Predictors for Telephone Outreach Post-hospital Discharge

The specific aims of this study were to examine whether sociodemographic variables and medical-surgical diagnoses were associated with telephone follow-up (TFU) reach rates, emergency department visits, and hospital readmissions.

Acute care inpatient units in an academic medical center.

A correlational design was utilized, and a prospective medical record review of patients was conducted while implementing face-to-face prehospital discharge meeting interventions. The study sample (N = 176) included adult patients in two neurosurgical wards who were admitted between June 2016 and September 2016. Parametric and nonparametric tests were used to explore the balance between the intervention group receiving a face-to-face prehospital discharge meeting and comparison group receiving standard prehospital discharge care. Bivariate statistics were employed to determine associations between variables.

A total of 15 sociodemographic and medical-surgical variables were used to correlate TFU reach rates, emergency department (ED) visits, and readmission rates. Educational attainment (p = .002), employment status (p = .014), parental status (p = .010), and hospital service (p = .039) had significant differences between the intervention and comparison groups. Results demonstrated an improved reach rate for the intervention group but despite the differences in the groups, phi and Cramer's V coefficients did not correlate any associations with TFU reach rate, ED visits, and readmission rates with sociodemographic and surgical variables. This outcome affirmed that despite the similarities and differences in the sample, a face-to-face meeting prehospital discharge is an effective intervention to improve telephone outreach.

There is a need to determine the most cost-effective way to increase TFU reach rates to prevent subsequent ED visits and hospital readmissions. There is also a need to develop a tool that can predict the hardest-to-reach patients posthospital discharge, so that case managers can meet those patients before leaving the hospital. In addition, it is important to identify alternative methods of "face-to-face" interactions during the COVID-19 pandemic crises. Case managers must explore ways with caution to leverage secured digital technology to bridge the gap of communicating with patients and family members when hospital visitations are limited.