IGH has developed Smart Discharges to help children stay healthy after they leave the hospital to return home.
Children hospitalized for serious infections in Africa have a very high post-discharge mortality rate. This means that many children who seem healthy after an infection return to their homes and then get sick again and die. One solution is identifying vulnerable children before they go home from the hospital so that we can make sure they have the tools to survive after they go home. This is the Smart Discharge approach.
Learn more about Smart Discharges through this video.
We conducted our initial feasibility study in children aged 6 months to 5 years, at Mbarara Regional Referral Hospital and Holy Innocents Children's Hospital in Uganda. We demonstrated a 3-fold increase in appropriate health seeking behavior and a 2-fold increase in post-discharge hospital readmissions, a critical outcome as two-thirds of post-discharge deaths occur outside of health facilities. We also showed a trend towards a 30% reduction in mortality.
Newborn babies and young infants are vulnerable to different kinds of infections than older children and their bodies react differently to infection. We cannot just use our existing models for these newborns and young infants, so in 2017 we began building a new model using the same processes.
We recently completed a pragmatic clinical effectiveness study of the Smart Discharges Program in children 0 to 5 years of age, across 6 hospitals in Uganda (manuscript in preparation).
Women in low- and middle-income countries are increasingly giving birth in healthcare facilities yet are frequently discharged home with their newborns within 24 hours of birth without plans for follow up care. During the early post-discharge period mother and newborn are vulnerable to infections and complications resulting from childbirth. The health of a newborn is closely linked to the health of its mother, and the same is true for the mother, making this a crucial missed opportunity. In 2022, we partnered with 2 health facilities to conduct an obervational study of post-discharge outcomes among dyads in Uganda. These data will be used to build a risk prediction model and inform the expansion of the Smart Discharges approach to dyads.
To learn more about Smart Discharges and how predicting risk can help to more efficiently and effectively use limited resources where they are needed most visit the project website. Smart Discharges is a part of the Smart Quality Improvement suite of tools.
Smart Discharges is being supported by the Canadian Institutes for Health Research, EHRLA, and the Lacuna Fund, and previously been supported by Mining4Life, Grand Challenges Canada, and the Thrasher Research Fund.
