After leaving the emergency department, many patients are too disoriented to understand their discharge instructions.
In Fruitland, patients now get a reassuring phone call from an ED team member to check on their general health, ensure follow-up care and assist with prescription management.
The goal of the new callback program is to provide personalized attention, listen to patient concerns and ensure that they get needed follow-up care, said Joe Young, Fruitland emergency department nursing supervisor.
“It gives us a chance to strengthen the bond,” he said.
Within two days of an ED visit, staff members access the patient’s electronic health record, review provider notes and read prescription follow-up instructions.
During the call, patients are asked about their general health, issues filling prescriptions and the status of follow-up appointments with primary care physicians and specialists.
Two days is “just about perfect for reminders,” Young said.
“The goal is to support the community and decrease unnecessary return ED visits,” said Teresa Hall, director of the Fruitland and Nampa emergency departments. “I am very proud of the team.”
St. Luke’s Wood River launched an ED patient callback program seven years ago, in part based on national statistics that indicated 65 percent of all patients discharged from emergency rooms had not received post-care instructions and that one in five reported an adverse event post-discharge.
The program has been beneficial in numerous ways, according to Angela Brady, St. Luke’s Wood River’s director of nursing and patient care. Nurses who review patients’ charts and make the calls have fielded questions and allayed concerns about everything from the tightness of casts to fevers and continued vomiting on the part of young patients to significant lingering psychosocial problems that might not have been turned up otherwise.
ER physicians have confidence that there is an additional layer of safety for patients, Brady said, and patients are thrilled with the service.
“It’s the icing on the cake for these patients,” she said. “It’s really great. The nurses have a good idea of where the problems really might be. They can provide some guidance about, ‘Do you have a follow-up appointment?’ The nurses can help with that transition of care.
“We’ve gotten great feedback. This isn’t a hard sell.”
Hall and the Fruitland team were inspired by a suggestion from Pam Lindemoen, St. Luke’s Health System vice president of acute care services. Working collaboratively, they developed a system that “shows patients that we care about them,” Hall said.
While the phone calls can uncover big issues, sometimes they are little more than reassurance and telling patients “you are on the right path,” Young said.
And as in the Wood River Valley, feedback has been positive.
“Even if everything was great, people are appreciative,” he said. “Even the tiny little things like this make the difference.”
Young says that program is successful because it is collaborative. He gives credit to his colleagues Sheri Davis, health unit coordinator; Bailee Jones, RN; Brianne Haun, RN; Randy Spurgeon, respiratory therapist; and others.
He is proud of the Fruitland team’s willingness to take the extra steps needed to improve outcomes for patients.
“When everybody is happy, you give better care,” Young said.
It’s a sentiment shared by the Wood River team.
“We’re trying to get the patient to the right spot and the right resource and the right access,” Brady said. “It supports better health at less cost, for sure.”
Amy Stahl works in the Communications and Marketing department at St. Luke's.