Andersons pediatric cardiology 1894
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FIG.72.4 Standardizedinterstagedischargechecklist.
■Assessmentofoutpatientpharmacycapabilityfor
compoundingpediatricmedications.
■Confirmationofhomemonitoringequipment
(infantscale,pulseoximeter)andhomenursing
servicesinplacepriortodischarge.
■Coordinationofapredischargeconferencecall
betweeninterstagecareteam,referringcardiologist,
primarycareprovider,andparents.
■Schedulingnecessaryoutpatientfollow-upvisits
priortodischarge(referringcardiologist,interstage
clinic,primarycare,andothersubspecialtiesas
needed).
■Identifyoutpatientemergencycentersandaction
plantocontactprimarycardiologyteamshouldneed
ariseforacuteevaluation.
AdditionalhelpfuldischargeactivitiesareincludedintheNPC-QICCare
TransitionBundle(Table72.1).44
Table72.1
NationalPediatricCardiologyQualityImprovementCollaborative
CareTransitionBundle(DischargePreparationActivities)
BundleElements
1.Assigndischargecoordinator
2.UsestandardizedchecklistformattoconfirmcompletionofCareTransitionBundle
Activities
3.Evaluatefamily'sabilitytoobtainmedicationsandreferforadditionalresourcesas
needed
4.Providewrittenmaterialsforpostdischargecarethatareculturallyandlanguage
appropriate
Suggested
Resources
Trainedand
dedicated
personnel
Dischargechecklist
journeyboard
Trainedand
dedicated
personnel
Medicationlist
Nutritionplan
Redflagactionplan
Homemonitoring
plan
5.OffertrainingininfantCPRandprovideahardcopyofCPRinstructions
6.Facilitatehomescalesandoxygensaturationmonitors;ensurecaregiveriscompetentin
use
7.Provideparentsandinfants“rooming-in”atleast24h(e.g.,simulatinghome
environment,withindependentfeedingandcareofinfant)
8.Use“teachback,”“demonstrateback,”orotherconfirmationmethodstoensurefamily
competencyofkeycareelements
9.Scheduleappointmentsconvenienttofamilywithprimarycarephysician,homehealth,
cardiologyclinic,etc.
10.Setatleastonefollow-upcontactorappointmentwithahealthcareproviderwithin72h
ofdischarge
11.Scheduleconferencecallwithallpostacutecaregivers(e.g.,parents,primarycare
physician,HH,cardiologist)tocommunicatepatientstatusandhomemonitoringplan
Prevention
plan/immunization
list
Interstage
EmergencyCard
CPRinstructions
Homemonitoring
plan
Use“teachback”
methodology
Rooming-inkey
driverdiagram
Rooming-in
checklist
Use“teachback”
methodology
Use“teachback”
methodology
Trainedand
dedicated
personnel
Trainedand
dedicated
personnel
Conferencecall
agendaandscript
Thistransitionalbundlepreparestheproviderteamandparentsforinterstagedischargeduring
therecoveryphaseafterstageIpalliation.Severaloftheelementscanbeaddressedpriortothe
patientbeingmedicallyreadyfordischarge.
FromNationalPediatricCardiologyQualityImprovementCollaborative.
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Centraltothedischargeprocessisasharedunderstandingofthepatient's
inherentinterstageriskandclearprocessesforescalationofcarefortheparents,
outpatientproviders,localemergencyrooms,andinpatientprovidersshould
clinicalstatuswarrantaction.Necessarycommunicationpriortodischarge
include:
■24-7access(phoneorpager)fortheparentsand
outpatientproviderstotheinterstagecareteamfor
breachofhomemonitoringcriteria,changeinclinical
status,questions,orreassurance.
■Verbalcommunicationbetweendischarging
inpatientteamandreferringcardiologistandprimary
