Telephone Calls After Discharge from CDU to Decrease Readmissions

Hospital readmission rates are used to convey quality of care and can cause financial penalties for hospitals. This direct practice improvement (DPI) project was implemented to answer the clinical question: Does telephone follow-up after discharge decrease the readmission rate? The readmission rate for the clinical decision unit (CDU) was unavailable, but the Virginia hospital readmission rate was 15.3%. This readmission rate was only for the readmission to the hospital whereas this DPI project will include the emergency department (ED) in the readmission rate. The purpose of this quality improvement project was to decrease the readmission rate by using telephone follow-up, for patients meeting inclusion criteria, one to two days after discharge from the CDU. A quantitative methodology with a correlation design was used to answer the clinical question. The framework for the project was the Donabedian model structure-process-outcome. Data was collected for one week prior to the intervention and one week for the intervention. The desired sample size was 80% of the usual 65 discharges per week. The week prior to intervention had 38 patients meeting inclusion criteria with a 31.5% readmission rate. The intervention week had 23 patients meeting inclusion criteria with a 21.7% readmission rate. This represents a 31.1% decrease in readmission rate to the CDU post intervention which was not statistically significant (p=.535). Despite lack of statistical significance, the results demonstrated an improvement in the readmission rates. Future projects are recommended to expand data collection and sample size