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Implementation of a Standardized Approach to Improve the Pediatric Discharge Medication Process.

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Title: Implementation of a Standardized Approach to Improve the Pediatric Discharge Medication Process.
Authors: Philips, Kaitlyn, Zhou, Roy, Lee, Diana S., Marrese, Christine, Nazif, Joanne, Browne, Constance, Sinnett, Mark, Tuckman, Steven, Modi, Anjali, Rinke, Michael L.
Source: Pediatrics. Feb2021, Vol. 147 Issue 2, p1-11. 11p.
Subjects: Caregivers, Chi-squared test, Children's hospitals, Counseling, Documentation, Interprofessional relations, Medical protocols, Medical records, Medication errors, Medical prescriptions, Pediatrics, Pharmaceutical arithmetic, Quality assurance, Therapeutics, Urban hospitals, Discharge planning, Human services programs, Medication therapy management, Descriptive statistics, Acquisition of data methodology, Tertiary care
Abstract: BACKGROUND AND OBJECTIVES: 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. METHODS: 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 χ² test and process control. RESULTS: 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%; P < .001) and more patients with simplified dosing (75.2% vs 95.6%; P < .001) in the intervention period. Special cause variation also occurred for these measures. CONCLUSIONS: 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. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Implementation of a Standardized Approach to Improve the Pediatric Discharge Medication Process.
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  Data: BACKGROUND AND OBJECTIVES: 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. METHODS: An interprofessional team at an urban, tertiary care children&#39;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&#178; test and process control. RESULTS: 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%; P &lt; .001) and more patients with simplified dosing (75.2% vs 95.6%; P &lt; .001) in the intervention period. Special cause variation also occurred for these measures. CONCLUSIONS: 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. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=148484986
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1542/peds.2019-2711
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      – Code: eng
        Text: English
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      – SubjectFull: Caregivers
        Type: general
      – SubjectFull: Chi-squared test
        Type: general
      – SubjectFull: Children's hospitals
        Type: general
      – SubjectFull: Counseling
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      – SubjectFull: Documentation
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      – SubjectFull: Interprofessional relations
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      – SubjectFull: Medical protocols
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      – SubjectFull: Medical records
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      – SubjectFull: Medication errors
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      – SubjectFull: Medical prescriptions
        Type: general
      – SubjectFull: Pediatrics
        Type: general
      – SubjectFull: Pharmaceutical arithmetic
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      – SubjectFull: Quality assurance
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      – SubjectFull: Therapeutics
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      – SubjectFull: Urban hospitals
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      – SubjectFull: Tertiary care
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              Text: Feb2021
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