A Patient Hotline: Developing a Postdischarge Telephone Triage System

1University of California, Sao Francisco, San Francisco, CA
2University of California, San Francisco, San Francisco, CA
3University of California, San Francisco, San Francisco, CA

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 187

Background:

Adverse events tallowing hospital discharge are common and represent a vulnerable time for patients. Unlike ambulatory practices That provide contact mechanisms for patients who have questions about their care, hospital medicine groups are faced with different challenges. Shift work, provider discontinuity, and lack of a dedicated provider to reach following discharge often leave patients without a necessary safety net.

Purpose:

To develop a patient‐driven telephone triage system that responds to patient concerns in a timely manner We also aimed to describe the frequency and nature of the postdischarge calls to understand if broader system issues were present that required targeted improvement initiatives.

Description:

We developed and implemented a Patient Hotline for patients discharged from our non‐house staff medical service. Our service operates a 26‐bed unit that averages 3.5 discharges daily. On the day of discharge, each palient received a preprinted card with a uniform telephone number To call with any questions or concerns after returning home. The cards also included the name of the discharging hospitalist and the hours of operation for the hotline (Bam‐5 pm daily). Patient calls were received by the unit clerks, who were trained and provided with a triage manual. Based on the patient's question or concern, the unit clerk contacted the appropriate provider — hospitalist, clinical pharmacist, or case manager—to speak with the patient the same day. Unit clerks used a tracking log to record each call, the patients information, the nature of the inquiry, and the health care provider they contacted lo speak wilh the patient. Following a discussion with the patient, each provider reviewed the tracking log and categorized the patient issue addressed. Our early results demonstrated that 18% of discharged patients utilized the Patient Hotline. Nearly 40% of calls were related lo medicalion issues such as an inability to obtain medications or questions about their side effects. The remaining calls were related to symptoms following discharge (30%) or pending test results (30%).

Conclusions:

Providing patients with an accessible mechanism to ask questions following hospital discharge is feasible and may serve as an impor‐lanl safety net. Our system leveraged existing resources to support a low‐cost intervention and early findings highlight the importance of addressing medication access and education prior to discharge. Creating a Patient Hotline may provide a process for patients To prevent unnecessary urgent care or emergency room visits while identifying opportunities for providers and hospital systems lo adopt discharge improvement initiatives.

Author Disclosure:

S. Rennke, none; S. Kesh, none; N. Sehgal, none

To cite this abstract:

Rennke S, Kesh S, Sehgal N. A Patient Hotline: Developing a Postdischarge Telephone Triage System. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 187. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/a-patient-hotline-developing-a-postdischarge-telephone-triage-system/. Accessed November 15, 2019.

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