Background: The Improving Pediatric Patient-Centered Care Transitions (IMPACT) Multi-site Quality Improvement Collaborative aims to improve discharge transitions by testing a patient-centered transition bundle. Teach-back is a core component. This is a well-established method of confirming understanding. However, limited evidence exists about the effect of using teach-back for pediatric discharge education on parental knowledge/understanding of essential home management skills or on hospital readmission.
Methods: Project IMPACT’s four pilot sites reviewed charts to determine if teach-back was used to confirm understanding on medications, follow-up appointments, contingency plan, and home equipment. 30 day readmission rates were noted. After discharge, parents were contacted by phone to assess their knowledge of these four elements. Misunderstandings and parental comfort with discharge were noted. General effect and effect by research category (technology supported vs. non-technology supported) was analyzed using Chi-square and Fisher’s exact tests.
Results: 2,485 charts were reviewed. 1338 received post-discharge phone calls. Of those, 711 had teach-back completed on the four elements of discharge education and 627 did not. During the post-discharge call, parents who had received teach-back on all four elements were more likely to report knowledge of essential home management skills (p<0.001), less likely to report misunderstandings (p<0.001), and more comfortable with discharge (p=0.003). They were also less likely to be readmitted within 30 days (p=0.004). Subgroup analysis showed no difference in improvement in knowledge between the technology supported and non-supported groups.
Conclusions: Using teach-back during pediatric patient discharge education positively impacts parental knowledge of essential home management skills regardless of the need for technology support. Teach-back also improves parental understanding and comfort with discharge and decreases readmissions. Further subgroup analysis may help target populations for whom teach-back is most beneficial.