Direct phone communication to primary care physician to plan discharge from hospital: feasibility and benefits

Abstract

Background The discharge summary is the main vector of communication at the time of hospital discharge, but it is known to be insufficient. Direct phone contact between hospitalist and primary care physician (PCP) at discharge could ensure rapid transmission of information, improve patient safety and promote interprofessional collaboration. The objective of this study was to evaluate the feasibility and benefit of a phone call from hospitalist to PCP to plan discharge. Methods This study was a prospective, single-center, cross-sectional observational study. It took place in an acute medicine unit of a French university hospital. The hospitalist had to contact the PCP by telephone within 72 h prior discharge, making a maximum of 3 call attempts. The primary endpoint was the proportion of patients whose primary care physician could be reached by telephone at the time of discharge. The other criteria were the physicians’ opinions on the benefits of this contact and its effect on readmission rates. Results 275 patients were eligible. 8 hospitalists and 130 PCPs gave their opinion. Calls attempts were made for 71% of eligible patients. Call attempts resulted in successful contact with the PCP 157 times, representing 80% of call attempts and 57% of eligible patients. The average call completion rate was 47%. The telephone contact was perceived by hospitalist as useful and providing security. The PCPs were satisfied and wanted this intervention to become systematic. Telephone contact did not reduce the readmission rate. Conclusions Despite the implementation of a standardized process, the feasibility of the intervention was modest. The main obstacle was hospitalists lacking time and facing difficulties in reaching the PCPs. However, physicians showed desire to communicate directly by telephone at the time of discharge. Trial registration French C.N.I.L. registration number 2108852. Registration date October 12, 2017.

General practice care following acute exacerbations of COPD: A survey of Australian general practitioners

“…The lack of GPs’ awareness of hospital admissions, however, emphasises the need for communication to commence earlier during admissions and via additional methods. Verbal handovers are one suggestion that warrants further consideration, with international data suggesting this approach may be feasible [ 25 ].…”

The complexities of communication at hospital discharge of older patients: a qualitative study of healthcare professionals’ views

“…One solution to the problematic communication gap, which nurses frequently mentioned, is the use of bidirectional communication by means of the phone or a range of IT-systems in addition to the notes in the EHR, despite the fact that the rules and routines state that only written communication should be used. However, there may be challenges in implementing such communication practice amongst physicians in the highly slimmed-down care organisations, as shown by Enzinger et al [60]. These authors evaluated the feasibility of introducing a phone call between the hospital physicians and GPs prior to discharge.…”

Improving the Timeliness of Discharge Summary Communication: A Quality Improvement Project

“…Delayed sending therefore not only creates additional workload and dissatisfaction for GPs [2,3], hospital doctors and other members of the multidisciplinary team including pharmacists [4], but also risks patient safety [5][6][7]. Various methods have been trialled in the past to improve communication between primary and secondary care, including direct phone conversations between hospital and primary care doctors on discharge [8] and post-hospitalisation multi-professional clinic visits [9], with little evidence for success. Clearly, this issue remains, and it is believed by this project team to be largely a result of increasing workload and clinical pressures, especially in the midst of a global pandemic [10].…”