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Bringing acutely ill children home from the hospital can overwhelm family caregivers and affect a child’s recovery and long-term health, according to a study published in Pediatrics.
Investigators interviewed family caregivers to determine how the hospital-to-home transition affects patients and their families.
The results provided investigators with “family-centered” input that has allowed them to design and test interventions for improving the transition.
The families suggested a need for in-home follow up visits, telephone calls from nurses, enhanced care plans, and other measures.
“Our study finds that transitions from hospital to home affect the lives of families in ways that may impact patient outcomes at discharge,” explained Andrew Beck, MD, of Cincinnati Children’s Hospital in Ohio.
“Many family caregivers expressed mental exhaustion, being in a fog, the emotional toll of having an ill child, and uncertainty on how to care for their child after hospitalization.”
To gain these insights, Dr Beck and his colleagues conducted focus groups and individual interviews with 61 family caregivers.
These individuals were caring for children who had been discharged from the hospital in the preceding 30 days. Eighty-seven percent of participants were female, 46% were nonwhite, 38% were the only adult in the household, and 56% resided in areas with high rates of poverty.
All of the children under care had been discharged from Cincinnati Children’s, a large urban medical center with a diverse patient population.
The investigators conducted a detailed analysis of transcripts from the focus groups and interviews, which revealed 12 different themes of caregiver concerns that fell into 4 overarching concepts:
- “In a fog”—barriers to processing and acting on information
a. mental exhaustion (this is too much)
b. handling uncertainty
c. information overload
d. usability of information
- “What I wish I had”
a. information desired
b. suggested improvements in the discharge process
- “Am I ready to go home?”
a. emotional discharge readiness
b. clinical discharge readiness
- “I’m home, now what?”—having confidence about post-discharge care
a. knowing who to call
b. bridging the gap (desiring a call or nurse home visit)
c. caring for a sick child
d. confidence in caring for a sick child.
“Participants in our study expressed a desire for specific details about worrisome clinical signs or symptoms,” said Lauren Solan, MD, a fellow at Cincinnati Children’s during the study and now a physician at the University of Rochester Medical Center in New York.
“Interventions designed to address informational needs and gaps identified by caregivers may improve feelings of readiness or preparation for transition to the home.”
The current study is part of a multi-stage research project led by Cincinnati Children’s called the Hospital-to-Home Outcomes (H2O) Study, which is focused on improving hospital-to-home transitions for children. This paper zeroed in on obtaining detailed qualitative input from caregivers that would help develop and refine “family-centered” solutions.
In a follow-up study already underway, investigators are testing the effectiveness of nurse follow-up visits in patient homes. The content and structure of these visits have been enhanced based on family input. The investigators are enrolling up to 1500 participants to measure the impact of these visits on hospital readmission rates and outcomes found to be meaningful to families. 
Photo by Logan Tuttle
Bringing acutely ill children home from the hospital can overwhelm family caregivers and affect a child’s recovery and long-term health, according to a study published in Pediatrics.
Investigators interviewed family caregivers to determine how the hospital-to-home transition affects patients and their families.
The results provided investigators with “family-centered” input that has allowed them to design and test interventions for improving the transition.
The families suggested a need for in-home follow up visits, telephone calls from nurses, enhanced care plans, and other measures.
“Our study finds that transitions from hospital to home affect the lives of families in ways that may impact patient outcomes at discharge,” explained Andrew Beck, MD, of Cincinnati Children’s Hospital in Ohio.
“Many family caregivers expressed mental exhaustion, being in a fog, the emotional toll of having an ill child, and uncertainty on how to care for their child after hospitalization.”
To gain these insights, Dr Beck and his colleagues conducted focus groups and individual interviews with 61 family caregivers.
These individuals were caring for children who had been discharged from the hospital in the preceding 30 days. Eighty-seven percent of participants were female, 46% were nonwhite, 38% were the only adult in the household, and 56% resided in areas with high rates of poverty.
All of the children under care had been discharged from Cincinnati Children’s, a large urban medical center with a diverse patient population.
