Telephone follow-up

Altra, BSN, RN · Nov 28, 2007

Hello! OK, so I've been out of work for almost 2 months now because I had foot surgery and want something to do work related, so I offered to do some research, etc, for the unit. I work in a Pediatric Emergency Department that has been open for about 2 years now. I am looking at developing a questionnaire for follow-up phone calls made by the nurses on the unit. This is NOT for numbers... this is for patient satisfaction, making sure they get the care they need.
Well, my questions are:
Do you do telephone follow-up in your unit?
Is this useful?
What types of questions?
And what institution so that I can maybe call and speak to your PCD or somethin?
I'm not sure which direction I'm going or even what types of questions to ask. I think it should be a mix of clinical and patient satisfaction to make sure the patient is doing OK and that they were happy with their visit all at the same time!
Any help would be GREATLY appreciated.

I must be too tired ...

I had trouble figuring out from your post exactly what you are proposing to do. Is this "questionnaire" for the department in which you work? Who will receive/respond to the questionnaire? What are you hoping to measure? Effectiveness of follow-up calls r/t patient outcomes? Patient satisfaction? (2 entirely different animals ...) Patients "getting the care they need" and "Patient satisfaction" are NOT the same thing.

I have trouble with the concept that an ER nurse would willingly volunteer to survey patients on their *satisfaction* ...

analee23 · Nov 28, 2007

Oh, no, no, no is this just for satisfaction. I'm looking at improving patient care. I want these people to get what they need so they don't bounce back time after time after time. :) Now THAT'S something I'd volunteer for! Well, that and catch those patients that really shouldn't have gone home and need to come back.... NOW.

thanks for the response though!

Altra, BSN, RN · Nov 28, 2007

Oh, no, no, no is this just for satisfaction. I'm looking at improving patient care.

Hmm ... IMO, improving patient care and increasing patient satisfaction are two entirely different things. Just curious -- has your facility utilized Press Ganey or some other satisfaction survey mechanism? What responses did you get? Did the patient surveys reflect good outcome = patient satisfaction, or did patients focus on non-clinical items like wait times, availability of comfort items on demand, etc.

I want these people to get what they need so they don't bounce back time after time after time.

Oh my.

analee23 · Nov 28, 2007

I'm not saying bounce-backs are bad... I'm saying that we should try and meet needs so that they aren't forced to bounce back over and OVER for the same complaint that should have been met on their first visit, or from misunderstanding of discharge instructions. I want to make sure these patients get what they're looking for and clearly understand their instructions.

A mother comes to mind who came in on 4-5 separate occasions for a child that had nothing more than a bad cold, kid was fine, eating great, but she couldn't figure out why the kid still was sick. It was clearly a lack of teaching and understanding.

OR, the kid that slips through the cracks and comes back barely alive because no one followed up properly or explained what they should return for. THIS is why I am doing this, I want to help these families. It's not a frustration thing. Just wanted to make that very clear.

I often am not quite as eloquent as I like and say things that get misconstrued pretty easily. It's a curse, really. sorry for the misunderstanding.

yes, we have used something similar to press-ganey and our scores are generally pretty high. It isn't press-ganey, it's something else, but very similar.

S.T.A.C.E.Y, LPN · Nov 28, 2007

Effectiveness of follow-up calls r/t patient outcomes? Patient satisfaction? (2 entirely different animals ...) Patients "getting the care they need" and "Patient satisfaction" are NOT the same thing.

I agree with the above quote and think the objective of your questionnaire needs to be clarified more. Whether or not they are satisfied with the care they recieved is not necessarily connected to them returning or not returning.

I think if I was to develop a questionnaire, this is what I would ask:

1. what they thought about the ER visit,

2. names of staff who they felt provided good patient care (how so?),

3. names of staff who they felt did not provide good patient care (how so?)

4. Did they have any specific problems with their care (opportunity to educate here, and clear up some misunderstandings)

5. How the patient is doing now -- did the ER visit solve the problem, have they returned to the ER for the same problem since

6. Then educate them.....was this an appropriate use of the ER, do they know what signs/symptoms to return to their family doctor for, do they know what signs/symptoms to return to the ER for, do they have a family doctor - maybe provide some names & numbers of family doctors who are taking patients, do they know about their diagnosis have, any questions they did not have answered during their ER visit.

And.......I would definitely use it for numbers. Introduce it into quality assurance/quality improvement. Taking numbers from a two month phone back period and studying them and making the appropriate changes can be valuable to your department for years to come, otherwise you are only making a difference for two months and then thats it.....kind of a waste. Also, I would make very sure to let the staff know about those who were specifcally identified as having provided good patient care. And would let management know about any staff who had their name mentioned numerous times for not providing good patient care.

As far as I know my unit does not do telephone phone calls back to patients. However a ski resort that I work at does on a routine basis for those who are hurt on the ski hill. And it is always used for QA/QI. Staff find out how these people fared, what they felt about their experience (constructive stuff), and how can we do better. And we always incorporate it into our education days...

JLARN77 · Nov 30, 2007

In the ER I work in, we do follow up phone calls.... well as often as we can! We try to call the patients seen the previous day. Of course we exclude addmissions, transfers, and we have found our frequent fliers such as migraines and chronic painers that we see every other day, if we call them within in a couple hours they are back in our ER!!

S.T.A.C.E.Y.'s list of questions is pretty close to what we use as a guideline to the phone calls. We do track our numbers and have a bulletin board that we acknowlege staff who have been mentioned by patients. We use Press-Ganey, and we tell our patients that they may receive a survey and to fill it out.

Overall I think that the follow up phone calls are helpful, and patient's really appreciate someone calling them to check in, unfortunatley right now if someone manages to call a couple days out of the week it is the best we can do. Our phone calls are pretty informal, just a way to reach out to our patient again and let them know that we care. Good luck with your project!