A NURSE CALL BACK SYSTEM: Does telephone follow-up post discharge from an Emergency Department lead to improved patient outcomes, and understanding of discharge plan instructions?

Mrs Vanessa Gorman1, Ms Emily Knights1,2

1Northpark Private Emergency Department, Bundoora, Australia, 2Melbourne University, Melbourne, Australia

OBJECTIVE: Discharge processes and instructions from emergency departments can expose patients to complications.  Does telephone follow up 24-72hours post discharge lead to improved patient outcomes and alleviate any concerns with the discharge plan instructions?

METHODS: A 6 month retrospective analysis of nurse telephone call-back post discharge from an emergency department.

ED patients were followed up by a nurse within 72 hours of discharge. Nurses who made the telephone calls adhered to a script.

Patients with Glasgow Coma Scale>15, interviews were obtained from either the patient, primary care giver or from legal guardians of children (0-18yo).  There were up to 3 attempts to contact each patient. Clinical advice was given using a medical escalation algorithm.

Deteriorating patients – meeting pre-specified criteria – were asked to return to the ED for assessment.

RESULTS: We followed up 400 patients who attended the ED and were discharged home. Significant deterioration was observed in around 1 in 20 patients, these patients were asked to return to the emergency department for re-evaluation resulting in improved patient outcomes.  Discharge plan instructions were re-explained in over a quarter of all patients discharge which included information and advice about medication administration and when to see specialist, general practitioner or allied health professional. Patient feedback was positive.

CONCLUSIONS: Nurse follow-up phone calls may be an effective way to determine patients clinical state post discharge from the emergency department. It may determine any issues, clinical deterioration or concerns about discharge plan instructions.


Biography:

Vanessa Gorman commenced her emergency nursing career in 1996 at Austin Hospital, Melbourne. Across her 20 year career in emergency nursing she has held positions such as Associate Unit Manager, Nurse Unit Manager, Project Manager, Senior Policy Advisor – Department of Health, Bed Access Coordinator, Nursing Educator and State Trauma Manager.  Vanessa holds an enduring passion for trauma nursing and is an accredited international trauma coder and actively works with the State Trauma Registry in Victoria.

Vanessa holds post-graduate qualifications in Emergency Nursing and is currently completing a Masters in Health Services Management through Monash University. Vanessa is an appointed member to the International Advisory Council for the Emergency Nursing Association (USA), which aims to make improvements within emergency nursing globally.  Vanessa is dedicated to improving nursing work conditions with a particular interest in fatigue management. In 2015 she was co-lead in a Worksafe Victoria project with a focus on fatigue management for Emergency Nurses.