Pagers combined with telephones improve successful follow-up from a pediatric emergency department.

OBJECTIVE To determine whether there is a significant difference in initial successful contact when attempting follow-up of patients discharged from a pediatric emergency department (ED) using either pagers or the telephone. In addition, to evaluate whether the combination of both pager and telephone follow-up is more successful than telephone follow-up alone when confined to a 2-hour period. DESIGN AND SETTING A prospective comparison of intervention and control groups taken from convenience samples of patients seen in an ED of an urban, tertiary care children's hospital. PARTICIPANTS One hundred eighty-five patients whose families had access to both a pager and a telephone (intervention group) and 112 patients whose families had access to only a telephone (control group) were enrolled. INTERVENTION Before discharging the patient from the ED, the investigators verified a pager number and/or a best contact telephone number for a follow-up telephone call. Participants were divided into 2 groups. The intervention group consisted of caretakers with both pagers and telephones. The control group consisted of caretakers with only telephones. On even calendar days after ED visits, intervention group caretakers were paged initially from 11:00 AM to 11:59 AM. On odd calendar days, intervention group caretakers were telephoned initially from 11:00 AM to 11:59 AM. Successful contact was defined as communication with a family member or guardian over the age of 18. If the caretaker spoke only Spanish, a translator was used. In a crossover design with the intervention group, if contact was unsuccessful after 1 hour, the alternative mode of communication was used at noon. Control group caretakers were telephoned from 11:00 AM to 11:59 AM. If telephone contact was unsuccessful, they were called again 1 hour later. RESULTS Two hundred forty-six (36%) of 685 of the convenience sample of caretakers had access to both a pager and a telephone. Fifty-two (55%) of 94 intervention caretakers were contacted initially using pagers versus 47 (52%) of 91 intervention caretakers contacted initially by telephones. Overall successful contact of intervention caretakers (telephones and pagers) was 145 (78%) of 185 when confined to a 2-hour time period. In contrast, overall successful contact of control caretakers was 68 (61%) of 112 when confined to a 2-hour time period. Successful contact was greater with the intervention caretakers than with control caretakers (78% vs 61%). CONCLUSIONS No significant difference in successful contact was seen whether paged or telephoned initially. The combination of both pagers and telephone follow-up was more successful than telephone follow-up alone when confined between 11:00 AM to 1:00 PM.