通过院前出院面对面会议提高出院后电话联系率
Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.
作者信息
Vergara Franz H, Sheridan Daniel J, Sullivan Nancy J, Budhathoki Chakra
机构信息
Franz H. Vergara, PhD, DNP, RN, ONC, CCM, is a Patient Access Line Case Manager at Johns Hopkins Health Systems, Baltimore, Maryland, and completed his doctorate in nursing degrees at the Goldfarb School of Nursing, Barnes Jewish College, St. Louis, Missouri. Dr Vergara's research focuses on transitions of care, specifically using face-to-face meetings, to improve patient engagements to posthospital discharge care plans. Daniel J. Sheridan, PhD, RN, FNE-A, SANE-A, FAAN, is a Professor and Director of the Forensic Health Care, Education and Research Program at the Texas A&M University College of Nursing. Dr Sheridan is also an Adjunct Professor at the Goldfarb School of Nursing at Barnes-Jewish College in St. Louis, Missouri. Nancy J. Sullivan, DNP, RN, is an Assistant Professor and Director of Clinical Simulation at the Johns Hopkins University School of Nursing. Throughout her expansive career, Dr Sullivan has had a great variety of nursing experiences that included ED/trauma/critical care nursing, nursing management, nursing education, and care coordination. Chakra Budhathoki, PhD, is an Assistant Professor at the Johns Hopkins University School of Nursing. He teaches biostatistics courses and offers statistical consultation at the school in addition to conducting collaborative health care research. Dr Budhathoki is broadly trained in applied statistics, and is an expert in the design, analysis, and reporting of both experimental research and observational studies.
出版信息
Prof Case Manag. 2017 Nov/Dec;22(6):275-283. doi: 10.1097/NCM.0000000000000243.
PURPOSE OF THE STUDY
The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge.
PRIMARY PRACTICE SETTING
Acute care adult medicine inpatient units.
METHODOLOGY AND SAMPLE
A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates.
RESULTS
Implementing brief (<10 min) face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p < .001).
IMPLICATIONS FOR CASE MANAGEMENT PRACTICE
Increasing reach rates by a telephonic case manager facilitates communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.
研究目的
本研究的目的是确定在出院前由电话病例管理员与患者进行面对面会面是否会导致出院后电话随访（TFU）覆盖率提高。
主要实践环境
急性护理成人内科住院病房。
方法与样本
采用准实验设计。选择两个成人内科住院病房作为干预组和对照组。研究框架为过渡理论。采用便利抽样技术，干预组的88名符合条件的患者在出院前接受了面对面会面，而对照组的123名患者接受标准护理（无面对面会面）。采用交叉表和卡方检验来检验面对面会面干预与TFU覆盖率之间的关联。
结果
在出院前由电话病例管理员进行简短（<10分钟）的面对面会面，干预组的TFU覆盖率达到87%，而对照组的TFU覆盖率仅为58%（p <.001）。
对病例管理实践的启示
提高电话病例管理员的覆盖率有助于出院后与更多患者进行沟通。在出院前与患者进行简短的面对面会面，有助于他们理解出院后电话随访的原因，使用准确的电话号码确定最佳通话时间，并教导患者如何最好地为通话做准备。此外，通过与患者面对面会面，电话病例管理员在电话中不再是询问他们病情的陌生人。这些因素综合起来可能显著有助于提高TFU覆盖率。
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