Creation & implementation of discharge guidelines for preterm infants with bronchopulmonary dysplasia.

BACKGROUND: Complex patients with bronchopulmonary dysplasia (BPD) are managed by neonatologists during the hospitalization, then care shifts to outpatient specialists, including pediatric pulmonologists, following discharge. During this transition, variable care among the medical team can lead to inconsistent care and adverse outcomes. METHODS: Through the development of BPD Discharge Guidelines and a "SAFER" Discharge Score, this project introduced a comprehensive approach to discharge planning in order to standardize care, ensure a smooth transition home, and improve the reliability of discharge planning. The "SAFER" Discharge Score consists of five criteria: pulmonology consultation during the admission (S - See patient), provision of an action plan with emergency contact information (A - Action Plan), scheduling of pulmonology follow up prior to discharge (F - Follow Up), caregiver education for oxygen equipment (E - Education), and a repeat chest radiograph prior to discharge (R - Radiograph). RESULTS: Our statistical analysis showed a significant process change, with an improvement in the mean discharge score from 3.0 to 3.9 from January 2021 to December 2022. We also observed a reduction in time to outpatient pulmonology follow up, decreasing from an average of 42.7 days following NICU discharge to 25.1 days (post-intervention). CONCLUSION: Our study demonstrates that a standardized discharge framework can improve consistency and reliability of discharge planning for infants with BPD requiring respiratory support.