| Title: |
Standardization Improves Discharge Care Coordination for Children with Nasogastric Tubes |
| Authors: |
Rickey, Lisa M.; Nagle, Katharine; Perkins, Julia; Kohler, Caroline; Ethier, Benjamin; Fontaine, Kristen; Matherson, Susan; Stack, Anne M.; McSweeney, Maireade E. |
| Source: |
Pediatric Quality & Safety ; volume 10, issue 4, page e823 ; ISSN 2472-0054 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2025 |
| Description: |
Introduction: Discharging patients with new nasogastric tubes (NGTs) for enteral nutrition at home is complex and requires intricate care coordination and education from a multidisciplinary team. We designed a quality improvement (QI) initiative to improve efficiency and decrease variation in care coordination for patients discharged with a new NGT. Our objective was to reduce mean modified hospital length of stay (mLOS) by 10% from baseline within 6 months and sustain improvement for 12 months. Methods: Applying the Model for Improvement, we used plan-do-study-act cycles to improve NGT discharge care coordination using a multidisciplinary team. Primary interventions rooted in Lean methodology included creating a standardized discharge algorithm, utilizing nurse practitioners as care coordination champions, routine consultation of an enteral tube service (ETS), and implementing a formula substitution guide. The primary outcome measure was mean mLOS. The process measure was the time from NGT placement to ETS consult. Balancing measures were ETS consult volume and 30-day healthcare reutilization. Statistical process control charts measured the impact of interventions. Results: Baseline mLOS decreased from 8.2 to 7.4 days with a sustained reduction in process variability over time. Time from NGT placement to ETS consult decreased from 4.1 to 3.0 days. There were no changes in 30-day healthcare reutilization or ETS consult volume over time. Conclusions: A multidisciplinary quality improvement initiative effectively improved complex NGT transitional care planning and was sustained over time. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1097/pq9.0000000000000823 |
| Availability: |
https://doi.org/10.1097/pq9.0000000000000823; https://journals.lww.com/10.1097/pq9.0000000000000823 |
| Rights: |
http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.C23E34D4 |
| Database: |
BASE |