The importance of postdischarge telephone follow-up for hospitalists: a view from the trenches

doi:10.1016/S0002-9343(01)00970-6

The American Journal of Medicine

Volume 111, Issue 9, Supplement 2, 21 December 2001, Pages 43-44

https://doi.org/10.1016/S0002-9343(01)00970-6 Get rights and content

Abstract

Hospitalist practice highlights the need for effective communication between doctors that share the care of a patient, and between doctors and patients. Telephone contact with patients after hospital discharge can enhance adherence, inform the hospitalist about the results of treatment or of adverse outcomes, and allow the hospitalist to receive feedback from the patient and family.

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Cited by (18)

Modified Rankin scale assessment by telephone using a simple questionnaire
2022, Journal of Stroke and Cerebrovascular Diseases
Citation Excerpt :
Thus, the difference in assessment may depend on the living environment, which needs to be verified in future studies. The use of the telephone surveys for outcome assessment is desirable for clinical studies as well as follow-up of patients after discharge19, 20. Telephone follow-up allows healthcare professionals to easily exchange medical information with patients, manage symptoms, and provide reassurance21, while saving the time spent by patients on traveling to the hospital.
: The modified Rankin Scale (mRS) is widely used as a measure of post-stroke physical disability in clinical stroke trials; however, it is affected by inter-rater discrepancies. A Japanese version of the simplified mRS questionnaire (J-RASQ) has the potential to overcome the inter-rater discrepancies and might be feasible for clinical surveys. We aimed to determine the reliability of J-RASQ in a telephone survey administered by non-medical staff.
: We recruited 103 patients (age = 73 ± 11 years; 57% males) with a history of ischemic stroke who visited the outpatient clinic of the department of neurology at our hospital between March and May, 2021. After obtaining informed consent for participation in the study, a stroke neurologist assessed the mRS score during the visit using the Japanese version of mRS. On the same day, a clerk telephoned the patient or his/her family members to administer the J-RASQ. The percentage of agreement between mRS and J-RASQ scores was evaluated using the kappa coefficient and weighted kappa coefficient.
: The median time for the telephone survey was 85 s (interquartile range = 70–135 s). The mRS and J-RASQ scores had an agreement of 63.1%, with a kappa statistic of 0.51 (95% confidence interval [CI] = 0.39–0.63). The weighted kappa statistic, which takes into account the extent of disagreement, was 0.81 (95% CI = 0.75–0.88).
: J-RASQ is easy to administer and reliable for assessment in telephone-based surveys performed by non-medical staff
Telephone follow-up improves patients satisfaction following hospital discharge
2009, European Journal of Internal Medicine
Citation Excerpt :
Modern technology, such as the internet, email and mobile telephones, may help medical authorities to track problems after discharge. Since many older patients have no access to web services, telephone follow-up, initiated by professionals in the hospital, remains the easiest tool for exchanging information, providing medical advice, identifying complications, and giving reassurance to patients [11]. A recent Cochrane review described 33 studies involving 5110 patients showed equivalent results between TFU and control groups.
Many patients encounter problems in the first weeks after discharge from hospital. Telephone follow-up (TFU) is reputed to be a good tool for providing medical advice, managing symptoms, identifying complications and giving reassurance after discharge. Therefore, we aimed to study whether tight TFU would increase patient satisfaction, improve compliance and reduce re-hospitalization rate.
The study population included 400 patients, hospitalized in an Internal Medicine Department, randomly divided into two groups; TFU and control. TFU took place one week and one month after discharge. Three months later, members of both groups were contacted by telephone.
Satisfaction was increased in the TFU group compared with control group by 6–12% in most fields. Notably, 87% of patients in the TFU group indicated that earlier telephone contact increased their satisfaction. In addition, 78.2% of the patients in the control group reported that they performed the tests that were recommended at discharge and 86.5% reported that they received explanations regarding their medications. In the TFU group, this percentage was increased significantly to 86.9% (P = 0.02) and 96.7% (P < 0.0001), respectively. As to treatment results, 93% of the patients in the TFU group as compared to 84% in the control group reported improvement in their symptoms. A non-significant trend towards fewer readmission was observed in the TFU group (26% vs. 35% P = 0.062).
TFU can improve medical treatment by increasing satisfaction and compliance. A trend towards decreased readmission rates was observed, which may lead to a reduction in the burden on the medical system.
Patient perceptions of quality in discharge instruction
2005, Patient Education and Counseling
The present study investigates patient perceptions of the quality of discharge instruction by assessing inpatients’ ratings of care and service in the United States over the past 5 years (1997–2001) (n = 4,901,178). As expected, patients’ ratings of “instructions given about how to care for yourself at home” showed a strong, consistent positive relationship with overall patient satisfaction from 1997 through 2001. Nevertheless, patient satisfaction with discharge instructions decreased significantly each year (p < 0.001). Patients gave lower ratings to the quality of discharge instruction than to the overall quality of their hospital stay which indicates a failure to match the quality delivered among other services within the hospital. Patient assessments of discharge instruction quality varied systematically among conditions. Patients with musculoskeletal diseases and disorders (MDC-8) rated discharge instruction considerably lower than all other patient groups. Patients’ age, sex, self-described health status and length of stay did not predict patients’ evaluations of discharge instructions. U.S. hospitals may not be meeting existing AMA and JCAHO standards for patient education and discharge.
Measuring outcomes in people who have had a stroke and their carers: Can the telephone be used?
2010, Topics in Stroke Rehabilitation
Peri-discharge complex interventions for reducing 30-day hospital readmissions among heart failure patients: overview of systematic reviews and network meta-analysis
2022, Perspectives in Public Health
Patient experiences using a novel tool to improve care transitions in patients with heart failure: A qualitative analysis
2019, BMJ Open

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The importance of postdischarge telephone follow-up for hospitalists: a view from the trenches

Abstract

Ann Emerg Med

J Emerg Med

Ann Emerg Med

Hospitalists and the practice of inpatient medicineresults of a survey of the National Association of Inpatient Physicians

Ann Intern Med

Patient-physician communication at hospital discharge and patients’ understanding of the postdischarge treatment plan

Arch Intern Med