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American Academy of Pediatrics
Research Articles

A Discharge Planning Template for the Electronic Medical Record Improves Scheduling of Neurology Follow-up for Comanaged Seizure Patients

Mark Brittan, Amy Tyler, Sara Martin, Jennifer Konieczny, Michelle Torok, Marcus Wheeler and Ann Boyer
Hospital Pediatrics November 2014, 4 (6) 366-371; DOI: https://doi.org/10.1542/hpeds.2013-0112
Mark Brittan
1Section of Hospital Medicine
2Department of Pediatrics, and
3Children’s Outcomes Research Program, University of Colorado School of Medicine, Aurora, Colorado; and
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Amy Tyler
1Section of Hospital Medicine
2Department of Pediatrics, and
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Sara Martin
4Quality and Patient Safety Department, and
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Jennifer Konieczny
5The Neuroscience Institute, Children’s Hospital Colorado, Aurora, Colorado
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Michelle Torok
1Section of Hospital Medicine
3Children’s Outcomes Research Program, University of Colorado School of Medicine, Aurora, Colorado; and
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Marcus Wheeler
6Department of Neurology, Neuroscience and Spine Institute, Kalispell, Montana
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Ann Boyer
1Section of Hospital Medicine
2Department of Pediatrics, and
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Abstract

objective: We examined whether the addition of a standardized discharge planning template (DPT) for the electronic medical record facilitated scheduling of outpatient neurology follow-up appointments in children hospitalized with seizures.

Methods: We reviewed medical records of patients discharged from a children’s hospital with a diagnosis of seizures between January 2012 and June 2013. The study cohort included children who were admitted to the hospitalist service with neurology service comanagement. To facilitate interdisciplinary communication around discharge planning, a DPT was added to the neurology consult note in July 2012. Multivariate regression was used to determine whether the postimplementation time period was associated with the primary outcome (scheduling of outpatient neurology follow-up before discharge).

Results: The final cohort included 300 patients, of whom 101 (34%) were discharged before implementation of the DPT, and 199 (66%) were discharged postimplementation of the DPT. The odds of having a neurology follow-up appointment scheduled before discharge was significantly higher after implementation of the DPT (adjusted odds ratio 2.8, 95% confidence interval 1.7–4.8) and for weekday as compared with weekend discharges (adjusted odds ratio 2.2, 95% confidence interval 1.2–3.9).

Conclusions: A discharge planning template for the electronic medical record can standardize the flow of discharge-related information between disciplines and may help expedite transitional care planning for hospitalized children, especially those with multiple consultants involved in their care. Given the inherent barriers to arranging outpatient services over the weekend, additional strategies may be necessary to enhance transitional care planning for patients going home over the weekend.

  • quality improvement
  • electronic health records
  • patient discharge
  • hospital medicine
  • pediatrics
  • seizures
  • Abbreviations:
    DPT
    discharge planning template
    EMR
    electronic medical record
    LOS
    length of stay
    QI
    quality improvement
    SAP
    seizure action plan
    • Copyright © 2014 by the American Academy of Pediatrics
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    Hospital Pediatrics: 4 (6)
    Hospital Pediatrics
    Vol. 4, Issue 6
    1 Nov 2014
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    A Discharge Planning Template for the Electronic Medical Record Improves Scheduling of Neurology Follow-up for Comanaged Seizure Patients
    Mark Brittan, Amy Tyler, Sara Martin, Jennifer Konieczny, Michelle Torok, Marcus Wheeler, Ann Boyer
    Hospital Pediatrics Nov 2014, 4 (6) 366-371; DOI: 10.1542/hpeds.2013-0112

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    A Discharge Planning Template for the Electronic Medical Record Improves Scheduling of Neurology Follow-up for Comanaged Seizure Patients
    Mark Brittan, Amy Tyler, Sara Martin, Jennifer Konieczny, Michelle Torok, Marcus Wheeler, Ann Boyer
    Hospital Pediatrics Nov 2014, 4 (6) 366-371; DOI: 10.1542/hpeds.2013-0112
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    Subjects

    • Health Information Technology
      • Health Information Technology
      • Electronic Health Records
    • Hospital Medicine
      • Hospital Medicine
      • Continuity of Care Transition & Discharge Planning

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