Date of Award

12-7-2017

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Amy Manderscheid

Second Advisor

Judith Westers

Third Advisor

Jean Barry

Abstract

Medically complex and/or fragile pediatric patients are high utilizers of health care dollars. This population represents less than one percent of the general pediatric population, yet they account for more than 30% of pediatric healthcare costs. These patients tend to have longer lengths of stay in the hospital, high readmission rates, and lower healthcare satisfaction scores. They also have multiple transitions between inpatient and outpatient care which increases the opportunity for medical errors. Research has shown that care conferences attended by key stakeholders tend to reduce readmissions and healthcare utilization while improving satisfaction rates and patient outcomes. Research also shows that efficient transitions of care processes improve patient outcomes through reduced errors while also improving satisfaction rates of patients, families, and providers. This project focused on both the evaluation of a process to streamline care coordination conferences as well as transitions of care for medically complex patients between inpatient and outpatient care. In order to streamline care conferences, standard work was written to standardize processes with the goal of increasing their perceived value and improving attendance. Results of a pre-implementation survey showed primary care providers desired more involvement throughout the course of hospitalization for their medically complex pediatric patients. A new process was begun where resident physicians notified primary care providers when these patients were admitted. A post-implementation survey showed improved satisfaction with communication.

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