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

Area of Science:

• Health Services Research
• Pediatric Healthcare Delivery
• Telemedicine Implementation

Background:

• The transition from hospital to home for children with medical complexity (CMC) is challenging, often due to poor communication between hospitals and primary care providers (PCPs).
• Suboptimal communication can lead to fragmented care and adverse outcomes for CMC during this critical period.

Purpose of the Study:

• To evaluate the implementation of a novel discharge videoconference intervention.
• To assess the adoption, cost, acceptability, feasibility, and appropriateness of this intervention for CMC.

Main Methods:

• A pilot study employed mixed methods at a tertiary children's hospital.
• Discharge videoconferences were conducted for hospitalized children (<18 years) with complex chronic diseases (C-CD).
• Data collection included field notes, surveys, and interviews; analysis used descriptive statistics and thematic content analysis.

Main Results:

• Low adoption rate: 4 CMC (9%) participated in the videoconferences.
• Low time burden: Videoconferences averaged 5 minutes to schedule and 21.5 minutes in duration.
• High acceptability: Participants (hospitalists, caregivers, PCPs) found the videoconferences acceptable and appropriate, citing improved shared understanding, remote assessment, transparency, and increased PCP confidence.

Conclusions:

• The videoconference intervention shows promise for improving discharge communication for CMC.
• Low adoption suggests recruitment strategies and addressing feasibility barriers (internet quality, scheduling) are crucial for future implementation.
• This visual approach offers benefits but requires optimization for wider use in pediatric care transitions.