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Observational Study
. 2025 Apr 19;15(4):e093693.
doi: 10.1136/bmjopen-2024-093693.

Bridging hospital to home for children with medical complexity and their families: an observational prospective cohort study protocol to assess the effectiveness of an innovative transitional care unit in the Netherlands (BRIDGE study)

Heleen N Haspels  1   2   3 , Misja C Mikkers  4 , Hennie Knoester  5 , Nicolaas J G Jansen  6 , Inge M L Ahout  7 , Jolanda M Maaskant  8 , Liz van de Riet  5 , Lotte Haverman  9 , Karolijn Dulfer  3 , Maartje Haasnoot  10 , Mattijs W Alsem  11 , Matthijs de Hoog  3 , Job B M van Woensel  5 , K F M Joosten  3 , Clara D van Karnebeek  12 ; Transitional Care Unit Consortium
Collaborators, Affiliations
Observational Study

Bridging hospital to home for children with medical complexity and their families: an observational prospective cohort study protocol to assess the effectiveness of an innovative transitional care unit in the Netherlands (BRIDGE study)

Heleen N Haspels et al. BMJ Open. .

Abstract

Introduction: Children with Medical Complexities (CMC) often require 24/7 expert care, which frequently necessitates prolonged (re)admissions to a university medical centre (UMC), thereby impeding discharge to home. The transition from hospital to home for CMC is a multifaceted process with numerous challenges and obstacles. This protocol describes the evaluation of an innovative transitional care unit (TCU), where families can stay together in a home-like environment between hospital and home. Under the supervision of healthcare professionals, parents are supported in preparing for a sustainable home situation. We hypothesise that an intermediate stay at the Jeroen Pit Huis (JPH) will have a favourable effect on healthcare consumption, patient, parent and family-relevant outcomes in comparison to discharge directly from a hospital ward to home. Therefore, the purpose of this study is to compare the transition via the TCU JPH versus transition from hospital ward to home as provided elsewhere for CMC patients in the Netherlands.

Methods and analysis: This observational prospective cohort study compares patients who transition directly from hospital to home with those who transition via the TCU. The control group comprises five UMCs in the Netherlands. Data will be collected by extracting information from electronic health records and through online questionnaires. Parents complete questionnaires at three time points: on discharge home, 3 months and 12 months postdischarge. Bayesian inverse probability weighting will be used to control for confounding effects and analyse the results.

Ethics and dissemination: Ethical approval was granted by the Amsterdam UMC Medical Ethics Committee (W20_220#20.007). The need for ethical approval was waived by all other participating UMCs. Results will be disseminated through peer-reviewed scientific journals and conference presentations. The insights gained from this study will contribute to the development of a national care pathway to enhance transitional care for CMC and their families in the future.

Trial registration number: NCT06599398 (ClinicalTrials.gov) - Bridging Hospital to Home for CMC and Their Families.

Keywords: Hospital to Home Transition; Hospitals; Organisation of health services.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Flow chart of the inclusion process.
Figure 2
Figure 2. Simplified generic directed acyclic graph for hospital length of stay and parental stress.
See this image and copyright information in PMC

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