This article describes the 1-year follow-up program implemented at Baystate Medical Center Emergency Department during 1999. Our previous system used staff who worked clinically, which led to prolonged delays in follow-up. Before initiating the program, 57% [95% confidence interval (CI): 55-59%] of all follow-up cases were done within 3 days. After program implementation, 69% (95% CI: 67-72%) of all follow-up cases were completed in the same time frame. We reduced our "delayed" follow-up cases from 20% (95% CI: 18-22%) to 4% (95% CI: 3-5%) of all cases. Critical to the new system is the assignment of nurse-physician pairing to do follow-up when they are not doing direct patient care.