Hospital Discharge of Respiratory-Technology-Dependent Children: Role of a Dedicated Respiratory Care Discharge Coordinator

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Abstract:

BACKGROUND: Preparation of respiratory-technology-dependent children for hospital discharge presents many challenges. Adequate training and education of parental caregivers, discharge planning, and coordination with the durable-medical-equipment and home-nursing companies must be completed. A process using multiple respiratory therapists (RTs) to achieve this may not be efficient. METHODS: We evaluated our model, in which a dedicated RT discharge coordinator provides education and coordinates discharge planning of respiratory-technology-dependent pediatric patients. This system provides a single contact for caregivers and outside agencies, a single respiratory-care educator for the caregivers, and a clinical pathway that involves the entire multidisciplinary team. Patient length of stay and customer satisfaction were evaluated before and after implementation of the discharge-coordinator program. RESULTS: Our dedicated-RT-discharge-coordinator model was associated with rapid initiation of frequent family-training sessions. Durable-medical-equipment-company personnel reported that they had increased satisfaction with the quality of training of the family caregivers. The members of the hospital multidisciplinary team had increased satisfaction with the discharge process. Patient length of stay nonsignificantly decreased after the implementation of the discharge-coordinator program. CONCLUSIONS: There are several advantages to using a dedicated RT-discharge-coordinator system for home-discharge preparation of respiratory-technology-dependent children.

Keywords: CUSTOMER SATISFACTION; HOME MECHANICAL VENTILATION; HOSPITAL DISCHARGE; RESPIRATORY CARE; TECHNOLOGY-DEPENDENT CHILDREN

Document Type: Research Article

Affiliations: 1: Department of Respiratory Care Services, Alfred I DuPont Hospital for Children, 1600 Rockland Road, PO Box 269, Wilmington DE 19899, Email: dtearl@nemours.org 2: Department of Respiratory Care Services 3: Department of Anesthesiology and Critical Care Medicine, Nemours Children's Clinic-Wilmington, Alfred I duPont Hospital for Children, Wilmington, Delaware

Publication date: July 1, 2006

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