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 Southwest 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 (PMPS-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 PMPS-E scores with the intervention, the number of post-discharge visits to Emergency Departments (ED) fell from 31 to 20 (p<0.05), with a significant reduction in associated healthcare costs (£3400 to £2200; p< 0.05) after discharge. In both study phases over 50% of infants went home more than 3 weeks before their EDD, though no reduction in LOS occurred.
Conclusions: Despite the lack of measurable effect on the parental self-efficacy scores, the reduction in ED attendances and associated costs supports the potential value of this approach.
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 Southwest 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 (PMPS-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 PMPS-E scores with the intervention, the number of post-discharge visits to Emergency Departments (ED) fell from 31 to 20 (p<0.05), with a significant reduction in associated healthcare costs (£3400 to £2200; p< 0.05) after discharge. In both study phases over 50% of infants went home more than 3 weeks before their EDD, though no reduction in LOS occurred.
Conclusions: Despite the lack of measurable effect on the parental self-efficacy scores, the reduction in ED attendances and associated costs supports the potential value of this approach.
| Original language | English |
|---|---|
| Article number | e010752 |
| Number of pages | 10 |
| Journal | BMJ Open |
| Volume | 6 |
| Issue number | 3 |
| Early online date | 11 Feb 2016 |
| DOIs | |
| Publication status | Published - Mar 2016 |
Fingerprint
Dive into the research topics of 'Does family-centred neonatal discharge planning reduce healthcare usage? A before and after study in South West England'. Together they form a unique fingerprint.Profiles
-
Professor Jenny Ingram
- Bristol Medical School (PHS) - Professor of Maternal and Infant Health
- Bristol Population Health Science Institute
Person: Academic , Member