Background: Discharge planning and education may directly influence patientoutcomes, including patient satisfaction and readmission rates. Discharge processes and followup vary across departments and facilities. Follow-up telephone calls after patient discharge arecommonly utilized; however, delivery techniques differ across healthcare areas. The purpose ofthis integrative review is to explore the various techniques of initiating post-discharge follow-upphone calls and their impact on patient outcomes and satisfaction. Method: A literature searchacross different Databases and the search engine Google Scholar yielded over 2,751 articlesutilizing the Boolean phrases: (follow up or follow-up or post-discharge or following dischargeor discharge) AND (techniques or methods or strategies or interventions) AND (patient safety orpatient outcomes or quality of care) AND telephone follow up. Other search phrases includedfollow up phone call methods and Re-Engineered Discharge (RED) discharge toolkit. A finaltotal of 22 studies were chosen for evaluation and analysis. Results: Methods examined were,calls by a registered nurse/advanced practice nurse or trained nonmedical personnel,communication via an automated short messaging system (SMS), and scripted or non-scriptedmethodology, with patient outcomes measured according to patient satisfaction and readmissionrates. A literature review indicated that scripting may be beneficial for all follow-up methods.Calls from nonmedical staff and SMS/automated messages can supplement nurse-led follow-up.Conclusion: Improvement was found with post-discharge follow-up; however, no consistentfindings indicate one follow-up method is more beneficial than another. Therefore, the impact ofthe various methods on healthcare costs should be considered when seeking the best practice.Keywords: follow-up, post-discharge, techniques/methods, telephone follow-up,SMS/automated messaging, RED discharge toolkit, patient outcomes, readmission rates
Scripted Methodology Telephone follow-up methods may use a scripted technique. Multiple studies demonstrated that individuals performing follow-up calls often experienced barriers to performing a follow-up call in a timely and targeted manner related to specific topics, overshadowing other concerns (Chen et al., 2021; Mwachiro et al., 2019). Chen et al. (2021) identified that medical staff desire to implement a standardized pain assessment protocol. Medical staff also noted that having a template of questions or topics to address during the follow-up call aided their ability to deliver an effective patient follow-up (Chen et al., 2021). The authors speculated that a standardized interview template, specifically for pain assessments, provided consistent information across various clinical settings that benefitted the patients and staff. 43
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Mikolay: POST DISCHARGE TELEPHONE CALL METHODS The studies conducted by Bressman et al. (2022) and Hendrickson et al. (2020) involved delivering one scripted post-discharge follow-up call within 48 hours and another within 3 to 5 days of discharge. The scripts utilized in the selected studies are similar, consisting of questions addressing the patients pain and physical status, whether the pain had questions or concerns regarding discharge instructions and follow-up appointment scheduling (Bressman et al., 2022; Chen et al., 2021; Hendrickson et al., 2020). Du et al. (2021) implemented a Project RED intervention specifically designed for surgical patients (RED-S). This discharge bundle included pre-discharge patient education, care plan development, and post-discharge planning and followup. Depending on whether the patient had a primary care provider, this intervention included a scripted follow-up call administered by a primary care or surgical clinic nurse.
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Non-scripted Methodology For this review, identifying studies specifically utilizing a non-scripted technique was difficult. Following various searches for scholarly literature across numerous databases, it was noted that a non-scripted phone call is a less explored area. Most follow-up calls involved some form of scripting or a questionnaire to direct the conversation. Discussion Twenty-two articles were examined to identify strategies commonly used in patient telephone follow-up following hospital discharge. These were then analyzed to determine the existence of a correlation between the follow-up technique with patient satisfaction rates and patient readmission rates as outcomes. Identifying relationships between follow-up practices and patient outcomes is critical to ensuring best practices and promoting organizational success.
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Patient Satisfaction Rates For this review, patient satisfaction is defined as positive patient feedback obtained through qualitative data collection methods. Patient satisfaction rates are a key quality indicator. Many studies noted that patients were pleased to receive a formal follow-up call (Chen et al., 2021; Luciani-McGillivray et al., 2020; Woods et al., 2019). Results also demonstrated that patients who experienced the RED-S intervention consisting of preand post-discharge education along with a post-discharge follow-up phone call gave more positive feedback regarding their discharge experience compared to the patients who received traditional discharge instructions and follow-up (Du et al., 2021; Mitchell, 2022). In one study, the average patient satisfaction score regarding discharge was 8.56 out of 10, with a standard deviation of 1.93 after
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