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Follow-Up Calls Reducing Readmission Rates: Design


Due to the importance of improving the transitional care model through follow-up calls to reduce patient readmission rates, the nursing practice should be based on a special methodology involving a comprehensive assessment of the problem. Since the work is aimed at the direct interaction of medical personnel with patients, any calculations and correlations are to be based on the information received from the target audience. For a proposed topic, a mixed research method can be a valuable and effective analysis strategy to evaluate the role of follow-up calls for older adults. Obtaining data from patients with the subsequent interpretation of this information in statistical correlations may help to accurately assess the significance of work and its importance in the context of transitional care.

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Literature Review

Despite the fact that such a parameter as hospital readmission is dynamic and depends on various factors, including the type of disease, patient age, and other criteria, some common features are characteristic of this problem. According to Jones et al. (2016), this issue is acute since, in 2014, more than half of hospitals faced the problem of an increased number of readmissions, which was also associated with low-quality transitional care. Van Spall et al. (2017) support this point of view and note that about 40% of readmissions are caused by the incorrect interaction of medical providers in healthcare settings (p. 1428). As a result, as Lewis, Samperi, and Boyd-Skinner (2017) state, the practice of follow-up calls to minimize the number of re-hospitalizations is seen as “a potentially cost-effective strategy” with positive health outcomes for older adults (p. 544). This strategy is taken as the basis for the research.

The considered practice is designed to solve a number of essential tasks that arise after patients are discharged from the hospital. Both physical and psychological support are incentives for recovery and a successful rehabilitation period (Lewis et al., 2017; Miller & Schaper, 2015). According to Lee, Yang, Hernandez, Steimle, and Go (2016), studies confirm a reduction in the number of readmissions when the follow-up call strategy is implemented within 72 hours of patient discharge. As a result, as Rennke and Ranji (2015) argue, the quality of transitional care directly depends on how efficiently providers organize their interaction with the target audience and what measures are taken to prevent re-hospitalization.

Methodology and Design

As a methodology for researching and proving the theory of follow-up calls for reducing readmissions among older adults, a mixed type of study may be applied. This strategy involves obtaining data from the target audience through interviews and surveys, as well as compiling statistical correlations based on this activity. The design of the study involves receiving valid information through the collection of data with their subsequent interpretation. The reliability and accuracy of the results may be achieved by engaging one category of the population (older adults) and the correlation principle of assessment, eliminating bias or ambiguity in the calculations.

Sampling Methodology

The sample methodology is based on the involvement of the older population discharged from the hospital within 72 hours. The age criterion is a priority, and other variables, for instance, the nature of the disease, gender, and other characteristics are not taken into account and are considered concomitant factors. As stakeholders, not only patients but also medical providers are engaged since the solution to the problem of a high level of readmission affects employees’ activities negatively. As Lee et al. (2016) note, for such a study, two groups may be involved. One group will receive standard treatment and care, while for the other one, the follow-up call strategy will be utilized. Based on the results of a 30-day intervention, the results will be compared, and conclusions will be drawn.

Necessary Tools

Such tools and are necessary as computing equipment that will help to conduct all calculations as accurately as possible, as well as relevant accounting programs. Also, to establish uninterrupted calls and contact between providers and patients, two-way communication should be maintained by using standard telephone equipment. Digital calling tools are not mandatory, but if desired, the parties can exchange video calls. Online tables may be needed to conveniently store all the research data and make changes in the research process.

Research Algorithms

The practice of the intervention may be based on three main steps. In the beginning, a telephone connection between the responsible medical staff and the patient is established. Further, for 72 hours, regular calls with a frequency of 6 hours in the daytime can be made. The third phase involves evaluating the results of patient surveys with the preparation of the necessary calculations. These actions will be carried out for one month with different patients, and at the end of this period, the results of the control group will be compared with the health outcomes of patients not involved in the research.

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A mixed methodology based on the review of data from the control group is the technique that can provide relevant data on the value of follow-up calls to reduce readmission rates among older patients. The age criterion is the key, and as necessary tools, standard telephone equipment may be applied, as well as programs for statistical calculations. The three-phase intervention over a period of one month can make it possible to determine the effectiveness of the proposed assistance strategy and its significance for reducing readmission rates.


Jones, C. E., Hollis, R. H., Wahl, T. S., Oriel, B. S., Itani, K. M., Morris, M. S., & Hawn, M. T. (2016). Transitional care interventions and hospital readmissions in surgical populations: A systematic review. The American Journal of Surgery, 212(2), 327-335. Web.

Lee, K. K., Yang, J., Hernandez, A. F., Steimle, A. E., & Go, A. S. (2016). Post-discharge follow-up characteristics associated with 30-day readmission after heart failure hospitalization. Medical Care, 54(4), 365-372. Web.

Lewis, E., Samperi, S., & Boyd-Skinner, C. (2017). Telephone follow-up calls for older patients after hospital discharge. Age and Ageing, 46(4), 544-546. Web.

Miller, D. A., & Schaper, A. M. (2015). Implementation of a follow-up telephone call process for patients at high risk for readmission. Journal of Nursing Care Quality, 30(1), 63-70. Web.

Rennke, S., & Ranji, S. R. (2015). Transitional care strategies from hospital to home: A review for the neurohospitalist. The Neurohospitalist, 5(1), 35-42. Web.

Van Spall, H. G., Rahman, T., Mytton, O., Ramasundarahettige, C., Ibrahim, Q., Kabali, C.,… Connolly, S. (2017). Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: A systematic review and network meta-analysis. European Journal of Heart Failure, 19(11), 1427-1443. Web.

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