Journal article
Implementation of a Standardized Approach to Improve the Pediatric Discharge Medication Process
Pediatrics (Evanston), Vol.147(2), p.1
02/2021
DOI: 10.1542/peds.2019-2711
PMCID: PMC7849199
PMID: 33408070
Abstract
The pediatric inpatient discharge medication process is complicated, and caregivers have difficulty managing instructions. Authors of few studies evaluate systematic processes for ensuring quality in these care transitions. We aimed to improve caregiver medication management and understanding of discharge medications by standardizing the discharge medication process.
An interprofessional team at an urban, tertiary care children's hospital trialed interventions to improve caregiver medication management and understanding. These included mnemonics to aid in complete medication counseling, electronic medical record enhancements to standardize medication documentation and simplify dose rounding, and housestaff education. The primary outcome measure was the proportion of discharge medication-related failures in each 4-week period. Failure was defined as an incorrect response on ≥1 survey questions. Statistical process control was used to analyze improvement over time. Process measures related to medication documentation and dose rounding were compared by using the χ
test and process control.
Special cause variation occurred in the mean discharge medication-related failure rate, which decreased from 70.1% to 36.1% and was sustained. There were significantly more complete after-visit summaries (21.0% vs 85.1%;
< .001) and more patients with simplified dosing (75.2% vs 95.6%;
< .001) in the intervention period. Special cause variation also occurred for these measures.
A systematic approach to standardizing the discharge medication process led to improved caregiver medication management and understanding after pediatric inpatient discharge. These changes could be adapted by other hospitals to enhance the quality of this care transition.
Details
- Title: Subtitle
- Implementation of a Standardized Approach to Improve the Pediatric Discharge Medication Process
- Creators
- Kaitlyn Philips - Children's Hospital at MontefioreRoy Zhou - New York Hospital QueensDiana S Lee - Mount Sinai Kravis Children's Hospital, New York, New York; and.Christine Marrese - Baystate Medical CenterJoanne Nazif - Children's Hospital at MontefioreConstance Browne - Children's Hospital at MontefioreMark Sinnett - Children's Hospital at MontefioreSteven Tuckman - Children's Hospital at MontefioreAnjali Modi - Children's Hospital at MontefioreMichael L Rinke - Children's Hospital at Montefiore
- Resource Type
- Journal article
- Publication Details
- Pediatrics (Evanston), Vol.147(2), p.1
- DOI
- 10.1542/peds.2019-2711
- PMID
- 33408070
- PMCID
- PMC7849199
- ISSN
- 0031-4005
- eISSN
- 1098-4275
- Grant note
- TL1 TR001072 / NCATS NIH HHS TL1 TR002557 / NCATS NIH HHS UL1 TR001073 / NCATS NIH HHS UL1 TR002556 / NCATS NIH HHS
- Language
- English
- Date published
- 02/2021
- Academic Unit
- Stead Family Department of Pediatrics; Hospital Medicine
- Record Identifier
- 9984353831902771
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