Date of Doctor of Nursing Practice Project Completion

Summer 7-31-2025

Faculty Advisor

Ololade Bello

Abstract

Purpose

This quality improvement project aimed to improve pediatric pulmonary outpatient follow-up after hospital discharge for pediatric patients hospitalized with asthma exacerbations through the implementation of a standardized discharge process designed to improve communication, education, and care coordination.

Background

The project was completed in acute care and intermediate care units within a women's and children’s hospital in San Antonio, Texas.

Methodology

Following the IHI Improvement Model, serial PDSA cycles were completed over a 10-week period. An interprofessional team developed a standardized process map and interventions, including a discharge checklist, communication board, patient/family education, medications in hand at discharge, community asthma and pediatric pulmonology referrals. Hospital staff/residents were educated prior to implementation. Twenty patients met the inclusion criteria. Limitations included project implementation delays, rotating resident services, and inconsistencies in documentation.

Results

Outpatient pediatric pulmonary referrals were placed for 71% of patients, and 55% were seen for follow-up after discharge. The discharge checklist was used for 67% of patients. Staff post-survey results show 71% felt the discharge checklist was beneficial to their workflow.

Implications

A standardized discharge process may enhance care coordination, strengthen communication, and improve follow-up adherence for pediatric patients with asthma. The importance of discharge planning is highlighted by these results. The unexpected limitations highlight opportunities to improve implementation strategies to fully integrate this process across disciplines. These results may also inform strategies to reduce healthcare resource utilization within the healthcare system.

Keywords

quality improvement, asthma, pediatric asthma, discharge follow-up, standardized process

Included in

Nursing Commons

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