Hospital-home transition is a very challenging task that if not well managed leads to a number of challenges. It is commonly known that most patients face a number challenges in the first few weeks after discharge. Such readmissions lead to extra hospital cost making it expensive in the end. Therefore, there has been unceasing research on the various ways through which readmissions to the hospital can be reduced. Follow ups after discharge has been perceived to be one of the effective ways of reducing readmission cases. Specifically, follow up phone call after discharge is believed, though not confirmed, to be a way of reducing the readmissions after discharge. This paper seeks to present a systematic literature review on the use of 24 hour follow-up phone call in reducing cases of hospital readmission after discharge especially among medical/surgical patients.
A report by Mistiaen and Poot (2008) indicates that the telephone follow-up initiated by hospital-based health professionals is effective. They argue that hospital initiated telephone call follow-up makes it possible to exchange information between the health care providers and the discharged victims. They believe that the calls allow for the provision of health education advice, managing symptoms, identifying complications in the discharged victims while give a reassurance (Mistiaen P, 2008). They, therefore, believed that phone call follow up is a means of controlling readmission. However, their research may not be very reliable due to the weaknesses in their methodology. They made so many assumptions that make their reasoning be doubted.
The weakness in their report was that there are a lot more factors that may act in favor of the service that is nothing to do with the follow up phone call. Comparatively, the control group and the research groups used in their study showed insignificant difference. Their argument should not be taken in isolation but rather requires to be complemented by other follow up services.
The same argument is supported by Bull (2002). Bull argued that after hospital discharge most patients get readmitted due to the lack of full and proper information on the nature of activities to avoid and the diet that the discharged patient should have for the first few weeks after discharge (GM., 2002). According Bull, telephone follow-up will help the hospital health providers to keep track on the diet and activities/duties that the patient should avoid. Conversely, LeClerc (2002) argues that diet and activities at home are factors that are dictated by several other factors. One cannot assume that phone call follow-up may be as effective as it may sound. The economic status and the social status of a parson determines a lot about diet and activities. There need be other factors considered before jumping into conclusions about the effectiveness of 24 phone calls follow up in controlling the rates of readmissions.
Moreover, Transition Theory by Meleis lays emphasis on types and patterns that characterize the transition from the hospital environment to the home environment. He considers that during the transition from the hospital to the home environment, there are facilitators and inhibitors. In his view, any follow up activities should aim at addressing various forms of facilitators and inhibitors. Inhibitors such as emotional and psychological factors need to be carefully addressed though follow up activities to the patients by the hospital attendants. Lindsey Moran (2013) avows that the Meleis theory of transition provides a guideline for scheduling follow-up activities on the discharged patients (Moran, 2013). In phone call acts as an immediate and convenient means of providing assurance to the discharged patients about their conditions. It should, however, not be taken without a clear and empirical basis.
In yet another study, Julia Sara Hager (2010) conducted a quasi-experiment research to establish a correlation between the phone calls follow-up services and the rates of readmission of discharged patients. In her report, she notes that there is a relationship between follow up activities and rates of readmission to the hospital after discharge (Hager, 2010). This study, however, does not provide statistical evidence on this relationship. The study gave a conclusion before creating insight into how phone call services used in the follow up helps in reducing the rates of readmission. Its needs to be understood that follow up activities without medical attendance to the patient may not be very effective. There is a need to couple the phone call follow up with face to face tracking to ascertain the condition of the patient.
After analyzing the five literatures on follow up phone call and the rates of hospital readmission, it is noteworthy that most studies do not provide empirical and statistical data on how the follow up phone call services help in controlling the rates of hospital readmission. The theory of transition by Meleis hints that there are several factors that characterize the transition from the hospital to the home environment. There are both inhibitors and facilitators. Every study on reducing readmission after discharged should consider both the facilitators and inhibitors. Factors such as psychological and emotional states, diet and home activities should be considered. Phone call in isolation without other follow-up activities may not give a significant reduction in the rates of readmission
GM., B. (2002). Practical utility of case-management telephone intervention in heart failure? Archives of Internal Medicine, 162(18):2142–3.
Hager, J. S. (2010). Effects of a Discharge Planning Intervention on Perceived Readiness for Discharge. St. Paul, Minnesota.
Mistiaen P, P. E. (2008). Telephone follow-up, initiated by a hospital-based health professional, for postdischarge problems in patients discharged from hospital to home. Utrecht: JohnWiley & Sons, Ltd.
Moran, L. (2013). Booking the Appointment: A Strategy to Reduce Readmissions in Heart Failure Patients. lcalderone: Rhode Island College,.