ArticlePediatrics2016
A Standardized Discharge Process Decreases Length of Stay for Ventilator-Dependent Children.
Article in Pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Care of Infants and Children with Tracheostomies: An Official American Thoracic Society Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2025Guideline
- Hospital-to-home transitions for children with medical complexity: part 1, a systematic review of reported outcomes.European journal of pediatrics · 2023Pooled it
- Pooled it
- Article
- Standard work tools for managing pediatric baclofen pump infections and withdrawal.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Chronic phase ventilation strategy in established severe bronchopulmonary dysplasia: A critical evaluation of the evidence.SAGE open medicine · 2026Review
- Discharge Practice Variability in Pediatric Chronic Home Invasive Ventilation.Pediatric pulmonology · 2025Article
- Hospital to home transition of children with medical complexities in the Netherlands: current practice.European journal of pediatrics · 2025Observational
- Exploration of the Evidence on Discharge From Hospital to Home for Children With Medical Complexity and Their Parents: A Review of the Literature.Child: care, health and development · 2025Review
- Correlation Between the Quality of Life of Stroke Caregivers and the Readiness of Patients and Caregivers for Hospital Discharge.Patient preference and adherence · 2025Article
- It's Time to Invest in Children Receiving Home Mechanical Ventilation.Annals of the American Thoracic Society · 2024Article
- Tracheostomy decision-making for children with medical complexity: What supports and resources do caregivers need?Palliative & supportive care · 2024Article
- Pediatric Tracheostomy Year in Review.Respiratory care · 2024Review
- Improved Patient Outcomes and Pediatric Resident Performance With a Parent and Faculty Communication Coaching Curriculum.Clinical pediatrics · 2024Article
- Parents' experiences of their children's medical journeys with tracheostomies: A Focus Group Study.Paediatrics & child health · 2024Article
- Nursing care protocol for critical users with tracheostomy under mechanical ventilation.Revista brasileira de enfermagem · 2024Article
- Impact of respiratory care training and family support using telemedicine on tracheostomized children admitted with respiratory infection after discharge.BMC pediatrics · 2023Article
- Using a Task Trainer for Caregiver Training: Can an Old Doll Teach New Tricks?Respiratory care · 2023Article
- Utilization of Training Dolls to Enhance Caregiver Education for Pediatric Tracheostomy Care.Respiratory care · 2023Article
- Risk of death at home or on hospital readmission after discharge with pediatric tracheostomy.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveChildren who require chronic mechanical ventilation via tracheostomy are medically complex and require prolonged hospitalization, placing a heavy burden on caregivers and hospital systems. We developed an interdisciplinary Ventilator Care Program to relieve this burden, through improved communication and standardized care. We hypothesized that a standardized team approach to the discharge of tracheostomy- and ventilator-dependent children would decrease length of stay (LOS), reduce patient costs, and improve safety.
methodsWe used process mapping to standardize the discharge process for children requiring chronic ventilation. Interventions included developing education materials, a Chronic Ventilation Road Map for caregivers, utilization of the electronic medical record to track discharge readiness, team-based care coordination, and timely case management to arrange home nursing. We aimed to decrease overall and pediatric respiratory care unit LOS as the primary outcomes. We also analyzed secondary outcomes (mortality, emergency department visits, unplanned readmissions), and per-patient hospital costs during 2-year "preintervention" and "postintervention" periods (n = 18 and 30, respectively).
resultsPatient demographics were not different between groups. As compared with the preintervention cohort, the overall LOS decreased 42% (P = .002). Pediatric respiratory care unit LOS decreased 56% (P = .001). As a result, unplanned readmissions, emergency department visits, and mortality were not increased. Direct costs per hospitalization were decreased by an average of 43% (P = .01).
conclusionsAlthough LOS remained high, a standardized discharge process for chronically ventilated children by an interdisciplinary Ventilator Care Program team resulted in decreased LOS and costs without a negative impact on patient safety.
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