Retention of discharge instructions using an interdisciplinary model for at‐risk children with cancer: A quality improvement initiative

• Published in: Pediatric blood & cancer 2023-01, Vol.70 (1), p.e30045-n/a
• Main Authors: Offenbacher, Rachel, Briggs, Jessica, Ronca, Kristen, Uong, Audrey, Ogidan‐Odeseye, Olamide, Kim, Mimi, Weiser, Daniel
• Format: Article
• Language: English
• Subjects: Aftercare; Cancer; Caregivers; Child; Fever; Hematology; Humans; Neoplasms - therapy; new diagnosis; Oncology; Patient Discharge; Patients; pediatric cancer; Pediatrics; Quality control; Quality Improvement; Retention; Sepsis
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.30045

Purpose We sought to improve caregiver retention of critical initial hospital discharge instructions using a multidisciplinary, team‐based intervention for newly diagnosed pediatric cancer patients at high risk for unfavorable outcomes. Materials and methods A multidisciplinary team of pediatric residents, nurses, social workers, pharmacists and hematology/oncology faculty implemented practices to optimize teaching of key discharge material as part of four Plan‐Do‐Study‐Act intervention cycles. An 11‐question survey distributed at the first post‐discharge clinic visit assessed the efficacy of the intervention, as defined by caregiver retention of critical home instructions. Results Thirty‐nine caregivers of pediatric cancer patients in an urban academic tertiary‐care children's hospital took part in this project. Overall retention of key discharge information was greater in the post‐intervention cohort compared to the baseline cohort (median total scores: 89 and 63, respectively; p = .001). Improvements in the proportions of correct responses post‐intervention were also observed across all subject matters: from 0.57 to 0.88 for fever guidelines (p = .059), from 0.71 to 0.78 for signs of sepsis (p = .65), from 0.57 to 1.00 for accurate choice of on‐call number (p = .004), and from 0.71 to 0.94 for antiemetic management (p = .14). Conclusion Initiation of our comprehensive cancer‐specific program to improve caregiver retention of discharge instructions at the first post‐hospitalization clinic visit has been successful and sustainable. This project demonstrated that a multi‐disciplinary collaborative team effort increases caregiver retention of critical health information, and this has potential to lead to improved outcomes for patients.