Discharge Phone Calls Deliver Quality Care, Higher Patient Satisfaction
"If our goal is to create an astonishing patient experience, then follow up phone calls after discharge make the difference," explains Studer Group Medical Director Dr. Jay Kaplan, MD, FACEP. They also feel cared about as people…one of the top three priorities of patients in the ED."
Dr. Stephen Crouch, Chairman and Medical Director of the Emergency Department of Advocate Good Samaritan Hospital in Downers Grove, IL agrees. "Patients are speechless when I call. They say they’ve never had a physician call them after discharge and how much they appreciate it," he explains. Dr. Kaplan adds, "As a physician, it reduces my own anxiety about how my patients are doing and I also learn from the calls. When I find out if the intervention I recommended works, my knowledge of clinical outcomes improves."
Why to Make the Calls
There is an ample body of research (see sidebar) that demonstrates the benefits of making discharge calls—to both inpatients and outpatients. They improve quality, decrease risk, improve patient satisfaction, and provide opportunity for quick service recovery, among others. "You have a 90% chance of keeping a patient if you call within 48 hours of discharge and do service recovery to reverse a less than optimal experience. If you wait longer than a week, which is when most people complain, you have only a 10% chance of keeping the patient and you’ll lose 10 other patients through word of mouth," adds Kaplan. At his practice, all ED physicians who do clinical shift work make follow up calls or face financial penalties.
One example in the persuasive case for making follow-up calls: In one study of 400 consecutively discharged patients, 19% of patients reported adverse events (drug events and procedure-related injuries) post-discharge. Forty-eight percent of these were preventable. In an Aug. 2005 follow-up study, researchers found that of those patients who reported adverse events in the original study, 71% were significant, 13% were serious, and 16% were life-threatening.5
While nurses are sometimes skeptical at first about the additional burden of making the calls, they almost always embrace the opportunity after making some calls. Once a nurse reaches a patient and finds out her call saved a life because a parent wasn’t giving a child prescribed medication or an elderly patient needed to be re-admitted, she will make those calls for the rest of her career and look forward to them. One chief nurse officer (CNO) tells her nurses, "Having a bad day? Call a patient. It bonds you to them."
Bottom Line Results from Discharge Phone Calls
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Service |
Quality |
People |
Finance |
Growth |
Increase patient satisfaction
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Improve clinical outcomes
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Reduce turnover
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Better payment
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Decrease readmissions
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Reduce patient anxiety
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Decrease length of stay
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Create culture of harvesting positives
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Decrease audits
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Increase access
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Reduce complaints
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Decrease adverse events
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Engage & reward physicians
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Accurate billing check
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Increase capacity
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Reduce claims
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Manage up
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Service recovery
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Increase patient satisfaction survey return rate
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Tremendous word of mouth
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Cross marketing
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5 2003 Annals of Internal Medicine, "The incidence and severity of adverse events effecting patients after discharge from the hospital", Feb 4; 138 (3): 161-7. Forster, A., Murff, H., Peterson, J., Gandhi, T., Bates, D. (Note: A second study in 2005 by these authors using a subset of patients from the original study validated these findings. 2005 Journal of General Internal Medicine "Adverse drug events occurring following hospital discharge." Apr; 20 (4): 327-23 Forster, A., Murff, H., Peterson, J., Gandhi, T., Bates, D.
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