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Safely Discharging Children From the Hospital :

January 22, 2020

Assuring a safe discharge of a sick child from the hospital is a priority of pediatricians, parents, and health systems.

Assuring a safe discharge of a sick child from the hospital is a priority of pediatricians, parents, and health systems. While it might seem easy from the outside, many potential pitfalls exist – including medication errors, inadequate communication with primary care doctors, and parental mis-understanding of instructions. Each of these issues can lead to a “failure” or readmission. In many states, hospitals do not receive payments for patients who are re-admitted within 30 days of discharge, so there are high stakes incentives to get the process right. And while hospitalists across the country pride themselves on creating good systems and “doing the right thing,” we really don’t have many tools to tell us that we do.

Fortunately, Dr. Desai and colleagues from Seattle Children’s Hospital published their work, early released today, validating a simple measurement tool that measures the quality of hospital to home transition (10.1542/peds.2019-2150). The Pediatric Transition Experience Measure is a brief 8-item parent-reported outcome measure that demonstrated good validity when compared to more complex measures. As such, it has the potential to be used in a more wide-spread manner and help guide individual hospitals working on improving their transitions from hospital to home. Importantly, the validation included a diverse population of patients and includes important facets of the transition like discharge preparation, post-discharge support at home, and care coordination between the inpatient and outpatient settings. Unfortunately for now, the tool is only in English, so it cannot be generalized to non-English speaking populations. Nevertheless, pediatric hospitalists around the country should think about incorporating this simple tool into their discharge follow up process in order to assure they are actually doing what they hoped to do in transitioning a patient from hospital to home.

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