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

Area of Science:

• Pediatric Hospital Medicine
• Healthcare Transitions
• Patient Safety

Background:

• The transition from inpatient hospitalization to outpatient care presents significant risks for pediatric patients.
• Effective communication and support systems are vital to mitigate these risks during the post-discharge period.

Purpose of the Study:

• To evaluate a "safety net" intervention providing direct inpatient provider contact information for urgent post-discharge issues.
• To profile the utilization and impact of this enhanced after-visit summary for pediatric patients.

Main Methods:

• Prospective study implementing an updated after-visit summary with specific contact details for the pediatric hospital medicine attending on call.
• Education provided to relevant staff (nursing, operators, providers); contact information automatically populated.
• Data collected on call volume, topics, duration, prior primary care provider (PCP) contact, and time of day; analyzed using descriptive statistics and Fisher's exact test.

Main Results:

• Over 13 months, 47 post-discharge calls were received from 5145 discharges (average 3.6 calls/month).
• Average call duration was 21 minutes; 30% of families attempted PCP contact first.
• Common call topics included symptom advice, reevaluation timelines, and medication assistance, with 55% occurring at night.

Conclusions:

• The implemented safety net facilitated real-time problem-solving for urgent post-discharge needs.
• This system provided critical support for symptom triage, medication counseling, recovery timeline information, and resource provision.