Issues Identified by Postdischarge Contact after Pediatric Hospitalization: A Multisite Study

Rehm, Kris P.; Brittan, Mark; Stephens, John; Mummidi, Pradeep; Steiner, Michael; Ayubi, Soleh Al; Gujral, Nitin; Mittal, Vandana; Dunn, Kelly; Chiang, Vincent W.; Hall, Matt; Blaine, Kevin P.; O’Neill, Margaret; McBride, Sarah; Rogers, Jayne; Berry, Jay G.

doi:10.12788/jhm.2934

Cited by 19 publications

(25 citation statements)

References 24 publications

(53 reference statements)

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“…Although numerous studies document the nature and frequency of negative transition outcomes, we identified only two that elaborate on the specific difficulties children and families encounter in the first several days at home. Rehm et al (2018) conducted a secondary analysis of telephone calls placed by various hospital staff to 12,986 children discharged from four U.S. children's hospitals. The authors identified postdischarge issues in 25% of respondents including difficulties obtaining a follow‐up appointment and medication concerns.…”

Section: Introductionmentioning

confidence: 99%

Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period

Tubbs‐Cooley

Riddle

Gold³

et al. 2020

Journal of Advanced Nursing

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Aim:To describe paediatric postdischarge concerns manifesting in the first 96 hr after hospital discharge.Design: Analysis of nursing documentation generated as part of a randomized controlled trial evaluating the effect of a nurse home visit on healthcare re-use. Methods:We analysed home visit records of 651 children (age <18) hospitalized at a large Midwestern children's hospital in 2015 and 2016 who were enrolled in the trial.Registered nurses documented concerns in structured fields and free-text notes in visit records. Descriptive statistics were used to summarize visit documentation. Free-text visit notes were reviewed and exemplars illustrative of quantitative findings were selected. Results:Overall, nurses documented at least one concern in 56% (N = 367) of visits. Most commonly, they documented concerns about medication safety (15% or 91 visits). Specifically, in 11% (N = 58) of visits nurses were concerned that caregivers lacked a full understanding of medications and in 8% (N = 49) of visits families did not have prescribed discharge medications. Pain was documented as present in 9% of all visits (N = 56). Nurses completed referrals to other providers/services in 12% of visits (N = 78), most frequently to primary care providers. In 13% of visits (N = 85) nurses documented concerns considered beyond the immediate scope of the visit related to social needs such as housing and transportation. Conclusion: Inpatient and community nurses and physicians should be prepared toreconcile and manage discharge medications, assess families' medication administration practices and anticipate social needs after paediatric discharge. Impact: Little empirical data are available describing concerns manifesting immediately after paediatric hospital discharge.Concerns about medication safety were most frequent followed by concerns related to housing and general safety. | 1395TUBBS-COOLEY ET aL. S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section.

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Section: Introductionmentioning

confidence: 99%

Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period

Tubbs‐Cooley

Riddle

Gold³

et al. 2020

Journal of Advanced Nursing

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“…Previous work has revealed that postdischarge phone calls can be beneficial in reinforcing both the discharge plan and use of home medications in pediatric patients. 35,36 The fact that most caregivers thought a postdischarge phone call would be helpful reinforces the importance of these calls as a component of complete hospital-to-home care. However, routine practice of placing postdischarge phone calls is labor intensive, representing significant organizational commitment and cost.…”

Section: Discussionmentioning

confidence: 98%

Parents Support Teach-back, Demonstration, and a Postdischarge Phone Call to Augment Discharge Education

Vepraskas

O'Day

Zhang

et al. 2018

Hospital Pediatrics

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To identify caregiver preferences for discharge education components, content, and techniques. METHODS: Before discharge education, a 9-question structured interview was performed with caregivers of children from 2 populations admitted to the hospital medicine service: patients with asthma (age 2-17 years) or children who were not dependent on technology (age ,2 years). McNemar's tests were used to evaluate for significant differences between response options. Open coding was used for theme development to interpret qualitative responses about information caregivers wished to receive before leaving the hospital. RESULTS: The interview was administered to 100 caregivers. More than 90% of caregivers believed that instruction regarding follow-up appointments, medications, and reasons to call the pediatrician or return to the emergency department were important aspects of discharge education. Caregivers also identified a desire for education on their child's condition, care at home, and illness prevention. Most caregivers reported that teach-back, early discharge education, and a postdischarge phone call would be beneficial. Caregivers varied in their preferences for written, verbal, and video instruction, whereas live demonstration was rated almost universally as an effective method by 97% of caregivers (P , .0001). CONCLUSIONS: In our study, we provide insight into caregivers' perspectives on the content, timing, and style of education needed to promote a safe transition of care from the hospital to the home. These findings add caregiver support to the expert consensus in Project Improving Pediatric Patient-Centered Care Transitions and elucidate additional themes to aid in further study and optimization of discharge education.

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“…These include poor preparation for home care management, conflicting expectations regarding the recovery process, lack of support after discharge, and discontinuity of care. 1 Approximately 1 of 4 pediatric patients experience a postdischarge problem, 2 with one third of these requiring significant action from a health care provider. 3 Thus, efforts to standardize pediatric hospitalization discharge processes and measure improvement in outcomes remains a clinical, research, and policy priority.…”

Section: Families Of Pediatric Patients Face Numerousmentioning

confidence: 99%

Utilizing Family-Centered Process and Outcome Measures to Assess Hospital-to-Home Transition Quality

Desai

Simon²,

Leyenaar

et al. 2018

Academic Pediatrics

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Issues Identified by Postdischarge Contact after Pediatric Hospitalization: A Multisite Study

Abstract: PDIs were identified often through hospital-initiated follow-up contact. Most PDIs were related to appointments. Hospitals caring for children may find this information useful as they strive to optimize their processes for follow-up contact after discharge.

Cited by 19 publications

References 24 publications

Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period

Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period

Parents Support Teach-back, Demonstration, and a Postdischarge Phone Call to Augment Discharge Education

Utilizing Family-Centered Process and Outcome Measures to Assess Hospital-to-Home Transition Quality

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