Project IMPACT Pilot Report: Feasibility of Implementing a Hospital-to-Home Transition Bundle

Mallory, Leah; Osorio, Snezana Nena; Prato, B. Stephen; DiPace, Jennifer; Schmutter, Lisa; Soung, Paula; Rogers, Amanda; Woodall, William J; Burley, Kayla; Gage, Sandra; Cooperberg, David

doi:10.1542/peds.2015-4626

Cited by 38 publications

(35 citation statements)

References 37 publications

(30 reference statements)

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“…** Both studies in which PCIs were evaluated (1 prepost study that was focused on children with multisystem complex illnesses and 1 prospective cohort study that was focused on the general population of children hospitalized) revealed an association with improved satisfaction. 43,86 CCIs were also associated with improved satisfaction across patient populations, including effective studies in children with chronic illnesses (n = 7), 43,44,48,49,52,53,64 patients in the NICU (n = 2), 78,80 and the general hospitalized population (n = 4). 86,87,89,94 CCIs that were associated with improved satisfaction included assistance with scheduling follow-up care, 43,53,89 in-home visits or follow-up telephone calls, 44,48,49,53,64,86,94 and intensive discharge planning.…”

Section: Results Of Individual Studies Regarding Patient And/or Caregmentioning

confidence: 99%

“…43,86 CCIs were also associated with improved satisfaction across patient populations, including effective studies in children with chronic illnesses (n = 7), 43,44,48,49,52,53,64 patients in the NICU (n = 2), 78,80 and the general hospitalized population (n = 4). 86,87,89,94 CCIs that were associated with improved satisfaction included assistance with scheduling follow-up care, 43,53,89 in-home visits or follow-up telephone calls, 44,48,49,53,64,86,94 and intensive discharge planning. 43,48,53,64,78,80,87,94 Similarly, FEIs were associated with improved satisfaction in children with chronic illnesses (n = 9), † † neonates (n = 3), 72,75,78 and general pediatric patients in the hospital (n = 4).…”

Section: Results Of Individual Studies Regarding Patient And/or Caregmentioning

confidence: 99%

“…The effect of PCIs on subsequent hospital use was evaluated in only 5 studies; in all of these studies, PCIs were pooled with other intervention types. 34,41,43,84,86 Only 2 of these studies revealed a significant effect on use. In their prospective cohort study, Cheney et al 34 found that combining a letter to the patient's primary care provider with CCIs and FEIs reduced readmissions (Table 2).…”

Section: Effects Of Provider Communication On Usementioning

confidence: 99%

“…The impact of PCIs was evaluated in only 5 studies. 34,41,43,84,86 Out of 59 studies in which CCIs were evaluated, postdischarge follow-up (via clinic, home visit, or telephone) was incorporated in 38, * and the impact of intensive discharge planning services was evaluated in 26. † Of 39 studies providing FEIs, ‡ inpatient parental education was incorporated in 29 studies (task-based or teachback learning was specifically noted in 2 of these studies), and 14 studies involved contingency planning in parental education.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Hospital-to-Home Interventions, Use, and Satisfaction: A Meta-analysis

Hamline

Speier

et al. 2018

Pediatrics

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Hospital-to-home transitions are critical opportunities to promote patient safety and high-quality care. However, such transitions are often fraught with difficulties associated with increased health care use and poor patient satisfaction. OBJECTIVE: In this review, we determine which pediatric hospital discharge interventions affect subsequent health care use or parental satisfaction compared with usual care. DATA SOURCES: We searched 7 bibliographic databases and 5 pediatric journals. STUDY SELECTION: Inclusion criteria were: (1) available in English, (2) focused on children <18 years of age, (3) pediatric data reported separately from adult data, (4) not focused on normal newborns or pregnancy, (5) discharge intervention implemented in the inpatient setting, and (6) outcomes of health care use or caregiver satisfaction. Reviews, case studies, and commentaries were excluded. DATA EXTRACTION: Two reviewers independently abstracted data using modified Cochrane data collection forms and assessed quality using modified Downs and Black checklists. RESULTS: Seventy one articles met inclusion criteria. Although most interventions improved satisfaction, interventions variably reduced use. Interventions focused on follow-up care, discharge planning, teach back-based parental education, and contingency planning were associated with reduced use across patient groups. Bundled care coordination and family engagement interventions were associated with lower use in patients with chronic illnesses and neonates. LIMITATIONS: Variability limited findings and reduced generalizability. CONCLUSIONS: In this review, we highlight the utility of a pediatric discharge bundle in reducing health care use. Coordinating follow-up, discharge planning, teach back-based parental education, and contingency planning are potential foci for future efforts to improve hospitalto-home transitions.

