Priority Pediatric Transitions: In 2016-17, over 2.4 million children and youth under the age of 19 visited an emergency department (ED) for care in Canada with the majority (87%) being discharged to their home residence. Ideally, parents or caregivers should transition from the ED with the necessary knowledge and skills to effectively manage their child’s care at home. Poor quality ED discharge communication impacts health outcomes, parent satisfaction with care and health care utilization (e.g., unnecessary return visits to the ED). Advanced information communication technologies [ICT] (computer kiosks, mobile apps, interactive whiteboards) used to support discharge communication have shown promising preliminary results. Many health-focused organizations in Canada (e.g., Pathways to Health Equity for Aboriginal Peoples) have expressed interest in advancing eHealth in their communities but knowledge about best practices for ICT in pediatric discharge communication are not widely known. Our interdisciplinary team views these barriers as a priority knowledge-to-action opportunity that clearly aligns with the TiC Focus Areas #2 Changing Health Status or Care (changes in care setting> hospital to home) and #3 Key Populations to Optimize Transition Outcomes (vulnerable populations and rural/remote communities).
Aim: To advance collaboration through exchange of knowledge about (1) the design of ED discharge planning technologies; (2) research evidence related to technological solutions that may/may not have a limited chance of achieving large-scale, sustained adoption; (3) policy and research implications for implementation, scale-up, or rollout of ICT discharge planning technologies; and, (4) emerging questions and methods for future patient-oriented
research in this area.
Proposed Activities: Grant funds would be used for four complementary activities that will inform practice and drive new research initiatives. Activity 1: with support from the Maritime SPOR Support Unit we will lead and publish the first environmental scan of established or emerging pediatric discharge planning technologies in EDs. A research brief, webinar and peer-reviewed manuscript will be key deliverables. Activity 2: We will complete secondary analysis of existing discharge communication observational video data (107 patient/provider interactions collected in two Canadian pediatric EDs). This will allow us to estimate the current penetration of ICT (verbal/non-verbal events) in pediatric discharge communication. Activity 3: We will recruit management, health information technology, and emergency clinicians from 5 PERC (urban) and 5 TREKK (rural) ED sites representing 5 different provinces for an ICT discharge planning readiness survey. Summary reports and peer-reviewed publication will be co-developed. Activity 4: Our team will host an in-person, strategic 2-day knowledge exchange meeting in Halifax that will facilitate linking regional stakeholders with key international and national knowledge user groups. A consensus brief will be co-authored and published by attendees as a tangible collaboration for emerging scholars in this area.
Team: Co-leads will be an early career investigator, Dr. Lori Wozney (e-Health implementation), and a mid-career investigator, Dr. Janet Curran (barriers and facilitators to practice and policy change in pediatric and emergency practice settings), who have worked together on a number of grant funded research initiatives. While sub-sets of this application team have partnered on high-quality research in the past, this collaboration represents a new inter-professional and cross-disciplinary partnership. We have longstanding stakeholder relationships (PERC, TREKK, MSSU) and have inaugurated conversations with international partners where widespread interest in developing a formal collaboration was confirmed. The Centre for Research in Family Health (Dr. Wozney) and the Strengthening Transition in Pediatric Care Lab (Dr. Curran), both at the IWK Health Centre, will act as the project hub with administrative staff, equipment and space available in both labs to support all activities in accordance with the terms and of the grant.