Pediatric Post-Discharge Follow-Up: How to Get it Right

This post was written by Clark Bosslet, Manager, and Shelby Jergens, Senior Consultant.

In an earlier post, we talked about five key benefits pediatric units realize when they adopt the practice of making post-discharge follow-up calls to patient family members. In this post, we’ll look at call strategies, tactics, and even provide a sample script to guide hospital staff as they incorporate this follow-up model into their standard discharge process.

Call Strategy: The Four D’s

The four D’s capture what we’ve found to be a tried-and-true, high-level strategy for post-discharge calls. They are a product of our experiences with a number of pediatric inpatient units that have adopted this model:

Detail the home care and medication instructions again now that the child and family are in a lower-stress setting.

Demonstrate the appropriate empathy and concern for the child’s condition and the family’s experience.

Define the family’s concerns by asking a series of clarifying questions to determine the root cause.

Defuse the family’s concerns by assuring them that steps will be taken to address any issues they’ve expressed (e.g., alerting a unit supervisor, receiving a physician callback, making changes in care protocols).

Call Tactics: Tips to Get the Most Out of Follow-Up Calls

It is equally important for staff to discuss how they will execute the call strategy. They need to put processes in place to ensure they get the most out of follow-up calls.

  • Before discharge, instruct staff members to confirm the family’s phone number and explain that someone will be calling in the next week to check on their child.
  • Develop a unit-specific script with input from a representative group of providers and administrative staff.
  • Limit the number of questions to 10 or fewer (we’ve found 7 to be an ideal number).
  • Develop a standardized form to document the answers and other feedback received during calls.
  • Keep the calls brief, extending past 5 minutes only if the family member wants to elaborate on answers.
  • Train callers so they are comfortable deviating from the script when families have specific questions or concerns, especially if their experience was negative.
  • Try to find a provider who interacted with the child and their family during the hospital stay to make the call.
  • Prioritize calls by stratifying pediatric patients into high, moderate, and low categories based on factors such as acuity and length of stay.
  • Track discharge call attempt and success rates.
  • Report on call findings at regular intervals (e.g., at unit meetings).
  • Have a nurse supervisor or administrator listen in on a sampling of calls to provide feedback on call quality.
  • Ensure there is process in place for escalating issues that aren’t resolved with an initial call.

Putting it into Practice: Sample Script

This sample script can serve as a starting point for pediatric units that are new to discharge follow-up calls.

Hello, this is Michelle. I’m a nurse from West Oak Hospital and I’m calling to follow up on your child’s recent stay. Is this a good time to talk? I’d like to ask you a few questions to see how things are going, and I can also answer any questions you have about follow-up care for your child.

  • How has your transition to home gone so far?
  • Do you have any questions about home care or medication?
  • Do you have time to answer a few questions about your experience at our hospital?
  • How would you rate the clarity and consistency of communication from the providers during your stay?
  • Did our team consistently help you understand the care decisions made for your child?
  • Do you feel our providers always displayed the proper empathy regarding your child’s stay on the unit?
  • How were the facilities and overall patient and family experience in our hospital?
  • Is there a specific area in which you feel we can improve our care delivery?
  • Are there any specific providers or staff members you would like to recognize for excellence in care?
  • I see you need to schedule a follow-up appointment with a specialist. If you’d like, I can transfer you to our schedulers so they can help you get that arranged.

Before scheduling follow-up appointments (this should be the last question, as it may involve a call transfer), be sure to also include any customized questions related to any current hospital initiatives (consistency of rounding time, quietness of unit at night, etc.).

Remember, these calls have both quantitative and qualitative benefits. They reduce preventable readmissions and improve compliance with follow-up instructions, while also closing the patient feedback loop, making sure the hospital has the information it needs to respond in a timely way, and driving higher patient satisfaction scores. In an era when brand loyalty is becoming increasingly important in the pediatric industry, a proactive and empathetic gesture can go a long way toward building a lasting patient relationship.

This entry was posted in Children's Health, Operations, Outcomes Measures, Patient Engagement and tagged , , , by Clark Bosslet. Bookmark the permalink.

About Clark Bosslet

As a member of ECG’s Children’s Hospitals practice, Clark works with academic medical centers and pediatric hospitals across the country to help them solve a broad range of financial and operational problems. He has extensive experience evaluating funds flow models, designing faculty compensation plans, and performing fair market valuations for physicians and physician groups. Recently, he worked on a yearlong engagement to integrate two major departments of pediatrics impacting over 500 faculty members and addressing issues related to clinical services, faculty employment and appointment models, residencies and fellowships, and research infrastructure. Previously, Clark worked on a pediatric department review at a major teaching hospital that involved the assessment of clinical and research efforts at the individual faculty and service line level, providing the client with a practical action plan for the future, as well as tools to help the department regularly benchmark its progress. He also helped to develop a regional pediatric strategy for two major pediatric providers in the Greater Seattle area. Prior to joining ECG, he worked as an internal Strategic and Financial Consultant at Texas Children’s Hospital in the finance department, where he performed market analyses and service line reviews, designed and executed patient flow analyses to assist with staffing projections, and led a team of more than 20 in the cross-functional implementation of a state grant valued at over $1 million. Clark earned a master of business administration degree in healthcare from Vanderbilt University and a bachelor of business administration degree from Texas A&M University.

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