What is the clinical evidence from this study?

Study design: Other. Population: Neurosurgical patients. Intervention: Face-to-face meetings before hospital discharge vs. Standard care (no face-to-face meeting). Primary outcome: Telephone follow-up (TFU) reach rate (p=<.001).

July 25, 2019Open Access

Face-to-Face Meetings with Neurosurgical Patients Before Hospital Discharge: Impact on Telephone Outreach, Emergency Department Visits, and Hospital Readmissions

Q: What are the key findings of this study?

Face-to-face meetings with neurosurgical patients before hospital discharge significantly increased telephone follow-up reach rates compared to standard care (97.7% vs 76.1%; P<0.001).

FVFranz H. VergaraWashington University in St. Louis JDJean E. DavisUniversity of Central Florida CBChakra BudhathokiJohns Hopkins University

Key Result

Face-to-face meetings with neurosurgical patients before hospital discharge significantly increased telephone follow-up reach rates compared to standard care (97.7% vs 76.1%; P<0.001).

Structured PICO

Do face-to-face meetings before hospital discharge improve telephone follow-up reach rates in adult neurosurgical patients?

Population

Adult inpatient neurosurgical patients at a single center.

Intervention

Face-to-face meetings with neurosurgical patients before hospital discharge

Comparator

Standard care (no face-to-face meeting) on a comparison unit

Outcome

Telephone follow-up (TFU) reach rates

Face-to-face meetings prior to discharge significantly increase telephone follow-up reach rates in neurosurgical patients, with a non-significant trend toward reduced ED visits and readmissions.

Main Result

Absolute Event Rate: 97.7% vs 76.1%

p-value: p=<.001

Abstract

The Johns Hopkins Community Health Partnerships (JCHiP) was developed in 2010 within the Johns Hopkins Health Systems. As part of JCHiP, the Patient Access Line call center was created. The average telephone reach rate at The Johns Hopkins Hospital in 2014 was only 53%. In a population of adult neurosurgical patients, this study aimed to: determine the impact of face-to-face meetings with neurosurgical patients before hospital discharge on telephone follow-up (TFU) reach rates, and determine the association between TFU reach rates and subsequent emergency department (ED) visits and hospital readmission rates. This quasi-experimental study used a posttest-only research design with a comparison group. Two adult inpatient neurosurgical units at the Johns Hopkins Hospital were selected as the intervention and comparison groups. A convenience sampling technique was used. Face-to-face meetings pre hospital discharge resulted in a TFU reach rate of 97.7% on the intervention unit while the comparison unit had only a 76.1% TFU reach rate ( P < .001). Reached patients had fewer ED visits (7.8%) than not reached patients (17.4%); however, the difference was not statistically significant ( P = .138). Reached patients also had fewer hospital readmissions (3.3%) than not reached patients (8.7%); this also was not statistically significant ( P = .214). This study demonstrated that face-to-face meetings with neurosurgical patients prior to discharge increased TFU rates. Results were statistically significant. ED visits and hospital readmissions were also reduced in reached patients and the findings were clinically significant.

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