Key result
The SAFER Care framework for written and verbal discharge counseling increased the proportion of caregivers correctly responding to all discharge instruction questions from 37% to 62%.
Why the study?
One in five pediatric patients suffers from adverse events related to hospital discharge, but current literature lacks evidence on effective interventions to improve caregiver comprehension of discharge instructions.
Does the SAFER Care framework improve caregiver comprehension of discharge instructions in a general pediatric inpatient unit?
Does the SAFER Care framework improve caregiver comprehension of discharge instructions in a general pediatric inpatient unit?
Implementation of a standardized discharge counseling framework significantly improved caregiver comprehension of discharge instructions in a general pediatric inpatient unit.
May support standardized discharge counseling in pediatric units; leaves open confirmation via randomized trials on clinical outcomes.
BACKGROUND: One in five pediatric patients suffers from adverse events related to hospital discharge. Current literature lacks evidence on effective interventions to improve caregiver comprehension (CC) of discharge instructions. We examined if a standardized framework for written and verbal discharge counseling was associated with increased CC of key discharge instructions after discharge from a general pediatric inpatient unit. METHODS: An interprofessional team created the SAFER Care framework to encourage standard, comprehensive discharge counseling. Plan-do-study-act cycles included electronic health record smartphrases, educational initiatives, data feedback, visual aids, and family outreach. Caregivers were surveyed by phone within 4 days of discharge. Our primary outcome was the proportion of caregivers correctly responding to all questions related to discharge care, comparing pre- and postintervention periods. Data were plotted on a statistical process control chart to assess the effectiveness of interventions. RESULTS: A total of 171 surveys were analyzed in the preintervention period, and 262 surveys were analyzed in the postintervention period. A total of 37% of caregivers correctly responded to all questions in the preintervention period, compared with 62% of caregivers in the postintervention period, meeting rules for special cause variation. CONCLUSIONS: Development of the SAFER Care framework and its use in written and verbal discharge counseling was associated with significantly improved CC of discharge instructions in a general pediatric inpatient unit. Further studies should be focused on expanding this to other populations, particularly limited-English-proficiency families.
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Uong et al. (2021) studied Pediatric hospital discharge (n=433). SAFER Care framework vs. Usual care (preintervention period) was evaluated on Proportion of caregivers correctly responding to all questions related to discharge care (p=0.002). The SAFER Care framework for written and verbal discharge counseling increased the proportion of caregivers correctly responding to all discharge instruction questions from 37% to 62%.
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