Does family-centred neonatal discharge planning reduce healthcare usage? A before and after study in South West England

Ingram, Jenny C; Powell, Jane E.; Blair, Peter S; Pontin, David; Redshaw, Maggie; Manns, Sarah; Beasant, Lucy; Burden, Heather; Johnson, Debbie; Rose, Claire; Fleming, Peter J

Abstract

Objective: To implement parent-oriented discharge planning (Train-to-Home) for preterm infants in neonatal care. Design: Before and after study, investigating the effects of the intervention during two 11-month periods before and after implementation. Setting: Four local neonatal units (LNUs) in South West England. Participants: Infants without major anomalies born at 27 33 weeks gestation admitted to participating units, and their parents. Train-to-Home intervention: A family-centred discharge package to increase parents involvement and understanding of their baby s needs, comprising a train graphic and supporting care pathways to facilitate parents understanding of their baby s progress and physiological maturation, combined with improved estimation of the likely discharge date. Main outcome measures: Perceived Maternal Parenting Self-Efficacy (PMP S-E) scores, infant length of stay (LOS) and healthcare utilisation for 8 weeks following discharge. Results: Parents reported that the Train-to-Home improved understanding of their baby s progress and their preparedness for discharge. Despite a lack of change in PMP S-E scores with the intervention, the number of post-discharge visits to emergency departments (EDs) fell from 31 to 20 ( p

• Journal Article Type: Article
• Acceptance Date: Jan 18, 2016
• Online Publication Date: Mar 10, 2016
• Publication Date: Mar 10, 2016
• Deposit Date: Mar 11, 2016
• Publicly Available Date: Mar 14, 2016
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 3
• Article Number: e010752
• DOI: https://doi.org/10.1136/bmjopen-2015-010752
• Keywords: train-to-home, parents, pre-term babies, reduced healthcare costs
• Public URL: https://uwe-repository.worktribe.com/output/920053
• Publisher URL: http://dx.doi.org/10.1136/bmjopen-2015-010752
• Contract Date: Mar 11, 2016