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Description
EBP
Background: Discharge follow-up programs help to reduce avoidable readmissions and unnecessary returns to the emergency department. Our organization lacked a clearly defined post-inpatient discharge process for patients on the hospitalist service. Information on the after-visit summary (AVS) includes follow-up appointment instructions and lists the main hospital phone number. Primary care providers often refer patients back to the hospital for questions related to the hospital stay. Post-discharge follow-up phone calls are labor-intensive, hard to sustain, and may not meet the patient’s needs. We sought a technology solution to assist and engage families post-discharge.
Purpose: This project aims to determine if patient-initiated calls to experienced triage nurses in a 24/7 centralized call center can identify barriers and assist with self-management at home.
Implementation: Leveraging technology and a new AVS phone number workflow, we implemented a pilot program to engage patients after discharge in January 2021. Patients discharged from the hospitalist service received a standardized text message script comprising seven discharge-related questions. In the technology solution, responses to the text questions either prompt the user to connect with the Nurse Advice Line (NAL) or move to the next question. The phone system identifies calls originating from either discharge method, and lines are open 24/7. In January 2022, the NAL partnered with Care Coordination. Symptom-based calls route to the NAL for triage 24/7, and all other call types route to the NAL after business hours.
Outcomes: In 2023, the hospitalist service discharged 2,305 patients.
For Quarter 1 of 2023, the NAL managed 95 calls. Of those, 56 had new or worsening symptoms, 24 had a medication issue or questions about their medications, and three had questions about their discharge instructions. The remaining had inquiries about durable medical equipment, general information, work or school notes, and follow-up appointments.
For Quarter 2 of 2023, the NAL managed 220 calls. Of those, 144 had new or worsening symptoms, 51 had a medication issue or questions about their medications, five had questions about their discharge instructions, and the remaining DME, general information, work or school notes, and follow-up appointments.
Of the 315 patient calls for 2023, 39 patients required readmission.
Relevance: This poster will enable the learner to understand why pediatric patients call after hours and meet them at their time of need for prompt answers.
- Binder, Andrew B. and Donald F. Cox. “Changes in Health Care Costs and Mortality Associated with Transitional Care Management Services after a Discharge among Medicare Beneficiaries.” JAMA Internal Medicine 178.9 (2018):1165-1171
- Bressman, Eric, MD, MSHP: Judith A. Long, MD and Katherine Honig, et al. “Evaluation of Automated Text Message-Based Program to Reduce Use of Acute Health Care Resources after Discharge.” doi:10.1001/jamanetworkopen.2022.38293
Publication Date
9-27-2024
Keywords
EBP, Evidence-Based Pracitce, Evidence-Based Nursing, Telephone Triage, Outpatient Nursing
Disciplines
Pediatric Nursing
Recommended Citation
Webber, Susan and Gosdin, Ann, "Got Questions? Call us: Utilizing Telephone Triage to Help Pediatric Patients After Discharge" (2024). 2024. 32.
https://scholarlycollection.childrens.com/nursing-anf2024/32
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
