Furthering the Value of the Emergency Department Beyond Its Walls: Transitions to the Medical Home for Pediatric Emergency Patients

Abstract

Transitions of care between providers occur frequently in the emergency department (ED), inviting opportunity for error. The evidence base for improving transitions within the hospital is growing, yet the vast majority of children seen in EDs are discharged home to complete outpatient evaluation and management. The transition of care to the caregiver at home, primary care physician, and specialists that will assume management of the patient offers a critical opportunity to generate value for stakeholders and ensure that their needs are addressed. When reviewing in-hospital transitions, many best practices are identified that may apply to both healthy children and those with complex conditions discharged from the ED. The barriers to performing and the enablers that facilitate strong transitions to the community suggest that there is opportunity to create tools and processes including evolving digital platforms to complete efficient, effective transitions that may reduce ED recidivism.