Contributing Factors of Delayed Discharge of Hospitalized Chronically Ill Pediatric Patients at Cook Children’s Medical Center in Fort Worth, Texas

Background. Children with chronic illnesses are at an increased risk of prolonged hospital stays. These patients make up less than 1% of children in the United States, but they contribute to 30% of all pediatric healthcare costs. Objective. This study aims to investigate common contributing factors to discharge delay in chronically ill pediatric patients and how they relate to length of delay, diagnosis, and demographic factors. Methods. The data collected for this study included 219 patients aged 0 to 18 years old with chronic illnesses discharged from Cook Children’s Medical Center in Fort Worth, Texas. Variables, including demographics, hospitalization characteristics, and discharge barriers, were analyzed. Results. Discharge delays were significantly related to patients with home equipment needs due to the resources necessary for discharge. Additional leading barriers included caregiver refusal, delivery of equipment, teaching, and nursing availability. Conclusion. This study confirmed that the discharge barrier themes discovered within the literature review are also leading discharge barriers in the TCU and RCU at Cook Children’s. It is necessary to have complex care teams and a clearly defined discharge plan established for all patients to address these barriers early in the admission to avoid delays, costs, stress, and adverse patient outcomes.