Date of Graduation

Fall 12-15-2017

Document Access

Project/Capstone - Global access

Degree Name

Master of Public Health (MPH)

College/School

School of Nursing and Health Professions

Abstract

Centers for Medicare and Medicaid (CMS) have recognized readmission rates as a public health problem. CMS incentivizes hospitals to reduce readmission rates and reduce payments for hospitals with high readmission rates (Berry et al., 2013). Patient education and discharge planning are associated with decreased readmission rates. I gained fieldwork experience at Children’s Health System of Texas in Dallas. Children’s Health, a pediatric non-profit, is the 8th largest pediatric health care provider in the U.S. Prior to discharge patient education occurs on topics related to their diagnosis, plus patients are provided discharge instructions including their diagnosis, medications, and simple instructions for the patients to continue care at home. With current discharge practice, patients and their parents report feeling partially prepared for the transition from hospital to home. I created a supplemental discharge tool, also called a journey map, and piloted the discharge tool by meeting with patients and parents to help them understand the tool. The tool is provided with a survey to gather patient feedback. The survey questions measure qualitative and quantitative data to assess the tool’s efficacy. The feedback will influence tool revisions. The tool is used during an inpatient admission and is divided into seven topics: hospital, care, medicine, follow-up, home care needs, and home. Each topic provides question prompts to help patients and their parents understand if they are ready to take ownership for their care. The tool is distributed to patients on a general pediatrics floor with an average length of stay between one to two days. Future research implications include reviewing the readmission rates of patients who used the journey map. There is potential to create diagnosis specific discharge tools for specialties like Neurosurgery. Policy implications include exploring reimbursement rates determined by CMS and may impact National Patient Safety Goals by Joint Commission.

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