Improving the Outcome of Sick Children Referred from District Hospitals in and around Puducherry by Establishing a Communication Network: A Community-based Quality Improvement Initiative.

Abstract

Introduction: Transferring patients between hospitals is an important aspect and is often the weak link in the health system. Robust real-time communication before transfer may be a valuable tool to improve the emergency care of children. Our study was aimed at developing evidence for the effectiveness of efficient communication networks between a tertiary care hospital and the referring hospitals in improving patient outcomes.

Materials and methods: We carried out a prospective observational study conducted in two phases. After the collection of baseline data in phase I, a communication network was established between our hospital and referring hospitals as the part of intervention. The effectiveness of the intervention was ascertained in the second phase.

Results: A total of 3,460 pediatric patients sought care from the emergency department of our hospital during the study period, 1,658 during phase I and 1,802 in phase II. Of the total patients admitted in pediatric emergency, 1,436 (86.61%) survived in the pre-establishment phase (phase I), and 1,762 (97.62%) survived in the post-intervention phase (phase II). The duration of stay during phase II was lower than in phase I, the difference being statistically significant. Propensity score matching analysis and interrupted time series analysis using a control chart also suggested improved survival of children during phase II after the intervention.

Conclusions: Our study showed that the establishment of a communication network improved the outcome of children attending our pediatric emergency. Further research is needed to assess if the usefulness of the intervention was not due to secular trends or the difference in patient profiles between the two phases.

How to cite this article: Antony J, Parameswaran N, Ramanathan, Kathavarayan R, Pothapregada S, Kumar S. Improving the Outcome of Sick Children Referred from District Hospitals in and around Puducherry by Establishing a Communication Network: A Community-based Quality Improvement Initiative. Indian J Crit Care Med 2024;28(12):1153-1158.