Improving Discharge Safety in a Pediatric Emergency Department.

Area of Science:

• Pediatric Emergency Medicine
• Patient Safety
• Healthcare Quality Improvement

Background:

• Emergency department (ED) discharges are complex, with preventable serious safety events (SSEs) indicating vulnerabilities.
• A tertiary children's hospital identified a need to improve ED discharge procedures to enhance patient safety.

Purpose of the Study:

• To implement a standardized discharge process in the ED.
• To improve multidisciplinary communication and family engagement during discharge.
• To reduce preventable, discharge-related SSEs.

Main Methods:

• A model for improvement framework was used to revise discharge care.
• Interventions included a discharge checklist, provider huddles, and scripted patient instruction reviews.
• Statistical process control evaluated performance, with primary outcomes being SSEs and patient satisfaction surveys.

Main Results:

• No preventable SSEs occurred during the study period.
• Checklist adoption reached 94%, and vital sign acquisition improved from 67% to 83%.
• Patient satisfaction scores for discharge information remained unchanged; length of stay and return rates were unaffected.

Conclusions:

• A standardized ED discharge process effectively eliminated safety events.
• The implemented changes improved patient safety without adverse effects on hospital metrics.
• Multidisciplinary communication and family engagement are key to safe ED discharge.