Telephone calls to patients after discharge from the hospital: an important part of transitions of care.
BACKGROUND
Teaching interns patient-centered communication skills, including making structured telephone calls to patients following discharge, may improve transitions of care.


OBJECTIVE
To explore associations between a patient-centered care (PCC) curriculum and patients' perspectives of the quality of transitional care.


METHODS
We implemented a novel PCC curriculum on one of four inpatient general medicine resident teaching teams in which interns make post-discharge telephone calls to patients, contact outpatient providers, perform medication adherence reviews, and engage in patient-centered discharge planning. Between July and November of 2011, we conducted telephone surveys of patients from all four teaching teams within 30 days of discharge. In addition to asking if patients received a call from their hospital physician (intern), we administered the 3-Item Care Transitions Measure (CTM-3), which assesses patients' perceptions of preparedness for the transition from hospital to home (possible score range 0-100).


RESULTS
The CTM-3 scores (mean±SD) of PCC team patients and standard team patients were not significantly different (82.4±17.3 vs. 79.6±17.6, p=0.53). However, regardless of team assignment, patients who reported receiving a post-discharge telephone call had significantly higher CTM-3 scores than those who did not (84.7±16.0 vs. 78.2±17.4, p=0.03). Interns exposed to the PCC curriculum called their patients after discharge more often than interns never exposed (OR=2.78, 95% CI [1.25, 6.18], p=0.013).


CONCLUSIONS
The post-discharge telephone call, one element of PCC, was associated with higher CTM-3 scores--which, in turn, have been shown to lessen patients' risk of emergency department visits within 30 days of discharge.
Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA; jrecord2@jhmi.edu.
Janet D
JD
Record
Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ashwini
A
Niranjan-Azadi
Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Colleen
C
Christmas
Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Laura A
LA
Hanyok
Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Cynthia S
CS
Rand
Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
David B
DB
Hellmann
Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Roy C
RC
Ziegelstein
D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D058006:General Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D055118:Medication Adherence; D010351:Patient Discharge; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration*; D013689:Telephone
care transitions; graduate medical education; patient-centered care; post-discharge telephone call