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Multi-Stakeholder Informed Guidelines for Direct Admission of Children to Hospital
JoAnna K Leyenaar1, Megan Shevenell2, Paul A Rizzo3
1Department of Pediatrics , The Dartmouth Institute For Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH; Graduate Program in Clinical and Translational Science, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA.
The Journal of Pediatrics
|April 30, 2018
Summary
Pediatric direct admission guidelines were developed through stakeholder discussions and a Delphi approach, focusing on communication, resources, and family needs to improve hospital admission safety and effectiveness.
Area of Science:
- Pediatric healthcare
- Health services research
- Quality improvement
Background:
- Hospital admission processes for children require standardized guidelines.
- Evaluating the safety and effectiveness of pediatric admissions is crucial.
- Multistakeholder perspectives are vital for optimizing care transitions.
Purpose of the Study:
- To develop pediatric direct admission guidelines.
- To prioritize outcomes for evaluating hospital admission safety and effectiveness.
Main Methods:
- Deliberative discussions with parents, physicians, and nurses across three hospitals.
- Analysis of discussions using a general inductive approach.
- National panel prioritization of guideline components and outcomes via a RAND/UCLA Modified Delphi approach.
Main Results:
- Identified key themes: communication, resources, written guidelines, and family needs.
- Endorsed 71 guideline components and 13 outcomes for pediatric direct admissions.
- Guideline components include pre-admission communication, written criteria, hospital resources, pediatric-specific considerations, family communication, and quality reviews.
Conclusions:
- Developed adaptable direct admission guidelines for hospitals and health systems.
- Multistakeholder engagement can enhance hospital admission processes and care transitions.
- Guidelines aim to improve the safety, effectiveness, and integration of pediatric hospital admissions.
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