Use of a Brief Phone Call After ED Discharge
- Conditions
- Emergency MedicineDischarge PlanningPatient ReadmissionGeriatrics
- Interventions
- Behavioral: Placebo ComparatorBehavioral: ED Discharge & Medication Call
- Registration Number
- NCT01893931
- Lead Sponsor
- University of North Carolina, Chapel Hill
- Brief Summary
The purpose of this study is to determine whether a phone call from a nurse within 1-3 days after discharge from the Emergency Department (ED) decreases return visits to the ED/ hospital admissions/ death (combined outcome) in patients age 65 and above. As secondary outcomes, time to follow up appointment with physician and economic impact of this intervention will be assessed.
Patients 65 years of age and older will be randomized following discharge from the ED into one of two groups. Group 1(Intervention) will receive a phone call collecting information about understanding of ED discharge instructions and guiding patient through the discharge instructions, and Group 2 (Placebo) will receive a follow up phone call for a satisfaction survey.
We hypothesize return visits to the ED and readmission to the hospital will decrease as a result of the nurse phone call intervention.
- Detailed Description
Procedures: All patients age 65 and above will be randomized to one of two groups within 1-3 days after discharge from the UNC ED: 1) Interventional follow-up phone call; or 2) Placebo phone call, implementing only a satisfaction survey.
The intervention phone call will ask whether patients have obtained the newly prescribed medicines, ask if the patient understands the instructions for taking the medicines and inquire if a patient has made an appointment with his/her personal physician. The caller will attempt to answer questions about the medicines, and encourage patients to take the medicines as directed. The caller will also encourage the patients to follow-up with their own physician in a timely manner and offer to help with setting up follow up appointments if needed.
Subsequently, 30-35 days after ED discharge, all patients will receive a phone call to evaluate rates of compliance with medicines and scheduling follow-up appointments. All calls will be made by trained nurses.
Using an α 0.05 and β 0.80 we will need to enroll 2235 patients to detect a decrease in ED return visits/re-admission/ death of 6%. There will be one interim analysis 1 year into the two year planned study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 2003
- All patients age 65 and above discharged from the ED
- English speaking
- Younger than 65 years of age
- Unable to pass 6-item memory screener
- Lives in skilled nursing facility
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Satisfaction Survey Placebo Comparator Within 1-3 days after ED discharge, patients will be called by a nurse to complete a brief satisfaction survey. ED Discharge and Medication Call ED Discharge & Medication Call Within 1-3 days after ED discharge, patients will receive a follow up phone call from a nurse to review discharge instructions, review medication instructions, and provide any necessary patient navigation.
- Primary Outcome Measures
Name Time Method Time to the first occurrence of hospital readmission, emergency department visit, or death. 0-35 days Measured by (1) Self-report via a phone call to the patient or care giver up to 35 days post-discharge, and (2) Utilization of existing medical records.
- Secondary Outcome Measures
Name Time Method Patient satisfaction as reported by phone survey 0-35 Days Time elapsed from initial emergency department visit to Physician follow up 0-35 Days
Trial Locations
- Locations (1)
University of North Carolina
🇺🇸Chapel Hill, North Carolina, United States