Standardizing Discharge Practices for Pediatric Urology Outpatient Procedures: A Quality Improvement Project

Background: Standard discharge instructions of verbal and written methods are only understood by about 45-50% of caregivers. Video discharge instructions (VDIs) in addition to standard methods of verbal and written instructions can be very effective for caregiver comprehension (CC), retaining discharge education information and improving patient outcomes. Problem: In an outpatient surgery department in a Midwestern Children’s hospital, 100% of the discharge instructions for pediatric urology outpatient procedures are different than the instructions given to caregivers by the surgeon. Methods: The study utilizes a descriptive evaluation of change in how discharge instructions were written and provided. Interventions: Updated discharge handouts and corresponding VDIs were created and replaced outdated, standard methods (verbal and written) of discharge teaching for pediatric urology outpatient surgeries. Data was collected via two surveys, one completed prior to discharge on the day of the procedure and the second completed by a phone call two weeks after the procedure. Results: All videos were highly effective in providing consistent instructions among providers, high levels of CC, and low levels of adverse events after discharge. There were no statistically significant differences between the four videos when comparing consistency of discharge information among providers, CC, and adverse events after discharge. Conclusions: In pediatric patients having urological outpatient procedures, standardized discharge instructions with educational videos are highly effective in providing consistent discharge information, high levels of CC, and preventing adverse events during a two-week period after hospital discharge