Follow-up Telephone Call Quality Initiative

Background: Outcomes of nursing interventions following discharge for recipients of transcatheter aortic valve replacement (TAVR) are scarce. Purpose: This quality improvement project was a retrospective cohort design to evaluate the effectiveness of a follow-up telephone call on reducing 30-day hospital readmission for patients recovering from the TAVR procedure. Methods and Results: A convenience sample of 50 patients was used, 25 who received the follow up phone calls and 25 who did not. Twenty-five patients were selected from those TAVR patients who did received a follow-up telephone call between January 20 - May 20, 2017 and 25 TAVR patients from those who were not exposed to the intervention between January 20 - May 20, 2016. The cohorts were matched based on sex and NYHA CHF classification at time of the hospital admission. Both hospital length of stay and postoperative length of stay were shorter in the intervention group than the control group. Patients who received the follow-up telephone call post discharge spent on average 2.20 days less in the hospital than those who did not receive the follow up telephone call, 3.92 ± 1.9 days vs 6.12 ± 3.95 days respectively, t = 2.53 (34), p = 0.01. Patients who received the follow-up telephone call post-discharge spent on average 1.28 days less in the hospital after their procedure than those who did not receive the follow-up telephone call, 2.84 ± 1.7 days vs 4.12 ± 2.57 days respectively, t = 2.07 (48), p = 0.01. However, there was no significant difference in readmissions within 30 days of discharge in those received the follow-up phone call post-discharge (n=4, 8%) and those who did not receive the follow-up phone call post-discharge (n=4, 8%). Conclusions: The quality improvement follow-up telephone call initiative did not reduce the rate of hospital readmission. Although, this program did not evaluate patient reported outcomes, future projects should not only consider hospital readmissions but other quality measures as well.