A simple intervention for improving telephone contact of patients discharged from the emergency department.

摘要

OBJECTIVE: To determine if emergency department (ED) follow-up contact rates can be improved by confirming a best contact telephone number with the patient prior to discharge. DESIGN/SETTING: Prospective comparison of intervention and control groups taken from convenience samples of ED patients from Children's Hospital of Pittsburgh (CHP) and Children's Hospital of Wisconsin (CHW). PARTICIPANTS: One hundred eighty-eight (188) patients (138 from CHP and 50 from CHW) who had x-rays and laboratory studies done in the ED were interviewed by the investigators prior to discharge (intervention group) and 305 control patients (256 from CHP, 49 from CHW) identified from ED log books. INTERVENTION: Prior to discharging the patient from the ED, the investigators verified and/or corrected the best contact number for a follow-up phone call with each intervention patient. Within 24 hours of each visit, a follow-up call was made to each intervention and control patient during one of three time intervals spaced between 8 AM and 10 PM. RESULTS: A total of 29 patients, or 15.4%, of the intervention group, gave a telephone number that differed from the one listed in the patient's medical record. Of the CHP group, 93.5% (129/138) of intervention patients and 78.5% (201/256) of the control patients were successfully contacted (P < 0.001). Of the CHW group, 96% (48/50) of intervention patients, and 94% (46/49) of control patients were successfully contacted (P = NS). Successful contact of control patients was greater in CHW than CHP (46/49 vs 201/256, P = 0.02). CONCLUSIONS: A significant proportion of telephone numbers listed in the ED medical records are incorrect, but the frequency of inaccuracy may be institution-dependent. Confirming the patient's "best contact" number can significantly increase the successful contact of ED patients.