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The Pediatric Post-Hospital Outreach Needs Evaluation (PHONE) Pilot Study
Amanda M Klafter1, Michael D Cabana1,2, Lisbel Guzman1
1Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York.
Insights
Postdischarge calls reveal key concerns in the first three days, often about medications and logistics. Targeted support during this period can improve pediatric patient safety and care transitions.
Area of Science:
- Pediatric Healthcare
- Patient Safety
- Communication Studies
Background:
- Effective hospital discharge communication is vital for safe care transitions.
- Postdischarge calls offer insights into discharge process improvements, but are understudied in pediatrics.
- This pilot study examined family calls after pediatric discharge to identify common concerns.
Purpose of the Study:
- To analyze the content and timing of caregiver-initiated postdischarge calls.
- To identify common clinical and nonclinical concerns following pediatric hospital discharge.
- To inform strategies for improving discharge support and patient safety.
Main Methods:
- Single-center, cross-sectional observational pilot study.
- Analysis of 32 caregiver-initiated calls over 8 months.
- Inductive thematic analysis of call content and comparison with electronic medical record data.
Main Results:
- Calls were evenly split between clinical (symptoms, medications) and nonclinical (system, provider issues) topics.
- Medication dosing questions were 50% of clinical inquiries.
- Nonclinical calls, often concerning logistics, peaked around day 3 post-discharge (70% of calls at 3 days were nonclinical).
Conclusions:
- The first three days post-discharge represent a critical window for family support.
- Calls during this period frequently involve medication and system-level issues.
- Proactive outreach to families can enhance communication and improve pediatric patient safety.
Introduction:
Clear communication at hospital discharge is essential for safe care transitions. The content of postdischarge phone calls may indicate areas for improved discharge processes, yet such data are underexplored in pediatrics. This pilot study analyzed postdischarge calls at a large, urban academic children's hospital to identify common concerns by categorizing the content and timing of calls placed by families.
Methods:
We conducted a single-center, cross-sectional observational pilot study of caregiver-initiated calls following discharge from a pediatric inpatient unit over 8 months (February-October 2024). Calls from legal caregivers were included. Call content was categorized through inductive thematic analysis. Using electronic medical record demographics, we compared characteristics of callers to the broader discharged population with chi-square tests.
Results:
We analyzed 32 calls. Calls were evenly divided between clinical topics-including return of symptoms, new medical problems, and medication issues-and nonclinical topics, such as system-, provider-, or individual-level concerns. Medication dosing questions comprised 50% of clinical inquiries, and nonclinical calls addressing logistical challenges, including scheduling follow-ups, obtaining school or work notes, and accessing necessary supplies tended to cluster within the first few days following discharge, particularly on day 3. The most common time interval between discharge and caregiver call was 3 days (30%), with 70% of calls placed at this time being nonclinical.
Conclusions:
Postdischarge calls occurring in the first 3 days, mostly about medications and system-level issues, highlight a key window for targeted support, with proactive outreach to families potentially improving communication and safety.
