A pilot program whereby oncology nurses telephone patients shortly after their hospital discharge helps improve patient satisfaction with the discharge process and discharge instructions, according to early results.
Mary Ann Long, MS, RN, OCN, at Roswell Park Cancer Institute (RPCI) in Buffalo, New York, and colleagues evaluated the effectiveness of discharge instructions in two groups of patients. One group had recently been discharged from the hospital after surgery for a gastrointestinal malignancy, and the other group had been discharged after treatment for leukemia.
“Results showed that a phone call to patients within 48 hours of their discharge helped patients feel significantly better equipped about how to manage at home,” said Long, who is director of patient care services.
In 2008, a task force was established at RPCI to identify ways to improve the discharge process. Notably, patient satisfaction scores in various surveys at her institution had exceeded 90% on all measures (including the extent to which nurses kept patients informed and the extent to which general staff respected the patient’s privacy and addressed their emotional needs), except for discharge instructions.
The surveys had found that oncology inpatients did not feel that they were prepared to be discharged and that patients did not want to care for themselves. Also, family members were not ready or willing to provide care at home for the patient.
The task force developed a pilot project whereby a registered nurse would telephone patients 24 to 48 hours after they had been discharged from his or her unit. The calls were made by the nurse in charge on the 3 PM to 11 PM shift or his or her designee.
In addition to questions about their general health status during the postdischarge phone call, patients were asked:
The researchers compared patient satisfaction scores from before the initiation of the telephone calls with scores taken 1 month after the telephone call process was started.
“Responses showed an improvement in all areas for both units,” she said. For example, during the time period before the intervention was implemented, 63% of gastrointestinal surgery patients said they considered themselves to be well informed about whom to call if they had difficulties at home versus 69% afterwards. The responses for leukemia patients were 59% and 63%, respectively.
After the intervention, significantly more patients said they considered themselves well informed about activities of daily living including dietary restrictions, lifting and exercise recommendations, and driving restrictions. Also, significantly more patients reported that they were satisfied with the instructions and preparation they received for continuing care at home after the intervention.
The investigators also documented an improvement in the extent to which patients felt that their family members (or other caregivers) were ready to provide continuing care at home.
Long told The Oncology Nurse that follow-up telephone calls provided benefits to patients as well as to the nurses who completed the calls. “This ‘process’ has identified patient concerns, including constipation and confusion about pain medications or nausea, which the nurse was able to rectify by reviewing the discharge instructions, offering advice such as increasing fluid intake, or contacting the prescriber,” she said.
For nurses, the telephone calls provided an opportunity to reconnect with patients to learn how they were doing. “In particular, the nurses loved hearing the comment: ‘Oh, it is so nice of you to call and check up on me.’”
Finally, she said that follow-up telephone calls reaffirm the role of the oncology nurse as a liaison between the patient/family and the healthcare team in achieving optimal health.
To sign up for our newsletter or print publications, please enter your contact information below.
