Sarah A. Sobotka, MD, MSc,a Emma Lynch, MPH,a Wendy Tian, BA,b Michael E. Msall, MD,a Monica E. Peek, MD MPHc
aSection of Developmental and Behavioral Pediatrics, University of Chicago, Chicago, IL; bRush Medical College, Chicago, IL; cSection of General Internal Medicine, Department of MedicineUniversity of Chicago, Chicago, IL
BACKGROUND: Children with medical technology dependency often remain hospitalized for long periods while preparing to transition home. To our knowledge, no comprehensive reports of alternative locations for hospital-to-home transition have been described in the literature.
OBJECTIVES: We present a comprehensive report and evaluation of patient and family outcomes before and after admission to Almost Home Kids (AHK), a hospital-to-home transitional care center, which provides a home-like setting for parent training, care coordination, and case management for children with medical technology dependency.
OUTCOMES: Descriptive statistics were used to characterize the children and their parents during the transitional care admission and following discharge. Parents were given questionnaires which assessed their community support, knowledge and skills with medical technology management, physical and mental health, and discharge readiness. After admission to the AHK transition program as compared to before, children had significantly increased access to primary care and home nursing, more referrals to Early Intervention and more received speech therapy services. Parents reported increased comfort with responding to ventilator alarms, checking back-up ventilators, and managing feeding tubes.
CONCLUSIONS: For children with technology dependency, enrollment in the AHK hospital-to-home transitional care program may effectively deliver parent training and broaden the child’s access to community health, rehabilitation and nursing resources.