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Factorial Analysis Quantifies the Effects of Pediatric Discharge Bundle on Hospital Readmission
Journal article

Factorial Analysis Quantifies the Effects of Pediatric Discharge Bundle on Hospital Readmission

Snezana Nena Osorio, Sandra Gage, Leah Mallory, Paula Soung, Alexandra Satty, Erika L Abramson, Lloyd Provost, David Cooperberg and IMPACT STUDY GROUP
Pediatrics (Evanston), v 148(4), p1
Oct 2021
DOI: https://doi.org/10.1542/peds.2021-049926
PMID: 34593650
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Aftercare Ambulatory Care Checklist Child Child, Hospitalized Child, Preschool Factor Analysis, Statistical Female Humans Male Patient Care Bundles - methods Patient Discharge - statistics & numerical data Patient Education as Topic Patient Readmission - statistics & numerical data Retrospective Studies Teach-Back Communication
Factorial design of a natural experiment was used to quantify the benefit of individual and combined bundle elements from a 4-element discharge transition bundle (checklist, teach-back, handoff to outpatient providers, and postdischarge phone call) on 30-day readmission rates (RRs). A 2 factorial design matrix of 4 bundle element combinations was developed by using patient data ( = 7725) collected from January 2014 to December 2017 from 4 hospitals. Patients were classified into 3 clinical risk groups (CRGs): no chronic disease (CRG1), single chronic condition (CRG2), and complex chronic condition (CRG3). Estimated main effects of each bundle element and their interactions were evaluated by using Study-It software. Because of variation in subgroup size, important effects from the factorial analysis were determined by using weighted effect estimates. RR in CRG1 was 3.5% ( = 4003), 4.1% in CRG2 ( = 1936), and 17.6% in CRG3 ( = 1786). Across the 3 CRGs, the number of subjects in the factorial groupings ranged from 16 to 674. The single most effective element in reducing RR was the checklist in CRG1 and CRG2 (reducing RR by 1.3% and 3.0%) and teach-back in CRG3 (by 4.7%) The combination of teach-back plus a checklist had the greatest effect on reducing RR in CRG3 by 5.3%. The effect of bundle elements varied across risk groups, indicating that transition needs may vary on the basis of population. The combined use of teach-back plus a checklist had the greatest impact on reducing RR for medically complex patients.

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2 citations in Web of Science
2 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Pediatrics
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