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Seize the day: A quality improvement approach to support transition of care and decrease 30-day readmissions for
Jenna Lang1, Danielle Altares Sarik1, Ivette Nieves Roldan1
1Nicklaus Children's Hospital, 3100 SW 62(nd) Ave, Miami, FL 33155, USA.
Insights
A new epilepsy discharge pathway significantly reduced 30-day hospital readmissions in children by 27.6%. This standardized education improves patient preparation and home management, saving nearly $1 million.
Area of Science:
- Pediatric Neurology
- Quality Improvement Science
- Healthcare Management
Background:
- Elevated 30-day readmission rates for pediatric epilepsy patients were identified.
- A need for improved discharge preparation and home transition support was recognized.
Purpose of the Study:
- To implement a standardized education pathway for pediatric epilepsy patients.
- To decrease unplanned 30-day readmissions through enhanced discharge preparedness.
Main Methods:
- A quality improvement (QI) approach was used to develop and implement a standardized education pathway.
- An interprofessional team received training on the pathway's communication and components.
- Patients and families received education, simulation, and teach-back exercises.
Main Results:
- A 27.6% decrease in unplanned 30-day readmissions was observed over six years.
- Estimated cost savings of $950,000 were achieved due to the program's implementation.
Conclusions:
- The standardized pathway effectively educates on epilepsy management and reduces pediatric readmissions.
- Standardized educational plans are crucial for effective discharge teaching and home epilepsy care.
- Continuous education refreshers, new nurse onboarding, and multilingual translations are vital for sustainability and health equity.
Purpose:
Elevated rates of 30-day readmission for children with epilepsy were noted at a stand-alone pediatric acute care facility. To address this issue, a standardized pathway was created and implemented in 2017. The main objective was to ensure that patients with epilepsy and their families were adequately prepared for discharge and the transition to home.
Design And Methods:
Using a quality improvement (QI) approach, a standardized education pathway was developed and implemented to decrease unplanned 30-day readmissions of patients with a diagnosis of epilepsy from a specialized neurology unit. An interprofessional care team received training to ensure standardized communication around the pathway approach and components. All patients with a diagnosis of epilepsy and their families were educated using the pathway and guided through additional simulation and teach-back exercises.
Results:
Analysis demonstrated a 27.6 % decrease in unplanned 30-day readmissions in the 6 years following implementation. An estimated $950,000 in cost savings was achieved secondary to program implementation.
Conclusions:
Utilizing the pathway standardizes epilepsy management education and decreases unplanned 30-day readmissions for pediatric patients diagnosed with epilepsy. A standardized educational plan is an essential component of patient discharge teaching and proper home management of epilepsy.
Practice Implications:
For sustainability, education needs to be continuously refreshed and included in onboarding new nurses. To ensure health equity, translation of the pathway into multiple languages is needed.
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