Auger KA, et al. - Whether a single nurse-led telephone call after pediatric discharge decreased the 30-day reutilization rate for urgent care services and enhanced overall transition success was examined in this Hospital-to-Home Outcomes (H2O) randomized clinical trial. Researchers reported that postdischarge nurse contact did not reduce the reutilization rate of postdischarge urgent health care services. Results of this study suggested that this method exhibits promise to support postdischarge education.

Methods

• This trial involved 966 children and adolescents younger than 18 years (hereinafter referred to as children) admitted to general medicine services at a free-standing tertiary care children’s hospital from May 11 through October 31, 2016.
• Information were analyzed as intention to treat and per protocol.
• Main intervention was a postdischarge telephone call within 4 days of discharge vs standard discharge.
• The 30-day reutilization rate for urgent health care services (ie, unplanned readmission, Emergency Department visit, or urgent care visit) was the primary outcome.
• Additional utilization measures, as well as parent coping, return to normalcy, and understanding of clinical warning signs measured at 14 days were the included secondary outcomes.

Results

• Nine hundred sixty-six children were selected and randomized (52.3% boys; median age [interquartile range], 2.4 years [0.5-7.8 years]).
• Out of 483 children randomized to the intervention, the nurse telephone call was completed for 442 (91.5%).
• Findings revealed that children in the intervention and control arms had similar reutilization rates for 30-day urgent health care services (intervention group, 77 [15.9%]; control group, 63 [13.1%]; P=.21).
• Data reported that parents of children in the intervention group recalled more clinical warning signs at 14 days (mean, 1.8 [95% CI, 1.7-2.0] in the intervention group; 1.5 [95% CI, 1.4-1.6] in the control group; ratio of intervention to control, 1.2 [95% CI, 1.1-1.3]).