Background: Post discharge (d/c) follow-up calls are utilized for many reasons: monitoring patient (pt) status, understanding of d/c instructions including medications and appointments, and satisfaction with hospital care. Adult data suggests such calls improve satisfaction and may impact readmission rates. Little data about the impact of such calls on pediatrics pts exists. Our objective was to examine the utility of d/c calls.
Methods: As part of a resident QI project to review our practice of d/c calls we reviewed all calls attempted July-August 2015. Residents do d/c calls on all pts to reinforce d/c plan and promote pt care responsibility. Our pediatric service is a 19 bed unit in an urban, public hospital, serving an ethnically diverse, low SES population largely consisting of immigrants or 1st generation citizens. We asked 8 focused questions about the child’s current state, care plan, and satisfaction with care. We examined the results, including demographics, to inform any possible changes. All calls were made by residents currently on the inpatient service. Calls were made in English, Spanish, or Bengali per the need of the patient. Up to 3 attempts were made to contact each patient. The study period predates our transition to electronic prescribing.
Results: Of 71 patients we were able to contact 51 (72%). 37 respondents were the mother, 8 the father, 1 a brother, and 5 the pt. 50 (98%) reported the pt was in good to excellent condition and 49 (96%) would return to our hospital for a similar condition. 98% felt the treatment was helpful and 96% were satisfied with their care. 88% said they understood the diagnosis and 86% said they understood the treatment. Those who didn’t were all parents. 61% were sent home with a prescription. All 31 filled the prescription and claimed to be taking the medicine as prescribed. We did not have any bounce back admissions in that time frame.
Conclusions: Our d/c follow-up calls were largely successful in reaching our pts, demonstrating that our population can be contacted and possibly followed this way. We were aided by multi-lingual staff able to make calls in pts’ native languages. Parents reported good understanding of their child’s diagnosis and treatment reinforcing our d/c counseling. Parents reported remarkably high levels of filling prescriptions and adhering to treatment. It is possible that having residents make the calls biased the responses positively. Based on this we continued our current d/c counseling and the d/c calls while looking for other means of assessing medication adherence.