Feasibility of Using a Pediatric Call Center as Part of a Quality Improvement Effort to Prevent Hospital Readmission

Kirsch, Sallie Davis; Wilson, Lauren; Harkins, Michelle; Albin, Dawn; Beccaro, Mark A. Del

doi:10.1016/j.pedn.2014.08.005

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…54 Studies assessing the effectiveness and cost-effectiveness of interventions to reduce pediatric readmissions are still rare, but promising approaches have included 1-on-1 inpatient education and postdischarge support by telephone or clinic visit. 55,56 Our finding of an overall unadjusted 30-day readmission rate of 5.5% after LRI index admissions was the same as the all-cause readmission rate reported by Bardach et al 57 as for other hospitalizations, that the "optimal" readmission rate is not known. Even if some readmissions could be prevented, others would be appropriate and unavoidable, and our study was not designed to distinguish among these possibilities.…”

Section: Figuresupporting

confidence: 77%

Pediatric Readmissions After Hospitalizations for Lower Respiratory Infections

et al. 2017

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Section: Figuresupporting

confidence: 77%

Pediatric Readmissions After Hospitalizations for Lower Respiratory Infections

et al. 2017

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“…In addition, the use of QI interns helped alleviate barriers and maximize nurses' clinical skills while maintaining patient continuum of care, which is a need that organizations have expressed. [6,13,14] This filtration system resulted in much higher nurse phone call completion compliance rate (85%) within the targeted 72-hour window as compared with other studies (e.g., 45%). [6] Of note, QI intern postdischarge follow-up calls, in conjunction with nurse follow-up intervention, showed a statistically significant (risk ratio ¼ À3.31, p ¼ 0.012) preventive effect on unplanned readmission rate.…”

Section: Discussionmentioning

confidence: 93%

Using Intern-Led Quality Improvement to Reduce Readmissions for Specialty Service Patients Within an Academic Medical Center

Felipe

Vats

Sleiman

et al. 2021

Global Journal on Quality and Safety in Healthcare

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Introduction Postdischarge patient calls are an effective intervention to decrease unplanned readmissions. Despite its efficacy, calls are time consuming and compete with other clinical obligations. The purpose of this study was to evaluate the viability of intern-led quality improvement (QI) on conducting initial postdischarge calls to filter patients who require clinical or nurse follow-up. Methods QI interns from an academic medical center's QI program completed postdischarge patient calls within 72 hours of patient discharge from a neurosurgery service between June 2018 and July 2019. QI interns filtered patients who required follow-up calls from a clinical service or nurse department. The departments called patients within 48 hours of requests. Unplanned readmission rate was compared between the cohort of patients who requested and received a follow-up call versus a cohort of patients who requested and did not receive a follow-up call (control). Results QI interns completed 83.8% postdischarge patient calls within 72 hours of discharge. Reasons for unsuccessful calls included patient unresponsiveness (74.6%), wrong phone number on file (13.9%), and request to be called at a different time (11.5%). Nurses completed 57.2% follow-up requests within the targeted 48 hours and completed remaining requests within 7 days. QI intern postdischarge follow-up calls, in conjunction with nurse follow-up intervention, showed a significant (risk ratio = −3.31, p = 0.012) preventive effect on unplanned readmission rate. Conclusions QI interns are a viable alternative to nurses to conduct the first contact of postdischarge patient follow-up calls. This system of QI interns filtering calls to the correct clinical service or nurse department increased postdischarge patient follow-up calls success rate and decreased readmission rates.

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“…These findings are consistent with the majority of studies that have shown that in addition to discharge instructions and education provided to patients and/or the patient's legal caregiver, follow-up calls post-discharge can be effective at reducing readmissions. [9,17,18,24,25] In the USA, readmissions make up $41 billion in health care spending. [5] Implementing small-scale low-cost interventions in health care, such as follow-up calls postdischarge, could save hospitals from penalties, improve patient outcomes, and contribute to the reduction of health care costs.…”

Section: Discussionmentioning

confidence: 99%

“…More common hospital follow-up calls are primarily conducted by clinical staff such as nurses, physicians, or pharmacists. [9,19,24,25,29] A recent review by Meek Clinical Partners, LLC, found that about 73% of the primary initiators of follow-up calls post-discharge are nurses. [25] The problem with utilizing clinical staff to initiate follow-up calls post-discharge is that it adds to their list of responsibilities and many dislike making post-discharge calls with over 20% affirming that they would rather do any other task.…”

Section: Discussionmentioning

confidence: 99%

Impact of Post-Discharge Follow-Up Calls on 30-Day Hospital Readmissions in Neurosurgery

Mwachiro

Baron-Lee

Kates

2019

Global Journal on Quality and Safety in Healthcare

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Background: Hospital readmissions that occur within 30 days of the initial hospital stay are costly and potentially avoidable. Studies have shown that in addition to patients’ discharge instructions and education, follow-up calls post-discharge can significantly reduce readmission that occurs within 30 days of the initial hospital stay. Objective: To evaluate the effectiveness of nurse follow-up calls conducted in the neurosurgery service for discharged patients between October 2017 and February 2018 in reducing readmissions that occur within 30 days of initial hospital stay. Methods: An audit was initially conducted to assess compliance with conducting follow-up calls. Weekly discharge reports were used to check if patients received a follow-up call within 24–48 h post-discharge. To capture the nurses’ feedback on follow-up calls, an anonymous survey was administered. Medical insurance claims data, also known as claims-based data in the American health care system, were reviewed and analyzed to assess whether there was any difference in number of days from initial discharge to readmission between patients who received a follow-up call and those who did not. Results: Results based on a multivariable regression model indicated that patients who received a follow-up call after they were discharged from initial admission stayed out of hospital longer (incidence-rate ratio = 1.54, 95% CI = [1.13, 2.10], p = 0.006) compared to those that did not receive a follow-up call. Conclusion: Readmitted patients who received post-discharge follow-up calls had significant improvements in the length of time out of the hospital. Future development could include developing additional call strategies.

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Feasibility of Using a Pediatric Call Center as Part of a Quality Improvement Effort to Prevent Hospital Readmission

Cited by 9 publications

References 11 publications

Pediatric Readmissions After Hospitalizations for Lower Respiratory Infections

Pediatric Readmissions After Hospitalizations for Lower Respiratory Infections

Using Intern-Led Quality Improvement to Reduce Readmissions for Specialty Service Patients Within an Academic Medical Center

Impact of Post-Discharge Follow-Up Calls on 30-Day Hospital Readmissions in Neurosurgery

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