Postdischarge phone calls after pediatric hospitalization: an observational study.

Abstract

Difficulties with transition from inpatient to outpatient care can lead to suboptimal outcomes for patients. We implemented a protocol for systematic follow-up phone calls to families of pediatric patients after discharge, primarily to improve care transition. We also hypothesized that the phone calls would decrease readmissions and emergency department (ED) visits after discharge and improve patient satisfaction. We conducted a quasi-experimental study examining the impact of routinely making follow-up phone calls, compared with historical control discharges. We implemented standardized attending physician phone calls to families of all patients discharged from a general pediatric hospitalist service. Calls were made within 72 hours of discharge to assess problems with transition. Charts were reviewed for documentation of difficulty with the care transition, 14-day and 30-day readmissions, ED visits, and Press-Ganey satisfaction scores. All results in the 12 months after the intervention were compared with the preceding12 months. We reached 78% of all patients' families by phone after discharge. Of the families reached, 19.9% needed an issue addressed, half of which were medication related. There were improvements in 14-day and 30-day readmissions and 14-day ED visit rates, as well as improvement in patient satisfaction scores, but none of these results reached statistical significance. Standardized, physician-performed, postdischarge phone calls identified frequent patient care issues related to difficulties with inpatient to outpatient transition, many of which were medication related. However, our study was underpowered to detect a statistically significant correlation with changes in readmission rates, ED visits, or patient satisfaction.