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Pediatric post-acute care hospital transitions: an evaluation of current practice
Jane E O'Brien1, Helene M Dumas2, Carol M Nash1
1Franciscan Hospital for Children, Boston, Massachusetts.
Insights
Pediatric post-acute care hospitals show variability in admission and discharge practices. This study details current transition care methods for children moving between acute care and post-acute settings.
Area of Science:
- Pediatric Healthcare
- Healthcare Transitions
- Quality Improvement
Background:
- Children often require post-acute care after acute hospitalization.
- Care transitions for these children occur during admission to and discharge from post-acute facilities.
- Standardized practices are crucial for effective care continuity.
Purpose of the Study:
- To report current admission and discharge practices in US pediatric post-acute care hospitals.
- To identify the frequency of use for specific transition care practices.
- To highlight variability in care transition protocols.
Main Methods:
- Survey administered to participants across 7 pediatric post-acute care hospitals.
- Practices categorized into assessment, communication, education, and logistics.
- Descriptive statistics used to analyze frequency of practice use.
Main Results:
- Few practices were consistently used ('always') by all hospitals (2/10 admission, 3/10 discharge).
- Assessment and communication practices were more frequent than education and logistics.
- Statistically significant differences (P=.03) were found in the frequency of discharge practices between hospitals.
Conclusions:
- Significant variability exists in pediatric post-acute care transition practices.
- This is the first report detailing admission and discharge practice frequency in US pediatric post-acute care.
- Further standardization may improve care continuity for pediatric patients.
Objectives:
After discharge from an acute care hospital, some children require ongoing care at a post-acute care hospital. Care transitions occur at both admission to the post-acute care hospital and again at discharge to the home/community. Our objective was to report the current practices used during the admission to and discharge from 7 pediatric post-acute care hospitals in the United States.
Methods:
Participants from 7 pediatric post-acute care hospitals completed a survey and rated the frequency of use of 20 practices to prepare and support children and their families during both admission to the hospital and at time of discharge to the home/community. For consistency with existing literature, practices were grouped into 4 previously reported categories: assessment, communication, education, and logistics. Descriptive statistics were used to report the frequency of use within practices and between hospitals.
Results:
Only 2 of 10 admission practices and 3 of 10 discharge practices were reportedly "always" used by all hospitals. Assessment and communication practices were reported to be more frequently used (57%-100% of the time) than education and logistic procedures. Between hospitals, only the reported frequency of use of the discharge practices was statistically significantly different (P = .03).
Conclusions:
Variability exists in transition practices among 7 post-acute care pediatric hospitals. This report is the first known to detail the frequency of use of admission and discharge practices for pediatric post-acute care hospitals in the United States.
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