Format

Send to

Choose Destination
Pediatrics. 2017 May;139(5). pii: e20164178. doi: 10.1542/peds.2016-4178. Epub 2017 Apr 14.

Validation of New Quality Measures for Transitions Between Sites of Care.

Author information

1
RAND Corporation, Santa Monica, California; parast@rand.org.
2
RAND Corporation, Santa Monica, California.
3
Seattle Children's Research Institute, Seattle, Washington.
4
Department of Pediatrics, University of Washington, Seattle, Washington.
5
Family Voices of Minnesota, Stillwater, Minnesota.
6
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
7
Tufts Medical Center, Boston, Massachusetts.
8
RAND Corporation, Boston, Massachusetts.
9
Boston Children's Hospital, Boston, Massachusetts.
10
Harvard Medical School, Boston, Massachusetts; and.
11
The Commonwealth Fund, New York, New York.

Abstract

BACKGROUND AND OBJECTIVE:

Assessing and improving the quality of transitions to home from the emergency department (ED) or hospital is critical for patient safety. Our objective was to validate 8 newly developed caregiver-reported measures of transition quality.

METHODS:

This prospective observational study included 1086 caregiver survey respondents whose children had an ED visit (n = 523) or hospitalization (n = 563) at Seattle Children's Hospital in 2014. Caregivers were contacted to complete 2 surveys. The first survey included the newly developed transition quality measures and multiple validation measures including modified versions of Child Hospital Consumer Assessments of Healthcare Providers and Systems (HCAHPS) composites, assessing communication and discharge planning. The second survey (administered 30 days later) included questions about follow-up appointments and ED return visits and readmissions. Using multivariate regression, we examined associations between the newly developed transition quality measures and each validation measure.

RESULTS:

All transition quality measures were significantly associated with ≥1 validation measures. The hospital-to-home transition measure assessing whether discharge instructions were easy to understand, were useful, and contained necessary follow-up information had the largest association with the Child HCAHPS nurse-parent and doctor-parent communication composites (β = 55.6; 95% confidence interval, 43 to 68.3; and β = 48.3; 95% confidence interval, 36.3 to 60.3, respectively, scaled to reflect change associated with a 0 to 100 change in the transition measure score).

CONCLUSIONS:

Newly developed quality measures for pediatric ED- and hospital-to-home transitions were significantly and positively associated with previously validated measures of caregiver experience. These new measures may be useful for assessing and improving on the quality of ED- and hospital-to-home transitions.

PMID:
28557755
DOI:
10.1542/peds.2016-4178
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center