Evidence map›Paper›PMID 37078242›Full record

ArticlePediatrics2023

Improving the Quality of Written Discharge Instructions: A Multisite Collaborative Project.

Arti D Desai, Anagha Tolpadi, Layla Parast, Megan Esporas, Maria T Britto, Courtney Gidengil, Karen Wilson, Naomi S Bardach, William T Basco, Mark S Brittan and 12 more

Abstract readMulticenter Study
In one paragraph

Article in Pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Arti D DesaiDepartment of Pediatrics, University of Washington School of Medicine, Seattle, Washington.
Anagha TolpadiRAND Corporation, Santa Monica, California.
Layla ParastRAND Corporation, Santa Monica, California.
Megan EsporasChildren's Hospital Association, Washington, District of Columbia.
Maria T BrittoDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Courtney GidengilRAND Corporation, Boston, Massachusetts.
Karen WilsonDepartment of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
Naomi S BardachDepartment of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California.
William T BascoDepartment of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
Mark S BrittanDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
David P JohnsonDepartment of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee.
Kelly E WoodDepartment of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
Steven YungDepartment of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
Erin DawleyDepartment of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
Darren FioreDepartment of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California.
LiseAnne GregoireDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
Laura N HodoDepartment of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
Brett LeggettDepartment of Pediatrics, University of Washington School of Medicine, Seattle, Washington.
Kirstin PiazzaDepartment of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
Laura F SartoriDepartment of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee.
Danielle E WeberDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Rita Mangione-SmithKaiser Permanente Washington Health Research Institute, Seattle, Washington.

Funding

Pediatric Hospital Care Improvement ProjectU18HS025291 · AHRQ · SEATTLE CHILDREN'S HOSPITAL · PI MANGIONE-SMITH, RITA · 2016 to 2019
$2.7M
AHRQ HHS U18 HS025291
6 · The paper itself

Abstract

BACKGROUND AND

objectivesWritten 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.

methodsWe 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.

resultsAmong 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).

conclusionsParticipation 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.

Indexed as

HospitalsPatient DischargeChildCooperative BehaviorHumansMedical RecordsQuality Improvement

Identifiers

PMID37078242
PMCPMC12166476

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.