A framework of pediatric hospital discharge care informed by legislation, research, and practice.

TitleA framework of pediatric hospital discharge care informed by legislation, research, and practice.
Publication TypeJournal Article
Year of Publication2014
AuthorsBerry JG, Blaine K, Rogers J, McBride S, Schor E, Birmingham J, Schuster MA, Feudtner C
JournalJAMA Pediatr
Volume168
Issue10
Pagination955-62; quiz 965-6
Date Published2014 Oct
ISSN2168-6211
KeywordsAftercare, Child, Child Care, Delivery of Health Care, Goals, Health Education, Hospitals, Pediatric, Humans, Medical Records, Needs Assessment, Patient Care Planning, Patient Care Team, Patient Discharge
Abstract

To our knowledge, no widely used pediatric standards for hospital discharge care exist, despite nearly 10‚ÄČ000 pediatric discharges per day in the United States. This lack of standards undermines the quality of pediatric hospital discharge, hinders quality-improvement efforts, and adversely affects the health and well-being of children and their families after they leave the hospital. In this article, we first review guidance regarding the discharge process for adult patients, including federal law within the Social Security Act that outlines standards for hospital discharge; a variety of toolkits that aim to improve discharge care; and the research evidence that supports the discharge process. We then outline a framework within which to organize the diverse activities that constitute discharge care to be executed throughout the hospitalization of a child from admission to the actual discharge. In the framework, we describe processes to (1) initiate pediatric discharge care, (2) develop discharge care plans, (3) monitor discharge progress, and (4) finalize discharge. We contextualize these processes with a clinical case of a child undergoing hospital discharge. Use of this narrative review will help pediatric health care professionals (eg, nurses, social workers, and physicians) move forward to better understand what works and what does not during hospital discharge for children, while steadily improving their quality of care and health outcomes.

DOI10.1001/jamapediatrics.2014.891
Alternate JournalJAMA Pediatr
PubMed ID25155156
Grant ListK23 HD058092 / HD / NICHD NIH HHS / United States