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Post discharge follow up phone call

To the Editor:My current role in nursing includes making post-

discharge follow-up phone calls and reviewing medi-cation reconciliation forms toprovide continuity of careand prevent unnecessary readmissions to our hospital.My experience in making follow-up phone calls hasgiven me the opportunity to prevent multiple patientswith differing diagnoses from being readmitted, as wassimilarly reported by Sawyer et al.1 Sawyer et al1 statedan intent to improve communication with patientsbefore and after discharge by including patient inter-views to assess their understanding of dischargeinstructions and postdischarge follow-up phone calls.This multidisciplinary team approach for improvedpatient communication can be of benefit to all patients,as was found for patients with congestive heart failure.

Harrison et al2 showed that discharge planning andpatient follow-up after the initial hospital visit forpatients with chronic illnesses such as asthma, dia-betes, chronic obstructive lung disease, congestiveheart failure, and endstage renal disease were effectiveat reducing 30-day readmissions. Postdischarge follow-up phone calls were conducted within 14 days ofdischarge. Results indicated a decrease in readmissionrates within 30 days of discharge, which helped reducethe healthcare costs associated with preventablereadmissions. Medicare expenditures for unplannedreadmissions in 2004 totaled $17.4 billion.2 The Advi-sory Commission alerted Congress about the magni-tude of this problem, and made recommendations forpolicy changes that would encourage hospitals toadopt measures for reducing readmissions.2

The goal at my hospital is to contact all patientsafter discharge. Many of our patients manifest chronicillnesses such as diabetes, renal disease, heart failure,or cardiovascular disease, and most have undergonea cardiovascular procedure during their stay. Dischargeinstructions formedications, activity, diet, and incisioncare are clarified when necessary by reviewing patientdata during the follow-up phone call, and instructions

or referrals are offered as necessary. This providesa second opportunity to ensure that all patients aretaking the correct medications pertaining to theirdiagnosis or procedure.3 As a result of effectivedischarge planning and postdischarge follow-up phonecalls, readmission rates have decreased while patientsatisfaction has increased at my institution. Theseprocesses have led to the national recognition of ourhospital for its decreased readmission rate of patientswith heart failure. I recommend that all hospitalsadopt a policy of follow-up phone calls after dischargefor all patients at risk for readmission.

References

1. Sawyer T, McBroom K, Granger B, Bride W,Harper M. Making the difference: a shared positionto address patients understanding of dischargeinstruction and post discharge adherence. HeartLung 2011;40:386.

2. Harrison P, Hara P, Pope J, Young M, Rula E. Theimpact of post discharge telephonic follow-up onhospital readmission. Popul Health Manage 2011;14:27-32.

3. Joint Commission. 2011 national patient safety goals.Available at: http://www.jointcommission.org/standards_information/npsgs.aspx. Accessed August 2,2011.

Aster Naffe, BSN, RN, CCRNBaylor Heart and Vascular Hospital

Baylor UniversityDallas, Texas

Available online 1 October 2011

0147-9563/$ - see front matter� 2012 Elsevier Inc. All rights reserved.

doi:10.1016/j.hrtlng.2011.08.002