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Improving Telephone Follow‐up for Patients Discharged from the Emergency Department: Results of a Randomized Controlled Trial
Author(s) -
Menchine Michael,
Oberfoell Stephanie,
Schriger David,
Walker Christopher,
Riddell Jeff,
Arora Sanjay
Publication year - 2013
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12128
Subject(s) - medicine , emergency department , confidence interval , odds ratio , randomized controlled trial , intervention (counseling) , emergency medicine , telephone call , multivariate analysis , randomization , medical emergency , physical therapy , family medicine , surgery , nursing , electrical engineering , engineering
Objectives Reliable telephone follow‐up offers physicians a timely method to notify patients of unexpected laboratory and imaging results, clarify discharge instructions, evaluate health status changes, and potentially boost patient satisfaction. This study sought to determine if verifying telephone numbers, obtaining best contact times, and informing patients that they will be contacted would increase the proportion of emergency department ( ED ) patients contacted at 48 to 72 hours postdischarge. Secondary outcomes included estimating successful postdischarge follow‐up across demographic categories. Methods This was a prospective, randomized controlled trial of adult patients in an inner‐city, public hospital ED . Patients were excluded for critical illness, no telephone number, non–English‐ or non–Spanish‐speaking, or anyone admitted as an inpatient. All subjects completed a demographic questionnaire. In the intervention arm, research assistants ( RA s) verified the telephone number, obtained best contact times, and informed subjects that they would be called. In the control arm, telephone numbers were obtained from registration materials and were not verified, and subjects were not informed that postdischarge telephone calls were planned. RA s made four telephone attempts to contact each subject 48 to 72 hours after discharge. Results The intervention did not significantly improve postdischarge contact. Most subjects, 72.8% in the intervention group and 68.2% in the control group, were successfully contacted (difference = 4.6%, 95% confidence interval [ CI ] = –2.2% to 11.4%). On multivariate analysis, Hispanic ethnicity and owning a mobile phone were associated with increased odds of successful postdischarge follow‐up. Conclusions Verifying contact information, obtaining best contact times, and notifying patients of impending follow‐up calls did not substantially improve postdischarge telephone contact rates.