A Content Analysis of Emergency Department Discharge Instructions for Acute Pediatric Febrile Illnesses: The Current State and Opportunities for Improvement

Abstract

Quality emergency department (ED) discharge communication is critical to understanding of disease progression, home management, and return instructions. Addressing social aspects of disease burden are important to improving satisfaction and healthcare utilization. The objective of this study was to understand the extent to which written ED discharge instructions address multifaceted aspects of disease to meet the comprehensive needs of families with common childhood illnesses. We analyzed a national sample of 28 written discharge instructions from pediatric EDs using thematic and inductive content analysis. Seven themes were identified. Nearly all discharge instructions devoted a majority of content to themes related to disease physiology. Other themes common to instructions were related to parental instructions for caring for the child and when to return for further care. Content on caregiver reassurance, returning to daily activities, improving well-being, and promoting community health were not a focus of discharge instructions. Inclusion of multifaceted discharge materials which address both medical and social aspects of disease may help improve family-centered emergency care and the quality of care transitions for common childhood illnesses.

Caregiver Quality of Life During Pediatric Influenza-Like Illness: A Cross-Sectional Study During the COVID-19 Pandemic

“…Our prior work found a lack of attention to this aspect in ED discharge instructions. 5 This finding suggests an area of opportunity to identify and address caregivers in which their worry about their child's illness is a key driving factor in healthseeking behavior and wellbeing.…”

“…Additionally, QoL is not systematically addressed in emergency departments (EDs) or in discharge instructions. [5][6][7] Therefore, understanding QoL changes during acute illness is important to optimize patient-and family-centered care (PFCC) and offers an opportunity to improve patient experience, quality, safety, and equity for children and families. 1,8,9 The clinical burden of influenza has been well-described but its effects on caregiver wellbeing are not understood.…”