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Implementation of a Follow-up Telephone Call Process for Patients at High Risk for Readmission

Miller, Danielle A. DNP, RN; Schaper, Ana M. PhD, RN

doi: 10.1097/NCQ.0000000000000069

This project included the development and implementation of a follow-up telephone call within 72 hours of discharge, targeting patients at high risk for readmission. The goal was to improve understanding of aftercare instructions and decrease readmissions. Clinical nurse leaders provided an intervention in 66% of patient contacts. Readmission rate within 7 days of discharge was significantly lower (P < .05), and the rate within 30 days of discharge trended lower (P = .053), in the clinical nurse leader contact group than in patients who were not contacted.

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Departments of Hospital Administration, Gundersen Health System (Dr Miller) and Nursing Research, Gundersen Medical Foundation (Dr Schaper), La Crosse, Wisconsin.

Correspondence: Danielle A. Miller, DNP, RN, Department of Hospital Administration, Gundersen Health System, 1900 South Ave, La Crosse, WI 54601 (

This research was supported by Gundersen Health System and Gundersen Medical Foundation.

The authors thank Lisa Sheldon, Quality Improvement Specialist, for her assistance with data analysis, and Laura Kloss, BSN, Clinical Nurse Leader Fellow, for her assistance with implementation of the intervention.

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: April 12, 2014

Published ahead of print: May 19, 2014

© 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins