Key result
A single post-discharge phone call resulted in a small improvement in Care Transition Measure scores compared to usual care (difference 1.87 points), with no effect on hospital utilization.
Why the study?
Does a 72-hour post-discharge phone call improve the quality of care transitions in general medical patients discharged home?
RCT (n=328)
Open-label
Cluster-randomized
No
Does a 72-hour post-discharge phone call improve the quality of care transitions in general medical patients discharged home?
Mean Difference: 1.87 (95% CI 0.47–3.27)
Absolute Event Rate: 73.1% vs 71.3%
p-value: p=0.01
A single post-discharge phone call by a non-clinician had a small, likely clinically insignificant impact on patient-reported care transition quality and no effect on 30-day hospital readmissions or ED visits.
Offers negligible benefit for transitions or readmissions; challenges routine implementation of single post-discharge calls.
IMPORTANCE: 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. DESIGN: Cluster-randomized control trial. SETTING: Urban, academic medical center. PARTICIPANTS: General medical patients age 18 and older discharged home after hospitalization. MAIN OUTCOMES AND MEASURES: 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 AND RELEVANCE: 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. TRIAL REGISTRATION: ClinicalTrials.gov NCT01580774.
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Soong et al. (2014) conducted an RCT in General medical patients discharged home (n=328). Post discharge phone call vs. Usual care (no post discharge phone call) was evaluated on Care Transition Measure (CTM-3) score (MD 1.87, 95% CI 0.47-3.27, p=0.01). A single post-discharge phone call resulted in a small improvement in Care Transition Measure scores compared to usual care (difference 1.87 points), with no effect on hospital utilization.
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