DOI: 10.14288/1.0433255
title: Smart Discharges Transition to Scale

description: &lt;br /&gt;&lt;strong&gt;Dataset Description:&lt;/strong&gt; This dataset contains materials from a the Smart Discharges Transition to Scale parent study within the &lt;a href = "https://bcchr.ca/smart-discharges"&gt;Smart Discharges&lt;/a&gt; program of research. Materials include the parent study protocol and associated documents. See the Metadata section below for links to related publications and datasets.&lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Background:&lt;/strong&gt; In Uganda, approximately 5% of children admitted with severe infections die after they have been discharged from the hospital, mostly at home. Most of these deaths are preventable as they are largely due to the way that discharges are done and how follow-ups are planned. Health workers and caregivers are often unaware of this period of vulnerability and are poorly equipped to identify and handle this critical situation. Our previous work focused on developing and evaluating models and technology to predict, before discharge, an individual child’s risk of recurrent illness, as well as to provide additional post-discharge support to at-risk children. The goal of this project is to determine how best to scale the Smart Discharges Program through a four-phased approach, each corresponding to a specific objective. &lt;strong&gt;Phase I :&lt;/strong&gt; aims to understand the reasons for suboptimal discharge by evaluating the pediatric discharge process from hospital admission through the transition to care within the community. &lt;strong&gt;Phase II :&lt;/strong&gt; aims to assess pediatric discharge policies and facility readiness for change in a nationally representative sample of health facilities in Uganda. &lt;strong&gt;Phase III :&lt;/strong&gt; aims to evaluate the effects of the Smart Discharges Health Worker Training Program on discharge care practices and procedures. &lt;strong&gt;Phase IV :&lt;/strong&gt; aims to complete the facility-based linkage to care through the use of a community-based follow-up system. &lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Each of the four project phases utilizes different research methodologies. &lt;strong&gt;Phase I &lt;/strong&gt; is a mixed methods prospective study utilizing patient journey mapping, discharge process mapping, and focus group discussions at 3 Ugandan Hospitals. &lt;strong&gt;Phase II &lt;/strong&gt; is a cross-sectional, survey-based study conducted at 36 health facilities providing in-patient pediatric care in Uganda. &lt;strong&gt;Phase III and IV :&lt;/strong&gt; (implemented together) is a quality improvement intervention at 16 health facilities in Uganda. &lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Discussion:&lt;/strong&gt; Ultimately this work is focused on ensuring widespread adoption of Smart Discharges practices throughout Uganda by building capacity that ensures sustainability. Exploring and characterizing the existing pediatric discharge process, including human and health system factors that impact this process, will allow us to operationalize the Smart Discharges innovation into an effective health-systems approach to this neglected issue.&lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Ethics Declaration:&lt;/strong&gt; Ethics approvals have been obtained from the Makerere University School of Public Health (MakSPH) Institutional Review Board (PI: 850; PII: 851; PIII/IV: 836), the Uganda National Council of Science and Technology (UNCST) in Uganda (PI: HS929ES; PII: HS928ES; PIII/IV: HS926ES) and the University of British Columbia in Canada (PI-IV: H20-02519). &lt;br /&gt;