One Call Away: Addressing a Safety Gap for Urgent Issues Post Discharge

Abstract

OBJECTIVES: The transition period from hospitalization to outpatient care can be high risk for pediatric patients. Our aim was to profile the use of a “safety net” for families through provision of specific inpatient provider contact information for urgent issues post discharge. METHODS: In this prospective study, we implemented an updated after-visit summary that directed families to call the hospital operator and specifically ask for the pediatric hospital medicine attending on call if they were unable to reach their primary care provider (PCP) with an urgent postdischarge concern. Education for nursing staff, operators, and pediatric hospital medicine providers was completed, and contact information was automatically populated into the after-visit summary. Information collected included the number of calls, the topic, time spent, whether the family contacted the PCP first, and the time of day. Descriptive statistics and Fisher’s exact test were used to summarize findings. RESULTS: Over a 13-month period, of 5145 discharges, there were 47 postdischarge phone calls, which averaged to 3.6 calls per month. The average length of time spent on a call was 21 minutes. For 30% of calls, families had tried contacting their PCPs first, and 55% of calls occurred at night. Topics of calls included requesting advice about symptoms, time line for reevaluation, and assistance with medications. CONCLUSIONS: This safety net provided families with real-time problem-solving for an urgent need post discharge, which included triaging patient symptoms at home, counseling on medication questions, information about the time line of illness recovery, and provision of additional resources.

Digital health intervention on patient safety for children and parents: A scoping review

“…A healthcare provider's responsibility to care for children does not end upon hospital discharge, and interventions are not provided in certain settings only. The transition from hospital to home is a particularly high‐risk factor for paediatric patient safety (Yale et al., 2021); however, this study did not identify digital health interventions related to post‐discharge care. These findings suggest the need to develop interventions to maintain nursing continuity during the hospital‐to‐home transition.…”

Improving Documentation of Postdischarge Issue Mitigation during Postdischarge Phone Calls

“…It can lead to postdischarge issues such as missed follow-up appointments, medication errors, and failure to activate contingency plans. [1][2][3][4][5] To mitigate these safety risks, many evidence-based and patient-centered discharge transition bundles have been developed, with most supporting the use of postdischarge phone calls (PDPCs) as adjunct safety tools and a component of complete hospital-to-home care. [6][7][8][9] Several studies have demonstrated the potential benefit of the PDPC in the early detection of postdischarge issues.…”