Disclosures: Brennan M. Wright, MD: No financial relationships or conflicts of interest

Objective: Improve outpatient pediatric TBI (traumatic brain injury) follow-up rate after acute hospitalization

Design: Quality improvementSetting : Urban academic medical centerParticipants : Patients age 0-21 hospitalized with an ICD-10 diagnosis starting with S06 (intracranial injury) within their first 10 listed diagnoses

Interventions: An outpatient nurse navigator trained in pediatric TBI care was hired. Based in the outpatient clinic, this nurse navigator addresses patient care and access for concussion through severe TBI pediatric patients.

Main Outcome Measures: “Follow-up rate”: percentage of patients seen within 30 days of hospital discharge in an outpatient clinic for the reason of an S06 diagnosis as documented in the electronic medical record.

Results: 77 patients met our criteria during our 6-month monitoring period of November 1, 2018 to May 31, 2019. The overall follow-up rate for this timeframe was 23%. The follow-up rate in November (prior to the nurse navigator starting) was 25%. The follow-up rate from December to May was 23%. The highest follow-up rate was January with a follow-up rate of 33%. Over the 6 months, there was a weak positive relationship between time and follow-up rate with a correlation coefficient of 0.23 and a p-value of 0.67.Conclusions: These data are inconclusive on the effectiveness of hiring a nurse navigator to improve outpatient follow-up rates for patients age 0-21 who are hospitalized with a traumatic brain injury. The benefit of this quality improvement assessment for outpatient follow-up discharge uncovered several areas of focus and training within departments and physician education regarding follow-up TBI care. An additional benefit was the support for a dedicated education process for inpatient transition to outpatient process in the pediatric TBI patient population.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/assessing-follow-up-rate-for-pediatric-patients-discharged-from-inpatient-hospitalization-with-traumatic-brain-injury-tbi-can-a-nurse-navigator-in-concussion-tbi-clinic-improve-follow-up-rate/