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2/20/14blog post

who you gonna call?

A mother of a toddler diagnosed with a stomach virus has misplaced her discharge instructions from the emergency department at Dayton Children’s and can’t remember what her doctor told her.

Who can she call for guidance?

An emergency department doctor wakes up in the middle of the night worried about a patient she cared for during her shift. She wants an update on the patient’s abdominal pain symptoms, and wants to make sure the patient is rechecked by their pediatrician.

Who can assist her in checking on the patient?

The answer to both of these questions is the emergency department (ED) outreach nurse.

I am proud to be part of the team of emergency room outreach nurses who are here every single day to help parents – and clinical team members – provide continuing care to families after they are discharged from the emergency department. Last year alone, we had 74,391 ED visits and outreach nurses made 29,842 follow-up calls to families.

The role of ED outreach nurses:

  • Call back patients/families with certain diagnoses to check on them.
  • Call back patients/families that have a positive lab or x-ray finding after discharge to make sure the patient gets the needed treatment or medication.
  • Help families with needed follow-up care (e.g. appointments with specialists, help find resources to pay for prescriptions)
  • Answer a family’s questions about their visit to the emergency room, within 72 hours of that visit.

Our ED outreach program is one of the many reasons Dayton Children’s was recently awarded Magnet designation. A Magnet Hospital is one that is recognized for excellence in nursing care. In fact, Dayton Children’s is one of only 31 pediatric Magnet hospitals nationwide and only 7 percent of all healthcare facilities in the country have this prestigious honor.

The ED outreach program is an example of a program that uses nurses’ expert knowledge to provide high-quality care to children in our community. It is important to note that high-quality care doesn’t stop when the patient is discharged. Often, families have to arrange additional follow-up care for their child.

For example, the patient’s lab tests may not result until after the patient is discharged, or the patient may require an appointment with a specialist. Having a dedicated, experienced ED nurse on duty every day gives parents a resource to ask for help with their child’s follow-up care.

One of the most important lessons learned from the outreach program is that post-discharge phone calls are necessary and valuable to both patients/families and the emergency department staff. Having a dedicated nurse who calls to check on a discharged patient allows the parent to ask questions, clarify instructions, seek help with follow-up care and obtain resources.

This program helps parents successfully – and safely – manage their child’s care at home.

Though the ED outreach program was featured when we were awarded Magnet, the real reason we do it is for the 285,000 children we treat each year. They are the real winners.

By: Pam Bucaro

Pam has worked as a nurse in a variety of units during her 20 year tenure at Dayton Children’s. For the past 16 years, she has worked in the Soin Pediatric Trauma and Emergency Center and is currently the clinical nurse specialist (CNS) for the emergency department. As a clinical nurse specialist, she facilitates delivery of high-quality clinical care by promoting evidence-based practice. In her role she provides tools for the bedside nurses, including guidelines, policies and standardizing processes.