Journal article
Improving the Quality of Written Discharge Instructions: A Multisite Collaborative Project
Pediatrics (Evanston), Vol.151(5), e2022059452
05/2023
DOI: 10.1542/peds.2022-059452
PMCID: PMC12166476
PMID: 37078242
Abstract
Written discharge instructions help to bridge hospital-to-home transitions for patients and families, though substantial variation in discharge instruction quality exists. We aimed to assess the association between participation in an Institute for Healthcare Improvement Virtual Breakthrough Series collaborative and the quality of pediatric written discharge instructions across 8 US hospitals.
We conducted a multicenter, interrupted time-series analysis of a medical records-based quality measure focused on written discharge instruction content (0-100 scale, higher scores reflect better quality). Data were from random samples of pediatric patients (N = 5739) discharged from participating hospitals between September 2015 and August 2016, and between December 2017 and January 2020. These periods consisted of 3 phases: 1. a 14-month precollaborative phase; 2. a 12-month quality improvement collaborative phase when hospitals implemented multiple rapid cycle tests of change and shared improvement strategies; and 3. a 12-month postcollaborative phase. Interrupted time-series models assessed the association between study phase and measure performance over time, stratified by baseline hospital performance, adjusting for seasonality and hospital fixed effects.
Among hospitals with high baseline performance, measure scores increased during the quality improvement collaborative phase beyond the expected precollaborative trend (+0.7 points/month; 95% confidence interval, 0.4-1.0; P < .001). Among hospitals with low baseline performance, measure scores increased but at a lower rate than the expected precollaborative trend (-0.5 points/month; 95% confidence interval, -0.8 to -0.2; P < .01).
Participation in this 8-hospital Institute for Healthcare Improvement Virtual Breakthrough Series collaborative was associated with improvement in the quality of written discharge instructions beyond precollaborative trends only for hospitals with high baseline performance.
Details
- Title: Subtitle
- Improving the Quality of Written Discharge Instructions: A Multisite Collaborative Project
- Creators
- Arti D Desai - University of Washington School of MedicineAnagha Tolpadi - RAND CorporationLayla Parast - RAND CorporationMegan Esporas - Children's Hospital Association, Washington, District of ColumbiaMaria T Britto - University of CincinnatiCourtney Gidengil - RAND Corporation, Boston, MassachusettsKaren Wilson - Icahn School of Medicine at Mount SinaiNaomi S Bardach - University of California - San Francisco School of MedicineWilliam T Basco - Medical University of South CarolinaMark S Brittan - Department of Pediatrics, University of Colorado, Aurora, ColoradoDavid P Johnson - Vanderbilt University School of MedicineKelly E Wood - University of IowaSteven Yung - Icahn School of Medicine at Mount SinaiErin Dawley - Medical University of South CarolinaDarren Fiore - University of California - San Francisco School of MedicineLiseAnne Gregoire - Department of Pediatrics, University of Colorado, Aurora, ColoradoLaura N Hodo - Icahn School of Medicine at Mount SinaiBrett Leggett - University of Washington School of MedicineKirstin Piazza - Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IowaLaura F Sartori - Vanderbilt University School of MedicineDanielle E WeberRita Mangione-Smith - Kaiser Permanente Washington Health Research Institute
- Resource Type
- Journal article
- Publication Details
- Pediatrics (Evanston), Vol.151(5), e2022059452
- DOI
- 10.1542/peds.2022-059452
- PMID
- 37078242
- PMCID
- PMC12166476
- NLM abbreviation
- Pediatrics
- ISSN
- 0031-4005
- eISSN
- 1098-4275
- Language
- English
- Electronic publication date
- 04/20/2023
- Date published
- 05/2023
- Academic Unit
- Stead Family Department of Pediatrics; Hospital Medicine
- Record Identifier
- 9984398209402771
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