February 20, 2024

Helping parents remember hospital discharge instructions

Study explores the communication needs of parents of children with mental health concerns admitted to the emergency department

(photo: WCHRI)

A rising number of children and youth are visiting emergency departments (EDs) for mental health crises, but their parents are often unsure what to do after discharge. 

According to Bruce Wright, a pediatric emergency physician at the Stollery Children’s Hospital and member of the Women and Children’s Health Research Institute (WCHRI), parents often leave the hospital either forgetting or not understanding what hospital staff have told them about their child’s diagnosis, treatment, and follow-up appointments.

“When a family comes in in crisis, they’ve probably had quite a prolonged stay in the ED and they often come in during the evening and late at night,” says Wright. “People are fatigued and stressed, obviously, and they just don’t remember exactly what was said and what are the next steps.” 

Unfortunately, parents can’t easily track down this information after discharge. Although Alberta has an online medical record system, My AHS Connect, it has not been universally adopted by patients and practitioners. On top of this, privacy laws limit parent access to the medical records of teenage children.

With funding from the Stollery Children’s Hospital Foundation through WCHRI – Wright and his team set out to understand the problem and figure out how to better communicate with families.

Over a three-year period, researchers ran a series of focus groups with parents, youth, and healthcare providers to tackle the problem and identified communication aids as a feasible solution. As part of the project, the team created a pamphlet to be given to families of children being seen at the ED for an acute mental health problem.

The document communicates what families can expect during their hospital stay and afterward, and includes an area for parents to jot down notes (such as when to expect a call from a specialist, what medications will be prescribed, etc.) or questions for health-care providers. The pamphlet also outlines what parents can do if their child is in crisis again.

The research also identified the potential of using an auto-generated text-messaging system to follow up with parents after their children have been discharged. Like the pamphlet, the text system would provide resources to parents who are unsure of what to do next or how to deal with another crisis.

Now that the study has concluded, Wright and his team are working to get the pamphlet into the hands of families visiting Alberta EDs and hope to conduct a small Plan-Do-Study-Act to determine the best way to give the pamphlet to families. Wright also plans to continue investigating the use of an automated text messaging system.

In addition to reducing parent stress and ensuring children get the care they need, improved communication may help families avoid future ED visits, says Wright: “A consistent message we heard was, ‘We don’t want to come to the ED, but we feel we have nowhere to go.’”