Pediatric Cardiology

, Volume 37, Issue 6, pp 1106–1110 | Cite as

Timely Post-discharge Telephone Follow-Up is a Useful Tool in Identifying Post-discharge Complications Patients After Congenital Heart Surgery

  • Entela B. Lushaj
  • Kari Nelson
  • Kate Amond
  • Eugene Kenny
  • Abbasali Badami
  • Petros V. AnagnostopoulosEmail author
Original Article


The objective of this study was to evaluate the effect of structured post-discharge telephone follow-up (TFU) on the time to the first postoperative clinic visit and early unplanned hospital readmissions in patients after congenital heart surgery. Structured phone calls delivered by senior surgical practitioners were made 1–4 days post-discharge. Demographics and clinical outcomes of pediatric patients receiving a TFU from 2012 to 2014 were assessed. In total, 196 phone calls were made in 165 patients. Thirty-four health problems were identified in 32 (19 %) patients (15 infants, 9 children, 8 neonates). Sixty-nine percent (n = 22) of the patients with problems identified at TFU were males. Fifty-three percent (n = 17) of the patients with problems identified at TFU were RACHS 2. Most of the problems (53 %) were identified in middle-class economic families. Gastrointestinal and incision site complications were the most common problems identified. Eighteen (56 %) patients had adjustments of medications. Six (19 %) TFUs resulted in earlier than scheduled post-op clinic visits. Overall incidence of unplanned readmissions was 16 % and similar between the patients that had problems during TFU (13 %) and patients that did not have problems identified at TFU (18 %; p = 0.50). Our study demonstrates the potential impact of the timely and structured post-discharge TFU in identifying post-discharge complications and modifying discharge instructions. When TFU identifies a problem, the interventions may be successful in preventing readmissions before first postoperative clinic visit. TFUs may be helpful, as a supplement standard of care with specific focus on patients <1 year of age to help identify adverse events that could otherwise escalate.


Congenital Cardiac Surgery Telephone Call 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Marelli AJ, Mackie AS, Ionescu-Ittu R et al (2007) Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 115:163–172CrossRefPubMedGoogle Scholar
  2. 2.
    Chen E, Bloomberg GR, Fisher EB Jr, Strunk RC (2003) Predictors of repeat hospitalizations in children with asthma: the role of psychosocial and socioenvironmental factors. Health Psychol 22:12–18CrossRefPubMedGoogle Scholar
  3. 3.
    Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW (2003) The incidence and severity of adverse events effecting patients after discharge from the hospital. Ann Intern Med 138(3):161–174CrossRefPubMedGoogle Scholar
  4. 4.
    Forster AJ, Clark HD, Menard A et al (2004) Adverse events among medical patients after discharge from hospital. CMAJ 170(3):345PubMedPubMedCentralGoogle Scholar
  5. 5.
    Jack BW, Chetty VK, Anthony D et al (2009) A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med 150(3):178CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Coleman EA, Parry C, Chalmers S, Min SJ (2006) The care transitions intervention: results of a randomized controlled trial. Arch Intern Med 166(17):1822CrossRefPubMedGoogle Scholar
  7. 7.
    Naylor MD, Aiken LH, Kurtzman ET, Olds DM, Hirschman KB (2011) The care span: the importance of transitional care in achieving health reform. Health Aff (Millwood) 30(4):746CrossRefGoogle Scholar
  8. 8.
    Dodds KM, Merle C (2005) Discharging neonates with congenital heart disease after cardiac surgery: a practical approach. Clin Perinatol 32(4):1031–1042CrossRefPubMedGoogle Scholar
  9. 9.
    Mistiaen P, Poot E (2006) Telephone follow-up, initiated by a hospital- based health professional, for postdischarge problems in patients discharged from hospital to home. Cochrane Database Syst Rev (4):CD004510Google Scholar
  10. 10.
    Laramee SA, Levinsky SK, Sargent J, Ross R, Callas P (2003) Case management in a heterogeneous congestive heart failure population. Arch Intern Med 163(7):809–817CrossRefPubMedGoogle Scholar
  11. 11.
    Harrison PL, Hara PA, Pope JE, Young MC, Rula EY (2011) The impact of post-discharge telephonic follow-up on hospital readmissions. Popul Health Manag 14(1):27–32CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Melton LD, Foreman C, Scott E, McGinnis M, Cousins M (2012) Prioritized post-discharge telephonic outreach reduces hospital readmissions for select high-risk patients. Am J Manag Care 18(12):838–844PubMedGoogle Scholar
  13. 13.
    STS National Database, executive summaries, spring 2013, all patients.
  14. 14.
    Jacobs JP, Wernovsky G, Elliott MJ (2007) Analysis of outcomes for congenital cardiac disease: Can we do better? Cardiol Young 17(Suppl 2):145–158PubMedGoogle Scholar
  15. 15.
    Jacobs JP, Jacobs ML, Austin EH et al (2012) Quality measures for congenital and pediatric cardiac surgery. World J Pediatr Congenit Heart Surg 3:32–47CrossRefPubMedGoogle Scholar
  16. 16.
    Belliveau D, Burton HJ, O’Blenes SB, Warren AE, Hancock Friesen CL (2012) Real-time complication monitoring in pediatric cardiac surgery. Ann Thorac Surg 94(5):1596–1602CrossRefPubMedGoogle Scholar
  17. 17.
    Perrin EC, Goodman HC (1978) Telephone management of acute pediatric illnesses. N Engl J Med 298:130–135CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Entela B. Lushaj
    • 1
  • Kari Nelson
    • 1
  • Kate Amond
    • 1
  • Eugene Kenny
    • 1
  • Abbasali Badami
    • 1
  • Petros V. Anagnostopoulos
    • 1
    Email author
  1. 1.Division of Cardiothoracic SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

Personalised recommendations