Coaching older adults discharged home from the emergency department: The role of competence and emotion in following up with outpatient clinicians.
Ranran Z Mi, Gwen C Jacobsohn, Jiaxi Wu and 7 others
PMID 36064518WHAT IT FOUND
Older adults whose coach notes showed they knew how to manage their health were more likely to contact outpatient clinicians within 30 days.
Those whose notes showed sadness were less likely to contact within 7 days.
Key findings
01Coach notes documenting knowledge-based competence significantly predicted any outpatient clinician contact within 30 days (odds ratio 2.15; 95% CI 1.20 to 3.85).
02Coach notes documenting sadness significantly predicted lower odds of any outpatient clinician contact within 7 days (odds ratio 0.37; 95% CI 0.15 to 0.96).
03No coach-note variables significantly predicted in-person outpatient follow-up within 30 days or electronic outpatient follow-up within 7 days.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis was correlational, so it cannot show that coach notes or emotions caused follow-up. Coaches were not trained to record psychological needs or emotions, and these notes were neither required nor standardized. The coding was mostly yes/no, so subtle differences may have been missed. Only participants who received the coaching intervention were analysed, so the study cannot separate the intervention's effect from other care. The sample was largely White and college-educated, so findings may not apply to more diverse older adult populations. Some reported associations were only trending toward significance and should be interpreted cautiously. Baseline health status and number of chronic conditions were important controls, so follow-up was not explained by coach notes alone.
Declared interests
The authors declare no competing interests. The paper is listed as NIH extramural-supported research.
The easy way to misread this
Do not read these results as proof that coach notes caused follow-up or that the intervention worked. The study only looked at participants who received coaching, did not compare them with usual care, and the notes were not standardized.