South Florida Hospital News
Tuesday March 26, 2019
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April 2006 - Volume 2 - Issue 10

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Discharge Phone Calls Deliver Quality Care, Higher Patient Satisfaction

Recently a nurse told me about a patient who thanked her for saving his life. She said, "When I called, the patient recognized my name and started to express his gratitude. He said we made him feel like the only patient we had that day in the ER and if it hadnít been for the doctor who insisted he be admitted (despite his reluctance), he wouldnít be alive today. "

She told me she would have never known she had made such a difference, if she hadnít made the phone call. While nurses are sometimes skeptical at first about the additional burden of making the calls, they almost always embrace the opportunity after making some calls because they connect to clinical excellence.

Why to Make the Calls

There is ample body of research (see sidebar) that post-visit phone calls to hospital inpatients deliver multiple benefits. 

Not only do they engage staff and offer an opportunity to harvest reward and recognition for high-performing physicians and employees, but patients are wowed by the calls. It makes them feel cared about as a person, one of patientsí top three priorities when they are in the hospital. As a result, patient satisfaction climbs dramatically at hospitals that implement and consistently make discharge phone calls.

Post-visit calls also:

  • Reconfirm discharge instructions,
  • Reduce patient anxiety,
  • Reduce complaints and claims,
  • Reinforce patient perception that excellent care has been provided, and
  • Offer an opportunity for quick service recovery.

"You have a 90% chance of keeping a patient if you call within 48 hours of discharge and do somethingólike apologizeóto make the patientís experience better. If you wait longer than a week, you have a 10% chance youíll lose 10 other patients through word of mouth," adds Studer Groupís medical director Dr. Jay Kaplan. At his practice, all ED physicians who do clinical shift work make follow up calls or face financial penalties.

Another example in the persuasive case for making follow-up calls: In one study of 400 consecutively discharged patients, 19% of patients reported adverse events (drug events and procedure-related injuries) post-discharge. Forty-eight percent of these were preventable.1 In an Aug. 2005 follow-up study, researchers found that of those patients who reported adverse events in the original study, 71% were significant, 13% were serious, and 16% were life threatening.2

Taking Action: How to Hardwire Post-Visit Phone Calls

Here is what I recommend for organizations interested in implementing these important calls to ensure they consistently take place.

First, select a unit to pilot the post-visit phone calls. Ask the unit secretary to pull face sheets and discharge instructions. Then, for the next four to six weeks (or until comfortable), ask the nurse manager to make calls to patients recently discharged home.

Be sure to use a standardized form to collect information. (Some organizations prefer Studer Groupís Discharge Call ManagerSM software to eliminate manual processes and document for JCAHO, but you can also use a simple paper form.)

Ask the nurse manager to keep track of patient feedback (appropriate individuals can be recognized and action can be taken in areas where there is opportunity for improvement). Also track the length of the calls, which should take three to five minutes each. Share this information with all nurses during the pilot period.

When you are ready to roll out the calls to all nurses, ensure that nurses call the patients whom they have taken care of (one to two patients per day).  Once nurses are making calls, the nurse manager collects information for review and educates staff on opportunities for improvement.

A Sample Script for Post-Visit Discharge Phone Calls

A good discharge phone call does a number of things. It demonstrates empathy and concern; assesses clinical outcomes; harvests reward and recognition (that can be shared with high performing physicians and staff); asks about the service the patient received; identifies opportunities for process improvement; and expresses appreciation. Here is an example:

In summary, discharge phone calls are good for the patient, the physician, the employee, and the health of the organization. Once a nurse reaches a patient and finds out his call saved a life because a parent wasnít giving a child prescribed medication or an elderly patient needed to be re-admitted, he will make those calls for the rest of his career and look forward to them. In fact, one chief nurse officer (CNO) I know tells her nurses, ĎHaving a bad day? Call a patient. It bonds you to them."

SG WebLink

Review the evidence.

Log on to www.studergroup.com and search on "discharge meta analysis" to review an in-depth meta-analysis of research supporting discharge phone calls to hospital patients.

Footnotes:

1 2003 Annals of Internal Medicine, "The incidence and severity of adverse events effecting patients after discharge from the hospital", Feb 4; 138 (3): 161-7. Forster, A., Murff, H., Peterson, J., Gandhi, T., Bates, D. (Note: A second study in 2005 by these authors using a subset of patients from the original study validated these findings. 2005 Journal of General Internal Medicine "Adverse drug events occurring following hospital discharge." Apr; 20 (4): 327-23 Forster, A., Murff, H., Peterson, J., Gandhi, T., Bates, D.

2 State University of New York Study, Mayo Clinic Proceedings

Quint Studer, CEO, Studer Group and author of Hardwiring Excellence, can be contacted at Quint@studergroup.com or (850) 934-1099.
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