A Re-Engineered Discharge Process with Telephone Follow-Up Call at a Psychiatric Hospital

Abstract

The 3-day readmission rates of all patient types are a known concern nationally. At the project site, psychiatric readmissions within 30 days were increasing, prompting the need for evidence-based solutions. The purpose of this quantitative quasi-experimental, quality improvement project was to determine if or to what degree the implementation of the Agency for Healthcare Research and Quality’s (AHRQ) Re-Engineered Discharge (RED) Toolkit Tool 5: Post-discharge Follow up Phone Call would impact 30-day readmission rates among adult psychiatric patients in an inpatient psychiatric unit in rural New Jersey over four weeks. Dorothea Orem's self-care deficit theory and Walter Shewhart and Edward Deming's plan-do-study-act (PDSA) change model were the frameworks for this project. The total sample size was 26, with n = 12 in the comparative group and n = 14 in the implementation group. Data on readmissions were collected from the electronic health record. A chi-square test was used to analyze the data which indicated there was no statistically significant improvement in readmission rates, X² (1, N = 26) = 2.33, p = .127 between the comparative and implementation groups. Despite the lack of statistical significance, there was clinical significance in reducing readmissions from n = 6; 50.0% in the comparative group to n = 3; 21.4% in the implementation group. Implementing the AHRQ RED Toolkit Tool 5: Post-discharge Follow up Phone Call may reduce readmissions for this population. It is recommended that the organization sustains the project with data analysis reanalyzed at six months prior to dissemination. Keywords: Readmission reduction, Agency for Healthcare Research and Quality Dorothea Orem's Self-Care Deficit, Re-engineered discharge (RED), follow-up phone call, quality improvement, psychiatric patients.