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Factors Correlated With Successful Pediatric Post-Discharge Phone Call Attempt and Connection
Amy Buczkowski1, Wendy Craig2, Rebekah Holmes3
1Department of Pediatrics, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine.
Insights
Postdischarge phone calls improve patient care transitions. Younger age and English as preferred language predict call success, while readmission and federal payors predict failure.
Area of Science:
- Healthcare Research
- Patient Safety
- Health Services Research
Background:
- Postdischarge phone calls are crucial for identifying errors during hospital-to-home transitions.
- Effective communication post-discharge can improve patient outcomes and reduce readmissions.
Purpose of the Study:
- To identify factors influencing the attempt and success of postdischarge phone calls.
- To analyze predictors of call connectivity in pediatric patients.
Main Methods:
- Utilized the multisite Project IMPACT dataset (Improving Pediatric Patient Centered Care Transitions).
- Included 0- to 18-year-old patients discharged between January 2014 and December 2017.
- Employed mixed model logistic regression to identify independent predictors of call attempt and connectivity.
Main Results:
- Postdischarge calls were attempted for 71.6% of discharges, with successful connection in 68.8%.
- Younger age (neonates and 1-6 years) and English as preferred language predicted higher call attempt and connectivity.
- Readmission within 3 days and federal/state payor status were negative predictors for call attempt and connectivity, respectively.
Conclusions:
- Targeted interventions, like improved interpreter services and reliable call models, can enhance postdischarge call attempt rates.
- Enhanced population-based communication strategies may improve call connectivity.
- Understanding predictors allows for tailored strategies to optimize postdischarge follow-up.
Objectives:
Postdischarge phone calls can identify discharge errors and gather information following hospital-to-home transitions. This study used the multisite Project IMPACT (Improving Pediatric Patient Centered Care Transitions) dataset to identify factors associated with postdischarge phone call attempt and connectivity.
Methods:
This study included 0- to 18-year-old patients discharged from 4 sites between January 2014 and December 2017. We compared demographic and clinical factors between postdischarge call attempt and no-attempt and connectivity and no-connectivity subgroups and used mixed model logistic regression to identify significant independent predictors of call attempt and connectivity.
Results:
Postdischarge calls were attempted for 5528 of 7725 (71.6%) discharges with successful connection for 3801 of 5528 (68.8%) calls. Connection rates varied significantly among sites (52% to 79%, P < .001). Age less than 30 days (P = .03; P = .01) and age 1 to 6 years (P = .04; P = .04) were independent positive predictors for both call attempt and connectivity, whereas English as preferred language (P < .001) and the chronic noncomplex clinical risk group (P = .02) were independent positive predictors for call attempt and connectivity, respectively. In contrast, readmission within 3 days (P = .004) and federal or state payor (P = .02) were negative independent predictors for call attempt and call connectivity, respectively.
Conclusions:
This study suggests that targeted interventions may improve postdischarge call attempt rates, such as investment in a reliable call model or improvement in interpreter use, and connectivity, such as enhanced population-based communication.
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