway, the team and the timeframe your policy says it belongs in.Open
- After-Hours CoverageEvery call that lands between the last clinic and the first one is answered, triaged against your protocol, and either resolved or escalated to the person actually on call — with a note waiting in the chart by morning.Open
- Task ManagementResults to action, letters to file, forms to complete, calls to return. Every task created, prioritised, drafted and routed — with the ones a person must sign arriving ready to sign.Open
Start with the discharges nobody rings
Most departments attempt follow-up on a fraction of discharges. Give us a week of them and we will call every one, and show you what the calls you are not making would have found.