Key result
Resident-led discharge televisits linked to ~4-fold higher odds of completed follow-up vs in-person visits.
Why the study?
Resident-led discharge televisits can improve the safety of hospital-to-home transitions by increasing completed follow-up and providing access to inpatient providers to troubleshoot issues.
Do resident-led discharge televisits improve completed follow-up in patients discharged from a general pediatric unit?
Observational (n=708)
No
Do resident-led discharge televisits improve completed follow-up in patients discharged from a general pediatric unit?
Odds Ratio: 4.4 (95% CI 2.9–6.8)
Absolute Event Rate: 88.3% vs 63.3%
Resident-led discharge televisits significantly increased the likelihood of completed follow-up compared to in-person visits for pediatric patients.
Resident-led discharge televisits were associated with higher follow-up; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Resident-led discharge "televisits" can improve the safety of hospital-to-home transitions by increasing completed follow-up and providing patients access to their inpatient providers to troubleshoot issues. METHODS: This single-center quality improvement study was set in a pediatric unit within an academically affiliated public safety-net hospital. By August 2021, the aim was to use resident-led phone call televisits within 72 hours of discharge to increase completed follow-up from 67% to 85% among patients discharged from the general pediatric unit and compare this to patients scheduled for in person visits. Patients were preferentially scheduled for televisits based on investigator-defined criteria to maximize benefit (eg, prescribed new medications). The process measure was the proportion of televisit slots filled. The balancing measures were 7-day emergency department visits and readmissions. Topics addressed during televisits were categorized to qualitatively assess potential benefits. RESULTS: Three hundred and fifteen (44.5%) patients had televisits, 234 (33.1%) in person visits, and 159 (22.5%) unconfirmed follow-up. The available televisit appointments scheduled were 315 of 434 (72.5%). Completed follow-up was 88.3% for televisits and 63.3% for in person visits, compared with 67% during the baseline period. Completed follow-up was 4.4 (95% confidence interval 2.9 to 6.8) times more likely for televisits compared with in person visits after controlling for confounding variables. Common topics addressed during televisits were test results, medication issues, and appointment issues. Emergency department revisits and readmissions were similar between groups. CONCLUSIONS: Resident-led discharge televisits are an innovative way to increase completeness of discharge follow-up.
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Bhatia et al. (2023) conducted an observational in Pediatric hospital discharge (n=708). Resident-led discharge televisits vs. In-person visits was evaluated on Completed follow-up (OR 4.4, 95% CI 2.9-6.8). Resident-led discharge televisits increased completed follow-up compared with in-person visits (88.3% vs 63.3%; OR 4.4, 95% CI 2.9-6.8).
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