Improving the Process for Late Preterm Infant Discharge Follow-Up After Birth: Executive Summary

Abstract

Objective: To increase the number of initial follow-up appointments scheduled and documented in the electronic health record (EHR) before discharge for late preterm infants (LPIs) by developing a workflow standardization process for healthcare providers. Design: Quality improvement project using pre-/post-intervention design Setting/Local Problem: Southeastern United States regional medical center Patients: All LPIs born between 34 0/7-36 6/7 weeks gestation and discharged from the mother/baby and neonatal intensive care units; pre-intervention period, n = 111, and post-intervention period, n = 154 Intervention/Measurements: Healthcare providers working in the designated units received education on best practices for LPI discharge using the situation, background, assessment, and recommendation format. A specific timeframe for recommended follow-up (within 24-48 hours of discharge) was included, along with instructions to document it in a central location in the EHR (discharge tab). An EHR documentation template and visual cues in provider workspaces reinforced the initial education. Pre-intervention data were collected retrospectively, and post-intervention data were collected monthly, with changes made as needed using the Plan-Do-Study-Act model. Results: The number of appointments scheduled in the post-intervention period increased by 40.2% (p = .0035). The number of appointments documented in the EHR within the discharge summary in the post-intervention period increased by 53.4% (p < .001), and within the discharge tab by 116.3% (p < .001). Conclusion: This project’s implementation increased the rate of initial follow-up appointments scheduled and documented in the EHR before discharge. These outcomes align with expert recommendations, current standards of care, and high-quality discharge practices for late preterm infants.