A study by the Bronx Collaborative (N.Y.) found that implementing a system of patient contact by care transition analysts before and after hospital discharge was an effective tool for lowering hospital readmission rates.
The Bronx Collaborative put the transitional intervention system in place at Montefiore Medical Center, St. Barnabas Hospital and Bronx Lebanon Hospital Center in New York. The group presented the results at the Case Management Society of America's annual meeting in New Orleans.
The transitional interventions consisted of pre-discharge education, a scheduled follow-up appointment within two weeks of discharge and a regimen of follow-up phone calls: a first call 2 to 3 days after discharge to address questions or concerns, a call 1 to 2 weeks after discharge to confirm attendance at the follow-up appointment and a final call 2 to 5 weeks after discharge to address lingering questions or concerns.
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