Patient Discharge
Conditions
Keywords
emergency medicine, primary care physicians
Brief summary
The investigators hypothesize that the acquisition and correct utilization of medications as well as arranging and attending follow-up appointments will improve as a result of a phone call intervention 1-3 days after elderly patients are discharged from the emergency department (ED).
Detailed description
Older patients seen in the ED are at high risk of functional decline and return visits to the ED. Previous studies have shown that a comprehensive assessment by a geriatric specialist at the time of discharge from the ED along with extensive integration with home services and/or referral to community services can decrease functional decline and return visits to the ED as well as increase patient satisfaction, but this intervention is resource intensive requiring a geriatric discharge specialist to be available to the emergency department 24 hours a day/ 7 days a week. It is also known that in other patient populations telephone reminders to make follow up appointments can increase rate of follow up and that comprehension of discharge instructions is the primary barrier to compliance with discharge instructions. It has been shown that telephone follow-up interviews are feasible for geriatric patients discharged from the ED, and that many elderly patients discharged from the ED do not understand their discharge instructions or attend follow-up appointments. However, there are no published studies evaluating whether a follow up telephone call after discharge from the ED can improve patient compliance with the medical treatment plan including obtaining follow - up appointments and obtaining prescribed medications as well as using them appropriately. We seek to determine if we can increase compliance with medications and outpatient follow up with a phone call from a nurse provider 1-3 days after discharge.
Interventions
OTHERPhone call follow-up
A nurse will call the patient to counsel patients on their medications and following up with their primary care provider.
OTHERSatisfaction survey
Patients will be given a satisfaction survey.
OTHERControl group --- no intervention
Control group
Sponsors
The Duke Endowment
University of North Carolina, Chapel Hill
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 65 or over * Discharged from the UNC emergency department
Exclusion criteria
* In the hospital at the time of phone call follow-up * Neither the patient nor their responsible party are able to pass a standardized test to assess cognitive function
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Whether patient obtained medications prescribed at their discharge from ED | 5-8 days after discharge from ED |
| Whether patient is using medications that were prescribed at their ED discharge correctly | 5-8 days after discharge from ED |
| Whether the patient arranged a follow-up appointment with their primary care provider | 5-8 days after discharge from ED |
| Whether patient attended visit with their primary care provider after discharge from the ED | 30-35 days after discharge from ED |
Secondary
| Measure | Time frame |
|---|---|
| Return to the ED within 30 days of initial visit | 30-35 days after discharge from ED |
| Cost of the intervention | 35 days after last patient enrolled |
| Patient's satisfaction with ED visit | 5-8 days after discharge from the ED |
Countries
United States
Outcome results
None listed