PMID- 27618589
OWN - NLM
STAT- MEDLINE
DCOM- 20170424
LR  - 20170424
IS  - 1535-1815 (Electronic)
IS  - 0749-5161 (Linking)
VI  - 33
IP  - 1
DP  - 2017 Jan
TI  - Improving Discharge Instructions in a Pediatric Emergency Department: Impact of a 
      Quality Initiative.
PG  - 10-13
LID - 10.1097/PEC.0000000000000816 [doi]
AB  - BACKGROUND: Effective communication between physician and patient is essential to 
      optimize care after discharge from the emergency department (ED). Written 
      discharge care instructions (DCI) complement verbal instructions and have been 
      shown to improve communication and patient management. In 2012, Centers for 
      Medicare and Medicaid Services proposed a quality measure (OP-19) that assesses 
      compliance with key elements considered essential for high-quality written DCI. 
      OBJECTIVE: To evaluate the impact of a QI intervention on improving quality of 
      written DCI in a pediatric emergency department (PED). METHODS: A QI initiative 
      was conducted at a tertiary PED with greater than 60,000 annual visits. Based on 
      Centers for Medicare and Medicaid Services OP-19 measure and group consensus, 8 
      elements were defined a priori as requisites for good quality DCI. These elements 
      are:Providers reviewed a random sample of DCI of patients. Proportion of DCI that 
      had each element documented was compared between preintervention phase (PRE) and 
      postintervention phase (POST). RESULTS: Three hundred twenty-nine DCI (PRE) and 
      1434 DCI (POST) were reviewed. The POST DCI showed statistically significant 
      improvement for each of the 8 elements. The bundle measure (proportion containing 
      all 8 elements) increased from 23% (PRE) to 79% (POST) (P < 0.001). CONCLUSIONS: 
      The ED DCI improved in all 8 elements after a QI intervention. A detailed DCI at 
      ED discharge enhances the patient's ability to comply with postdischarge 
      treatment plan. Further studies are needed to evaluate the impact of improving 
      DCI on ED return rates and other outcomes.
FAU - Akinsola, Bolanle
AU  - Akinsola B
AD  - From the *Emory University School of Medicine; daggerChildren's Healthcare of Atlanta, 
      Atlanta, GA.
FAU - Cheng, John
AU  - Cheng J
FAU - Zmitrovich, April
AU  - Zmitrovich A
FAU - Khan, Naghma
AU  - Khan N
FAU - Jain, Shabnam
AU  - Jain S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pediatr Emerg Care
JT  - Pediatric emergency care
JID - 8507560
SB  - IM
MH  - Child
MH  - Documentation/standards
MH  - Emergency Service, Hospital/*standards
MH  - Female
MH  - Health Services Research
MH  - Humans
MH  - Male
MH  - Patient Discharge/*standards
MH  - *Quality Improvement
MH  - United States
EDAT- 2016/09/13 06:00
MHDA- 2017/04/25 06:00
CRDT- 2016/09/13 06:00
PHST- 2016/09/13 06:00 [pubmed]
PHST- 2017/04/25 06:00 [medline]
PHST- 2016/09/13 06:00 [entrez]
AID - 10.1097/PEC.0000000000000816 [doi]
PST - ppublish
SO  - Pediatr Emerg Care. 2017 Jan;33(1):10-13. doi: 10.1097/PEC.0000000000000816.