title: The effectiveness of family-centered transition processes from hospital settings to home: a review of the literature.
abstract: OBJECTIVE
  The quality of care transitions is of growing concern because of a high incidence of postdischarge adverse events, poor communication with patients, and inadequate information transfer between providers. The objective of this study was to conduct a targeted literature review of studies examining the effectiveness of family-centered transition processes from hospital- and emergency department (ED)-to-home for improving patient health outcomes and health care utilization.
  
  
  METHODS
  We conducted an electronic search (2001-2012) of PubMed, CINAHL, Cochrane, PsycInfo, Embase, and Web of Science databases. Included were experimental studies of hospital and ED-to-home transition interventions in pediatric and adult populations meeting the following inclusion criteria: studies evaluating hospital or ED-to-home transition interventions, study interventions involving patients/families, studies measuring outcomes≤30 days after discharge, and US studies. Transition processes, principal outcome measures (patient health outcomes and health care utilization), and assessment time-frames were extracted for each study.
  
  
  RESULTS
  The search yielded 3458 articles, and 16 clinical trials met final inclusion criteria. Four studies evaluated pediatric ED-to-home transitions and indicated family-tailored discharge education was associated with better patient health outcomes. Remaining trials evaluating adult hospital-to-home transitions indicated a transition needs assessment or provision of an individualized transition record was associated with better patient health outcomes and reductions in health care utilization. The effectiveness of postdischarge telephone follow-up and/or home visits on health care utilization showed mixed results.
  
  
  CONCLUSIONS
  Patient-tailored discharge education is associated with improved patient health outcomes in pediatric ED patients. Effective transition processes identified in the adult literature may inform future quality improvement research regarding pediatric hospital-to-home transitions.
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, Washington; and Seattle Children's Research Institute, Seattle, Washington arti.desai@seattlechildrens.org.
authors.forename: Arti D
authors.initials: AD
authors.lastname: Desai
authors.affiliation: Seattle Children's Research Institute, Seattle, Washington.
authors.forename: Jean
authors.initials: J
authors.lastname: Popalisky
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, Washington; and Seattle Children's Research Institute, Seattle, Washington.
authors.forename: Tamara D
authors.initials: TD
authors.lastname: Simon
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, Washington; and Seattle Children's Research Institute, Seattle, Washington.
authors.forename: Rita M
authors.initials: RM
authors.lastname: Mangione-Smith
mesh_terms: D000359:Aftercare / Q000592:standards; D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards*; D011368:Professional-Family Relations; D058996:Quality Improvement
keywords: adults; comparative effectiveness research; health transition; hospital readmission; hospitalists; outcome and process assessment (health care); patient discharge; patient-centered care; pediatrics; review