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What if We Don’t Have Time to Make Discharge Calls?

Question

All nurses on our staff are to complete approximately five callbacks per shift. How can this rule be enforced? When we are very busy, the nurses just don’t get them done.

Answer

Here are a couple of suggestions:

First, we suggest using a format with questions specific to the key words on the patient satisfaction survey tool. Then have one or two of your high performers do their five calls and time each one. Average the length of time the calls take. (Typically, they average two minutes.) This means that you are asking nurses to spend only 10 extra minutes checking on their patients.

Also, keep in front of the staff the actions you are taking as a leader to provide them with this time. Perhaps you are acquiring basic tools and equipment so staff members don’t spend time looking for them. Perhaps you get one unit a copier so they don’t have to go to another floor. Another area may receive blood pressure cuffs.

When we do discharge phone calls, we eventually get a clinical win. A parent tells us her child who came in the day before with a closed head injury has been sleeping for the last 10 hours. Or we may discover that an elderly man’s walker—or worse, his oxygen—was not delivered. Nurses will get their arms around discharge phone calls when they see that such calls can make a positive difference.

In your daily rounding, ask if nurses did their discharge phone calls. Sit at the desk in the morning, and make one or two calls yourself. Managers enjoy hearing the compliments that usually come with the calls. This is great for reward and recognition! (Remember, too, that physicians and physician extenders can do discharge phone calls.) And last, set a goal of how many patients you want to call and how many you hope to reach. If you document progress toward goals and share with staff, they will be more motivated.