Early Post-discharge Telephone Follow-Up in a Psychiatric ED: A Quality Improvement Initiative to Strengthen Care Transitions and Patient Engagement.
Background Psychiatric EDs manage high volumes of patients who often face barriers to medication access, limited understanding of discharge instructions, and difficulty securing timely outpatient follow-up. Structured early outreach has shown promise in improving these transitions. This quality improvement initiative evaluated a 72-hour nurse-led telephone follow-up program for patients discharged from a psychiatric service within an ED. Methods All patients discharged over the study period were eligible for a structured telephone call within 72 hours. The call assessed medication pickup, medication adherence, follow-up appointment status, transportation needs, and satisfaction with both emergency care and the follow-up call. Diagnoses were extracted from clinician documentation. Demographic characteristics and patient-reported needs were summarized. Outcomes included call reach rate, patient-reported understanding of discharge instructions, medication-related behaviors, and follow-up completion. Results A total of 69 patients met the inclusion criteria, with a mean age of 35.3 years. The most common diagnoses were major depressive disorder with suicidal ideation, schizophrenia, and bipolar disorder. The nurse navigator successfully contacted 37.7% of discharged patients. Among reached patients, half reported taking their medications, and over two-thirds had a scheduled follow-up appointment. Transportation barriers were uncommon. Patient satisfaction with psychiatric emergency care averaged 4.45 on a five-point scale, and satisfaction with the follow-up call averaged 4.95. Patients commonly sought clarification regarding medications, follow-up appointments, and transportation resources. Conclusion Early nurse navigator-led telephone follow-up after discharge from psychiatric emergency care demonstrated strong patient engagement and high satisfaction. The calls created opportunities to reinforce discharge instructions, support medication use, and assist with follow-up planning. These findings suggest that early nurse-led contact can highlight actionable barriers and support safer care transitions following psychiatric emergency discharge.