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Discharge Handoff Communication and Pediatric Readmissions.
Ryan J Coller1, Thomas S Klitzner2, Adrianna A Saenz2
1Department of Pediatrics, University of Wisconsin, Madison School of Medicine and Public Health, Madison, WI, USA.
Journal of Hospital Medicine
|January 27, 2017
Summary
Hospital handoff practices for children did not reduce readmissions. Scheduled follow-up appointments were linked to increased readmissions, suggesting other factors influence post-discharge care.
Area of Science:
- Pediatric Healthcare
- Health Services Research
- Patient Outcomes
Background:
- Improving transitional care is a national priority.
- The impact of hospital care transitions on pediatric postdischarge outcomes remains unclear.
Purpose of the Study:
- To characterize common hospital to primary care provider (PCP) handoff practices.
- To assess the association between common handoff practices and unplanned pediatric readmissions.
Main Methods:
- Prospective cohort study of pediatric patients at a tertiary children's hospital.
- Data collected via administrative records, caregiver, and PCP questionnaires.
- Logistic regression analyzed 30-day unplanned readmissions against 11 handoff communication practices.
Main Results:
- 701 children enrolled; 685 identified PCPs.
- Verbal handoffs were rare (10.7%); PCP notification occurred in 50.8%.
- Most handoff practices were unrelated to readmissions; scheduled follow-up appointments increased readmissions (aOR=2.20).
Conclusions:
- Common hospital to PCP handoff practices may not reduce pediatric postdischarge utilization.
- Broader factors like caregiver self-efficacy and social determinants may be more critical.
- Further research is needed to improve transitional care for children.
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