Abstract:
Trigger: Late preterm infants (LPIs) (34-36 weeks gestation) require specialized support due to unique developmental challenges that increase readmission risks. The initial assessment identified significant variability in existing discharge methodologies across a Southeastern U.S. healthcare system, particularly regarding feeding plans, outpatient lactation service, and timely primary care provider (PCP) follow-up. This project addresses these inconsistencies to enhance successful transitions home for LPIs and ultimately prevention of readmissions.
Problem/Goal Statement: This quality improvement initiative aims to standardized LPI discharge preparedness, The primary goal is to increase adherence to the set LPI criterion by 15% by December 31, 2025. The targeted objectives include ensuring robust and consistent documentation of feeding plans, lactation consultants scheduling outpatient follow-up lactation services, and assuring a PCP appointment is scheduled before discharge.
Actions Taken: A multidisciplinary team developed and implemented a comprehensive education plan for all Mother Baby staff and providers. The training emphasized consistent LPI feeding plans (caloric intake, schedule, supplementation), the necessity of continued outpatient lactation services, and early establishment of PCP care. Monthly, re-education was necessary to improve consistency and hard-wire these LPI discharge preparedness practices.
Measurable Outcomes: Monthly LPI audits will track key metrics: completeness of feeding plan (breast/bottle, caloric intake, supplementation) and confirmation of prompt post-discharge PCP and lactation appointments.
Conclusion: Preliminary data indicates that standardizing discharge preparedness for LPIs has slowly but significantly enhanced infant health and decreased hospital readmission rates. The findings reinforce the critical importance of a structured approach to strengthening feeding plans and promoting follow-up care, ultimately fostering a supportive environment for families and promoting better long term LPI health outcomes.
Recommendations for Practice: Recommendations include integrating structured LPI discharge preparedness into routine clinical practice. Sustained success requires ongoing staff training, regular audits, and continuous improvement of care based on data-driven insights. Prioritizing these strategies empowers healthcare systems to substantially improve care quality and outcomes for late preterm infants.
