A Quality Improvement Initiative to Optimize Pediatric Post-Discharge Outcomes

Abstract

Patients and caregivers commonly experience stress during the discharge process, and brief teaching encounters may not provide enough time to ensure understanding of home care instructions. Families often leave the hospital without scheduled follow-up appointments or access to their patient portal, creating gaps that can compromise care continuity and contribute to readmission's and emergency department revisits. Pediatric patients enrolled in a hospital-at-home program between March 2026 and May 2026, along with their primary caregivers, received additional educational support. The program's nurse navigators served as facilitators for this quality improvement project. Ninety-three patients and their caregivers received enhanced discharge education, which included guidance on using the patient portal and literature specific to their clinical diagnosis. Ninety-one patients activated their patient portal, and 78 received the educational materials. Of those patients, three had unplanned 30-day readmission's, resulting in a 3.2% any-condition readmission rate, outperforming the site's 6.3 %. For pediatric populations, improved caregiver readiness directly affects child safety and recovery, while reducing anxiety and strengthening trust between the family and the healthcare team. Ensuring that education is plain language, accessible, and family-centered leads to safer discharges.