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Pediatricians' Perspectives on Routine Hospital Discharge Follow-Ups: A Qualitative Study
Quynh Pham1, Natalie Weston2, Farya Phillips3
1Division of Pediatric Hospital Medicine, Dell Children's Medical Center, Austin, Texas.
Background:
There is considerable practice variation among pediatric hospitalists in how they recommend hospital discharge follow-up visits for pediatric patients hospitalized with common, self-limiting, acute illnesses. Literature lacks evaluation of the preferences of primary care pediatricians (PCP) for HDFV.
Objective:
We aimed to explore PCP perspectives on hospital discharge follow-up visits for pediatric patients hospitalized with common, self-limiting, acute illnesses.
Methods:
We conducted a qualitative study using a semistructured interview guide to interview PCP working within a 30-mile radius of an academic, urban children's hospital, selected through purposive and maximum variation sampling. The analytic approach was informed by a constructivist-interpretivist worldview, and inductive thematic analysis was used to identify themes.
Results:
Thematic saturation was reached at 12 interviews. Four major themes emerged relating to PCP perspectives on the necessity, benefits, and drawbacks of hospital discharge follow-up visits. Themes include the following: (1) need for follow-up and optimizing follow-up timing, (2) communication and information-sharing gaps during care transitions, (3) patient centered guidance tailored to psychosocial needs and social drivers of health, and (4) unintended consequences and operational challenges of routine follow-up visits.
Conclusion:
In healthy children hospitalized for common, self-limiting, acute illnesses, PCP characterize the necessity of routine hospital discharge follow-up visits to be tailored to individual family circumstances and scheduled for optimization according to the expected illness course. PCP perspectives were significantly shaped by health care system factors and information access. These findings offer insights for pediatric hospitalists to optimize anticipatory guidance and follow-up planning at hospital discharge.
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