Do post discharge phone calls improve care transitions? A cluster-randomized trial.
OBJECTIVE
The transition from hospital to home can expose patients to adverse events during the post discharge period. Post discharge care including phone calls may provide support for patients returning home but the impact on care transitions is unknown.


OBJECTIVE
To examine the effect of a 72-hour post discharge phone call on the patient's transition of care experience.


METHODS
Cluster-randomized control trial.


METHODS
Urban, academic medical center.


METHODS
General medical patients age 18 and older discharged home after hospitalization.


METHODS
Primary outcome measure was the Care Transition Measure (CTM-3) score, a validated measure of the quality of care transitions. Secondary measures included self-reported adherence to medication and follow up plans, and 30-day composite of emergency department (ED) visits and hospital readmission.


RESULTS
328 patients were included in the study over an 6-month period. 114 (69%) received a post discharge phone call, and 214 of all patients in the study completed the follow outcome survey (65% response rate). A small difference in CTM-3 scores was observed between the intervention and control groups (1.87 points, 95% CI 0.47-3.27, p = 0.01). Self-reported adherence to treatment plans, ED visits, and emergency readmission rates were similar between the two groups (odds ratio 0.57, 95% CI 0.13-2.45, 1.20, 95% CI 0.61-2.37, and 1.18, 95% CI 0.53-2.61, respectively).


CONCLUSIONS
A single post discharge phone call had a small impact on the quality of care transitions and no effect on hospital utilization. Higher intensity post discharge support may be required to improve the patient experience upon returning home.


BACKGROUND
ClinicalTrials.gov NCT01580774.
Division of General Internal Medicine, University of Toronto, Toronto, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
Christine
C
Soong
Division of General Internal Medicine, University of Toronto, Toronto, Canada.
Bochra
B
Kurabi
Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
David
D
Wells
Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
Lesley
L
Caines
Division of General Internal Medicine, University of Toronto, Toronto, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
Matthew W
MW
Morgan
Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
Rebecca
R
Ramsden
Division of General Internal Medicine, University of Toronto, Toronto, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
Chaim M
CM
Bell
D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010351:Patient Discharge; D017060:Patient Satisfaction; D013689:Telephone; D055815:Young Adult