DOI: 10.5683/sp3/qrumnq
title: Smart Discharges to improve post-discharge health outcomes in children: A prospective before-after study with staggered implementation

description: &lt;br /&gt;&lt;strong&gt;Dataset Description:&lt;/strong&gt; This dataset contains materials from a 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; Substantial mortality occurs after hospital discharge in children under 5 years old with suspected sepsis. A better understanding of risk and ability to mitigate risk for those who are most vulnerable is needed to reduce child mortality in resource limited settings. &lt;br /&gt;

&lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a prospective before-after study with staggered implementation at six Ugandan hospitals. Phase I is a prospective observational cohort study, while Phase II is a stepped-wedge intervention. The study also includes a long-term follow-up phase.&lt;br /&gt;

&lt;br /&gt;The ultimate outcome to be studied is post-discharge mortality for children &lt; 5 years old by 6 months after admission.
The study has two objectives, each corresponding to a phase:
&lt;ol&gt;&lt;li&gt;&lt;strong&gt;Phase I:&lt;/strong&gt; To refine and externally validate the existing post-discharge mortality prediction model.&lt;/li&gt;
&lt;li&gt;&lt;strong&gt;Phase II: &lt;/strong&gt; To determine the effectiveness of a Smart Discharge program on post-discharge health seeking behaviour and mortality.
We also seek to lay the groundwork to study the long-term effects of sepsis on morbidity over a 10 year period.&lt;/li&gt;&lt;/ol&gt;

&lt;br /&gt;&lt;strong&gt;Data Collection Methods:&lt;/strong&gt; All data were collected at the point of care using encrypted study tablets. These data were then uploaded to a Research Electronic Data Capture (REDCap) database hosted at the BC Children’s Hospital Research Institute (Vancouver, Canada). 
At admission, trained study nurses systematically collected data on clinical, social and demographic variables. Following discharge, field officers contacted caregivers at 2 and 4 months by phone, and in-person at 6 months, to determine vital status, post-discharge health-seeking, and readmission details. Verbal autopsies were conducted for children who had died following discharge.&lt;br /&gt;

&lt;br /&gt;&lt;strong&gt;Ethics Declaration:&lt;/strong&gt; This study was approved by the Mbarara University of Science and Technology Research Ethics Committee (No. 15/10-16; No. 07/01-21), the Uganda National Institute of Science and Technology (HS 2207), and the University of British Columbia / Children & Women’s Health Centre of British Columbia Research Ethics Board (H16-02679).&lt;br /&gt;

&lt;br /&gt;&lt;strong&gt;Associated datasets:&lt;/strong&gt; &lt;br /&gt;
&lt;a href = "https://borealisdata.ca/dataset.xhtml?persistentId=doi:10.5683/SP3/REPMSY"&gt;Post-discharge mortality among children under 5 years admitted with suspected sepsis in Uganda: a prospective multi-site study &lt;/a&gt;&lt;br /&gt;
description: &lt;br /&gt;&lt;strong&gt;NOTE for restricted files:&lt;/strong&gt; If you are not yet a CoLab member, please complete our &lt;a href = "https://rc.bcchr.ca/redcap/surveys/?s=EDCYL7AC79"&gt;membership application survey&lt;/a&gt; to gain access to restricted files within 2 business days.
&lt;br /&gt;Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator on &lt;a href = "https://www.bcchr.ca/pediatric-sepsis-data-colab"&gt;this page&lt;/a&gt; under "collaborate with the pediatric sepsis colab."