Effect of Facilitated Discharge in Pediatric Orthopedic Patients at an Academic Medical Facility

Abstract

Introduction: Because health care reimbursement is being linked to discharge quality and patient satisfaction, this quality improvement initiative reviewed the outcomes of embedding a pediatric nurse practitioner within the resident team at an academic medical facility.

Methods: The project was completed at a pediatric orthopedic unit at a large Southeastern U.S. academic medical facility. During the intervention, the pediatric nurse practitioner student completed daily rounds, communicated with the resident team, assessed readiness for discharge, provided patient education, and ensured that comprehensive discharge materials were completed.

Results: Analyses were completed for 219 patients (pre-intervention, n = 116; post-intervention, n = 103). Patient satisfaction was measured for provider communication and discharge. All areas experienced improvement, with provider communication benchmarks obtained. Ambulatory call volume decreased from 97 to 45 calls/100 patients.

Discussion: This study shows that embedding a pediatric nurse practitioner into the resident team helped improve patient satisfaction and reduce ambulatory workload by decreasing call volume.

Keywords: academic medical facility; discharge; nurse practitioner; orthopedic surgery; pediatric.