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Section: Results Of Individual Studies Regarding Patient And/or Caregmentioning

confidence: 99%

Section: Results Of Individual Studies Regarding Patient And/or Caregmentioning

confidence: 99%

Section: Effects Of Provider Communication On Usementioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Hospital-to-Home Interventions, Use, and Satisfaction: A Meta-analysis

Hamline

Speier

et al. 2018

Pediatrics

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“…These barriers may have been heightened by the competing priorities faced by hospitalists including clinical duties, supervisory responsibilities, and administrative/non-clinical tasks. Potential strategies for improving adoption include more frequent eligibility screening, in-person discussion of recruitment at daily discharge planning rounds, discharge bundles to improve prediction of discharge timing [15], or opt-out formats with standardized scheduling of discharge videoconferences for all CMC.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a multidisciplinary discharge videoconference for children with medical complexity: a pilot study

Ravid

Zamora

Rehm³

et al. 2020

Pilot Feasibility Stud

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Background: The hospital to home transition for children with medical complexity (CMC) poses many challenges, including suboptimal communication between the hospital and medical home. Our objective was to evaluate the implementation of a discharge videoconference incorporating the patient, caregiver, primary care provider (PCP), hospitalist physician, and case manager. Methods:We evaluated implementation of this pilot intervention at a freestanding tertiary care children's hospital using mixed methods. A discharge videoconference was conducted for hospitalized children (< 18 years old) meeting complex chronic disease (C-CD) criteria. We collected field notes and conducted surveys and semistructured interviews. Outcomes included adoption, cost, acceptability, feasibility, and appropriateness. Adoption, cost, and acceptability were analyzed using descriptive statistics. Acceptability, feasibility, and appropriateness were summarized using thematic content analysis.Results: Adoption: A total of 4 CMC (9% of the 44 eligible children) had discharge videoconferences conducted. Cost (in provider time): On average, videoconferences took 5 min to schedule and lasted 21.5 min. Acceptability: All hospitalists involved (n = 4) were very likely to participate again. Interviews with caregivers (n = 4) and PCPs (n = 5) demonstrated that for those participating, videoconferences were acceptable and appropriate due to benefits including development of a shared understanding, remote physical assessment by the PCP, transparency, and humanization of the care handoff, and increased PCP comfort with care of CMC. Feasibility: Barriers included internet connection quality and scheduling constraints. Conclusions: This novel, visual approach to discharge communication for CMC had low adoption, possibly related to recruitment strategy. The videoconference posed low time burdens, and participating physicians and caregivers found them acceptable due to a variety of benefits. We identified several feasibility barriers that could be targeted in future implementation efforts.

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Essential elements nurses have to address to promote a safe discharge in paediatrics: A systematic review and narrative synthesis

Rossi,

Hayter,

Zuco

et al. 2023

Nursing Open

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AimThe aim of the study was to synthesize the evidence on the essential elements, nurses must address when they perform therapeutic education to patients and their caregivers to promote a safe paediatric hospital‐to‐home discharge.DesignA systematic review and narrative synthesis.MethodsThe search strategy identifies studies published between 2016 and 2023. The quality of the included studies was assessed using the Critical Appraisal Skills Programme checklists. The protocol of this review was not registered. A search of three electronic databases (PubMed, CINAHL and Web of Science) and a search in the reference lists of the included studies was conducted in February 2021 and June 2023.ResultsFifteen studies met the inclusion criteria. The essential elements identified are grouped into the following topics: emergency management, physiological needs, medical device and medications management, long‐term management and short‐term management. Nurses have a critical role in ensuring patient safety and quality of care, and the nurses' competence makes the difference in the discharge's related outcomes. Our results can help the nursing profession implement comprehensive discharge projects. Our results support the improvement of nurse‐led paediatric discharge programmes. Nurse managers can identify the grey areas of therapeutic education provided in their units and work for their improvement. Following the implementation of therapeutic education on these topics, measuring the discharge's related outcomes could be interesting. This study addresses the problem of managing a safe and efficient nurse‐led discharge in a paediatric setting. It presents evidence on the essential elements to promote a safe paediatric discharge at home. These could impact nursing practice by using them to implement project and discharge pathways. We have adhered to relevant EQUATOR guidelines—PRISMA guidelines for reporting systematic review. No patients, service users, caregivers or public members were involved in this study due to its nature (systematic review).

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Project IMPACT Pilot Report: Feasibility of Implementing a Hospital-to-Home Transition Bundle

Cited by 38 publications

References 37 publications

Hospital-to-Home Interventions, Use, and Satisfaction: A Meta-analysis

Hospital-to-Home Interventions, Use, and Satisfaction: A Meta-analysis

Implementation of a multidisciplinary discharge videoconference for children with medical complexity: a pilot study

Essential elements nurses have to address to promote a safe discharge in paediatrics: A systematic review and narrative synthesis

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