The investigators conducted a detailed analysis of transcripts from the focus groups and interviews, which revealed 12 different themes of caregiver concerns that fell into 4 overarching concepts:
- “In a fog”—barriers to processing and acting on information
a. mental exhaustion (this is too much)
b. handling uncertainty
c. information overload
d. usability of information
- “What I wish I had”
a. information desired
b. suggested improvements in the discharge process
- “Am I ready to go home?”
a. emotional discharge readiness
b. clinical discharge readiness
- “I’m home, now what?”—having confidence about post-discharge care
a. knowing who to call
b. bridging the gap (desiring a call or nurse home visit)
c. caring for a sick child
d. confidence in caring for a sick child.
“Participants in our study expressed a desire for specific details about worrisome clinical signs or symptoms,” said Lauren Solan, MD, a fellow at Cincinnati Children’s during the study and now a physician at the University of Rochester Medical Center in New York.
“Interventions designed to address informational needs and gaps identified by caregivers may improve feelings of readiness or preparation for transition to the home.”
The current study is part of a multi-stage research project led by Cincinnati Children’s called the Hospital-to-Home Outcomes (H2O) Study, which is focused on improving hospital-to-home transitions for children. This paper zeroed in on obtaining detailed qualitative input from caregivers that would help develop and refine “family-centered” solutions.
In a follow-up study already underway, investigators are testing the effectiveness of nurse follow-up visits in patient homes. The content and structure of these visits have been enhanced based on family input. The investigators are enrolling up to 1500 participants to measure the impact of these visits on hospital readmission rates and outcomes found to be meaningful to families.
Photo by Logan Tuttle
Bringing acutely ill children home from the hospital can overwhelm family caregivers and affect a child’s recovery and long-term health, according to a study published in Pediatrics.
Investigators interviewed family caregivers to determine how the hospital-to-home transition affects patients and their families.
The results provided investigators with “family-centered” input that has allowed them to design and test interventions for improving the transition.
The families suggested a need for in-home follow up visits, telephone calls from nurses, enhanced care plans, and other measures.
“Our study finds that transitions from hospital to home affect the lives of families in ways that may impact patient outcomes at discharge,” explained Andrew Beck, MD, of Cincinnati Children’s Hospital in Ohio.
“Many family caregivers expressed mental exhaustion, being in a fog, the emotional toll of having an ill child, and uncertainty on how to care for their child after hospitalization.”
To gain these insights, Dr Beck and his colleagues conducted focus groups and individual interviews with 61 family caregivers.
These individuals were caring for children who had been discharged from the hospital in the preceding 30 days. Eighty-seven percent of participants were female, 46% were nonwhite, 38% were the only adult in the household, and 56% resided in areas with high rates of poverty.
All of the children under care had been discharged from Cincinnati Children’s, a large urban medical center with a diverse patient population.
The investigators conducted a detailed analysis of transcripts from the focus groups and interviews, which revealed 12 different themes of caregiver concerns that fell into 4 overarching concepts:
- “In a fog”—barriers to processing and acting on information
a. mental exhaustion (this is too much)
b. handling uncertainty
c. information overload
d. usability of information
- “What I wish I had”
a. information desired
b. suggested improvements in the discharge process
- “Am I ready to go home?”
a. emotional discharge readiness
b. clinical discharge readiness
- “I’m home, now what?”—having confidence about post-discharge care
a. knowing who to call
b. bridging the gap (desiring a call or nurse home visit)
c. caring for a sick child
d. confidence in caring for a sick child.
“Participants in our study expressed a desire for specific details about worrisome clinical signs or symptoms,” said Lauren Solan, MD, a fellow at Cincinnati Children’s during the study and now a physician at the University of Rochester Medical Center in New York.
“Interventions designed to address informational needs and gaps identified by caregivers may improve feelings of readiness or preparation for transition to the home.”
The current study is part of a multi-stage research project led by Cincinnati Children’s called the Hospital-to-Home Outcomes (H2O) Study, which is focused on improving hospital-to-home transitions for children. This paper zeroed in on obtaining detailed qualitative input from caregivers that would help develop and refine “family-centered” solutions.
In a follow-up study already underway, investigators are testing the effectiveness of nurse follow-up visits in patient homes. The content and structure of these visits have been enhanced based on family input. The investigators are enrolling up to 1500 participants to measure the impact of these visits on hospital readmission rates and outcomes found to be meaningful to families.