We regularly receive manuscripts about transitions in care –whether it be from hospital to office or vice versa or from one primary care pediatrician to an adult provider as a teenager becomes a young adult. So how do we know that a transition goes well for a patient? Is there a way to measure the quality of that transition?
Leyenaar et al. (10.1542/peds.2016-0906) answer these questions in regard to the transitions between hospitals and other sites of care by developing a set of quality measures using a multi-stakeholder panel and a modified Delphi-method to achieve consensus on the measures. They then field-tested the measures at three children’s hospitals and two community hospitals to look at quality of hospital to home transition record content, timeliness of discharge communication between inpatient and outpatient clinicians, and the quality of ICU to floor transition notes.
The investigators then used the scores given for these measures relative to readmission and ED-return visit rates as well as readmission and length of stay in the hospital. Although the quality scores did not associate well with readmissions, ED-return visits, ICU readmissions or length of hospital stay, the authors have still been able to create quality metrics that we all might want to utilize in determining the overall quality of the transitions our patients experience as they move through the in-patient health care system.
We suspect that these quality metrics will be used more and more in future studies to determine how we can improve transition care—development of these metrics is a quality first step!