A medical resident post-discharge phone call study

Area of Science:

• Healthcare quality improvement
• Patient safety
• Medical education

Background:

• The period after hospital discharge presents a critical vulnerability for patients, often leading to complications.
• Adverse drug events are a primary cause of post-discharge complications.
• Scripted medication reconciliation processes show promise in enhancing patient care quality.

Purpose of the Study:

• To evaluate if a post-discharge phone call by medical residents within 72 hours improves patient satisfaction and care quality.
• To assess the impact on residents' practice-based learning, attitudes, and systems-based practice.
• To identify medication reconciliation errors post-discharge.

Main Methods:

• A prospective randomized study compared patients receiving a medication reconciliation call with a control group.
• Participants included adult patients discharged home after a minimum two-day stay on a medical resident service.
• Primary endpoint was patient satisfaction; secondary endpoints included readmissions, ED visits, PCP follow-up, and resident competence.

Main Results:

• No statistically significant improvement in patient satisfaction or secondary endpoints was observed.
• Medication reconciliation errors were identified in 48% of patients.
• 93% of residents perceived the phone calls as beneficial for patient care.

Conclusions:

• Post-discharge phone calls by residents effectively identify medication reconciliation errors missed otherwise.
• While not improving patient satisfaction, this intervention offers valuable insights for residents into their discharge practices.
• Residents reported the calls were worthwhile, fostering self-reflection and intended improvements in discharge processes.