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Pediatric discharge planning: complications, efficiency, and adequacy
E K Proctor1, N Morrow-Howell, A Kitchen
1George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130, USA.
Insights
Pediatric hospital discharge planning faces challenges including financial issues, family cooperation, and medical complexities. Addressing these factors is crucial for timely and effective patient releases.
Area of Science:
- Pediatric Healthcare
- Hospital Administration
- Patient Discharge
Background:
- Discharge planning in pediatric acute care is complex.
- Effective planning ensures continuity of care and resource optimization.
- Identifying common barriers is essential for improving processes.
Purpose of the Study:
- To document complications in pediatric hospital discharge planning.
- To identify factors associated with discharge delays and plan adequacy.
- To understand the impact of family, resource, and team dynamics.
Main Methods:
- Retrospective case review of 105 children.
- Data collected from selected units in a Midwest pediatric hospital.
- Analysis of complications, delays, and plan adequacy.
Main Results:
- Frequent complications included financial issues, family unavailability/cooperation, patient care learning barriers, custody issues, medical developments, and transportation.
- Team differences in psychosocial understanding and custody disputes correlated with discharge delays.
- Private insurance, late referral, and family availability impacted discharge plan adequacy.
Conclusions:
- Pediatric discharge planning is a multifaceted process.
- Family, resource, and inter-team collaboration issues significantly affect outcomes.
- Targeted interventions are needed to mitigate identified discharge barriers.
Abstract:
The complications encountered in discharge planning in an acute care pediatric hospital were documented. The cases of 105 children hospitalized on selected units of an acute care, regional, pediatric hospital in the Midwest were studied. The most frequently encountered complications were financial, family unavailability and lack of cooperation, family inability/unwillingness to learn patient care, custody issues, unexpected medical developments, and transportation problems. Team differences in understanding the child's psychosocial situation and custody disputes were associated with delays in discharge. Private insurance, late referral, and lack of family availability were associated with the adequacy of the discharge plan, as rated by the discharge planner at discharge. Results show discharge planning to be a complex process, affected by family, resource, and team work issues.