487 - Effectiveness of a Novel Social Determinants of Health-Informed Discharge Planning Curriculum for Pediatric Residents

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 487
Publication Number: 487.221

Emily Murphy, Johns Hopkins Children's Center, Washington, DC, United States; Marielle T. Bugayong, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Eric Balighian, Johns Hopkins Children's Center, Baltimore, MD, United States; Sean Tackett, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Presenting Author(s)

Jillian E. Heckman, MD (she/her/hers)

Resident Physician, PGY-2
Johns Hopkins Children's Center
Baltimore, Maryland, United States

Co-Author(s)

EM

Emily Murphy, MD (she/her/hers)

Johns Hopkins Children's Center
Washington, District of Columbia, United States

Background: Nearly 6 million pediatric patients are discharged from the hospital yearly in the United States, and social determinants of health (SDoH) impact discharge outcomes. Effective discharge planning prevents patient readmissions, but the literature on how best to educate pediatric trainees is limited.

Objective: We aimed to assess the impact of a discharge planning workshop on pediatric residents’ reported self-efficacy in discharge planning and ability to generate an SDoH-informed discharge bundle.

Design/Methods: Pediatric residents (postgraduate years 1 & 2) participated in a one-hour discharge planning workshop during their 4-week inpatient community pediatrics rotation between January and November 2022. Before the workshop, residents completed a pre-survey that included baseline resident characteristics, prior experience with discharge planning education, and reported self-efficacies with discharge planning (rated on a 5-point Likert scale: 1 = strongly disagree; 5 = strongly agree). During the workshop, residents completed an initial discharge bundle for a case patient with asthma, and then integrated the findings of an SDoH screen into a final SDoH-informed discharge bundle (Figure 1). Initial and final discharge bundles were submitted in real time during the workshop. Residents then completed a post-survey reporting self-efficacies and attitudes. Discharge bundles were scored by an independent coder for completeness relative to a reference discharge bundle. Differences in pre- and post-workshop self-efficacy and discharge bundle scores were assessed with Wilcoxon signed rank test and paired Student’s T-test, respectively. Two-tailed P-value of < 0.05 was considered significant. The study was acknowledged as exempt by the Johns Hopkins Medicine Institutional Review Board (IRB00312106).

Results:

Forty residents participated in the study. Self-efficacy improved across all measures, and discharge bundle scores were significantly higher post-workshop (mean score 6.7 ± 1.3 vs. 8.7 ± 2.4, p = 0.001; Table 1). 100% of participants agreed or strongly agreed that the workshop improved their understanding of discharge planning and that they will apply the workshop framework to future discharges.

Conclusion(s):

Baseline self-efficacy for discharge planning activities, including incorporating SDoH, was low but improved with a brief workshop that taught residents to use a discharge bundle and screen for SDoH. Discharge bundle completeness improved with use of the SDoH screening tool. Next steps include assessment of the replicability of our findings and impact on patient care.