Implementation of clinical practices to reduce return visits within 72 h to a paediatric emergency department

Jeong, Jin Hee; Hwang, Seung Sik; Kim, Kyuseok; Lee, Jin Hee; Rhee, Joong Eui; Kang, Changwoo; Sh, Lee; Kim, Hooyoung; Im, Yeon Sook; Lee, Boeknam; Byeon, Young Im; Lee, Jisook

doi:10.1136/emermed-2013-203382

Cited by 13 publications

(11 citation statements)

References 17 publications

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“…We did not find differences, probably due to the sample size not being calculated for this outcome: in order to find a difference between 25 and 15% rates of return visits, we would have needed to randomize 464 patients, more than three times more the sample size we used for our primary outcome. A previous before-and-after study [21] found that implementing a set of clinical practices which included standardized (but not video) instructions would reduce subsequent visits to PED. However, this study included more measures such as identification of risk factors, management plans, feedback systems, and planned visits to clinics.…”

Section: Discussionmentioning

confidence: 98%

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

et al. 2020

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The aim was to evaluate if the addition of video discharge instructions (VDIs) to usual verbal information improved the comprehension of information provided to caregivers of patients who consult for acute gastroenteritis (AGE). We conducted an open-label, parallel, randomized trial, enrolling patients who consulted for AGE at a tertiary hospital. First, caregivers answered a written test concerning AGE characteristics and management. They were randomly allocated to a control group, which received the usual verbal instructions, or to an intervention group, which additionally received VDI. After discharge, caregivers were contacted by telephone and answered the same test, satisfaction questions, and follow-up information. From September 2019 to March 2020, 139 patients were randomized, 118 completed follow-up. The mean score was 3.13 (SD 1.07) over 5 points in the initial test and 3.96 (SD 0.96) in the follow-up test. Patients in the intervention group had a greater improvement (1.17 points, SD 1.11) than those in the control group (0.47 points, SD 0.94, p < 0.001). In the follow-up test, 49.1% in the intervention group and 18.6% in the control group answered all questions correctly (p < 0.001). There were no significant differences in return visits. Caregivers gave high satisfaction scores regardless of the allocation group. Conclusion: Video instructions improve caregivers' understanding of discharge information. Trial registration: [NCT04463355, retrospectively registered July 9, 2020]. What is Known: • Poor comprehension of discharge instructions leads to incorrect treatment after discharge, increased readmissions and a reduction of caregivers' satisfaction. • Video discharge instructions are useful providing concise information independently of the patients' health literacy level or communication skills of the health care provider What is New: • The addition of video discharge instructions to verbal instructions improves caregivers' knowledge about AGE improved with respect to those who only receive verbal instructions • Video instructions do not add extra time to the emergency department visits

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Section: Discussionmentioning

confidence: 98%

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

et al. 2020

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“…Measuring paediatric re‐attendances that do require admission may be a better measure. Improvement work has been described with respect to this measure, with caution raised regarding the use of physician review to identify improvement opportunities and reductions in re‐attendance achieved by patient flow improvements …”

Section: Effectiveness and Efficiencymentioning

confidence: 99%

Quality in paediatric emergency medicine: Measurement and reporting

Borland

Shepherd

2016

J Paediatrics Child Health

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There is a clear demand for quality in the delivery of health care around the world; paediatric emergency medicine is no exception to this movement. It has been identified that gaps exist in the quality of acute care provided to children. Regulatory bodies in Australia and New Zealand are moving to mandate the implementation of quality targets and measures. Within the paediatric emergency department (ED), there is a lack of research into paediatric specific indicators. The existing literature regarding paediatric acute care quality measures has been recently summarised, and expert consensus has now been reported. It is clear that there is much work to be performed to generalise this work to ED. We review suggestions from the current literature relating to feasible indicators within the paediatric acute care setting. We propose options to develop a quality 'scorecard' that could be used to assist Australian and New Zealand EDs with quality measurement and benchmarking for their paediatric patients.

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“…5,6 Discharge instruction complexity and inadequate comprehension is associated with medication errors, suboptimal postdischarge care, and unnecessary recidivism. [7][8][9][10] Medication errors can be reduced using standardized discharge instructions, and parents prefer these to verbal summaries. [11][12][13] Video discharge instructions have been shown to be preferred over paper instructions in many pediatric presentations; however, no study has explored the effectiveness of video instructions for AOM.…”

Section: Introductionmentioning

confidence: 99%

Hot Off the Press: Video for Acute Otitis Media Discharge Instructions

Bond

Morgenstern

Heitz

et al. 2020

Academic Emergency Medicine

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Implementation of clinical practices to reduce return visits within 72 h to a paediatric emergency department

Abstract: The development and implementation of clinical practices were effective in reducing return visits of paediatric patients to the ED.

Cited by 13 publications

References 17 publications

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

Quality in paediatric emergency medicine: Measurement and reporting

Hot Off the Press: Video for Acute Otitis Media Discharge Instructions

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