Table 2 Description of intervention studies (n = 44)
Author, publication year | Intervention type | Description of intervention | Intervention target | Who delivered intervention | Description of primary outcome | Direction of effect |
|---|---|---|---|---|---|---|
1 Intervention function | ||||||
Baker et al. 2009 [64] | Education | Parents watched a video (11 min) about how to manage child’s fever at home. | Parent | Research team | Reducing return ED visits. | + |
Bloch and Bloch 2013 [67] | Education | Parents watched a video (3 min) regarding their child’s illness in addition to standard discharge communication. Parents were provided the opportunity to ask clarifying questions to a clinician prior to leaving the ED. | Parent | Medical student volunteers | Parent comprehension of treatment plan and follow-up information. | + |
Boychuk et al. 2006 [70] | Education | Parents watched a video (6Â min) outlining asthma and asthma management techniques, in addition to conversations with ED staff about the importance of asthma management and treatment, a review or written or verbal instructions, and a demonstration of how asthma affects the lungs. Health care providers also received asthma education. | Patient, parent, and health care provider | Research team, and physicians | Improving asthma management through written action plans and medications. | + |
Brooks et al. 2017 [90] | Education | Parents received written discharge instructions specific to their child’s concussion level and symptoms they experienced. | Parent | Research team | Use of discharge instructions. | + |
Chande et al. 1996 [69] | Education | Parents watched a video (10 min) and received an information booklet on pediatric illnesses. A research assistant reviewed the booklet with parents and answered parent questions. | Parent | Research team | Reducing return ED visits. | – |
Cheng et al. 2002 [22] | Education | Caregivers received education about asthma and a demonstration of an appropriate MDIS technique during the ED visit. | Parent | Discharge facilitator and ED clinicians | Improving rates of MDIS use. | + |
Considine and Brennan 2007 [78] | Education | Nurses in the ED attended two tutorials that reviewed the physiology and treatment of fevers to improve the content of discharge communication provided to parents. | Health care provider | Online tutorial | Information caregivers received about fever as part of their discharge instructions. | + |
Delp and Jones 1996 [60] | Education | Parents received cartoon wound care instructions in addition to standard written instructions. | Patient and parent | Physicians | Patient compliance with ED discharge instructions. | + |
Hanson et al. 2017 [29] | Education | Patients and parents received cartoon pain management information. | Patient and parent | Research team | Parent recall of information provided in the cartoon. | + |
Hart et al. 2015 [72] | Education | Parents received one of two interventions. One intervention group received access to a standard fever education website. The second intervention group received accessed to an interactive fever education website. | Parent | Research team | Parent knowledge of fever. | + for both interventions |
Hussain-Rizvi et al. 2009 [81] | Modeling | Physician demonstrated for the parent how to use of the albuterol MDIS. The parent then provided the treatment while under observation. | Parent | Physicians | Adherence to MDIS use at home following ED discharge. | + |
Gaucher et al. 2011 [28] | Education | Parents who notified the triage nurse they were leaving without being seen by a physician received information about their child’s illness and when to seek additional care and return to ED | Parent | Triage nurse | Rates of return ED visits within 48 h of the initial visit. | + |
Isaacman et al. 1992 [74] | Education | Parents whose child presented with otitis media received one of two interventions. One intervention group received verbal instructions. The second intervention group received the same verbal instructions in addition to a written copy of discharge communication. | Parent | Residents and medical students | Parent recall of medications and signs to monitor at home. | + for both interventions |
Ismail et al. 2016 [68] | Education | Parents watched a video (3–5 min) about fever or closed head injury in addition to standard verbal discharge communication. Parents were also given the opportunity to ask questions to clinicians prior to leaving ED. | Parent | Clinicians | Parent comprehension of diagnosis and follow-up care. | + |
Kaestli et al. 2015 [55] | Education | Parents received written information regarding drug dosing, indication, and frequency of administration. | Parent | Research team | Improving comprehension of prescribed drug usage. | + |
LeMay et al. 2010 [73] | Education | Parents received a booklet about pain management and a bookmark printed with pain scale information in addition to standard care. | Parent | Research team | Children’s pain and parents’ perceptions of pain management 24 h following ED visit. | No change |
Macy et al. 2011 [65] | Education | Parents watched a video (20Â min) about an asthma management. | Parent | Health care providers and research assistants | Parent knowledge of asthma information provided during ED visit. | + |
Patel et al. 2009 [76] | Education | Parents received verbal reinforcement of discharge communication from a discharge facilitator in addition to standard written information. | Parent | Discharge facilitator | Parent recall of discharge instructions. | + |
Petersen et al. 1999 [77] | Education | Parents received personalized written asthma information about signs of asthma attack, medication doses, and following up with a PCP within 72Â h of the ED visit. | Parent | Respiratory care providers and clinicians | Compliance with attending follow-up appointment and length of time before appointment was made. | No change |
Porter et al. 2006 [80] | Environmental Restructuring | Parents used an interactive asthma kiosk to document asthma symptoms and care needs. Information generated from the kiosk was shared with ED clinicians through a reminder summary on chart. | Parent and health care provider | Research team and clinicians | Parent satisfaction with care and providers’ adoption of guideline-endorsed process measures. | No change |
Stevens et al. 2012 [66] | Education | Parents watched a video (6Â min) that provided information about common myths and misunderstandings surrounding home management of pain. | Parent | Research team | Parent use of pain management information provided at the ED following discharge. | + |
Thomas et al. 2017 [47] | Education | Parents received verbal reinforcement of written discharge instructions. | Parent | Research team | Parent understanding of discharge instructions. | + |
To et al. 2010 [79] | Environmental Restructuring | Health care providers received an evidence-based asthma guideline reminder card. | Health care provider | Research team | Changes to asthma medication, asthma education, and discharge planning provided to families in the ED. | +/ No change/ No change |
Waisman et al. 2005 [50] | Education | Parents received a written information sheet regarding their child’s illness. | Parent | Physicians | Parent understanding of discharge instructions. | + |
Williams et al. 2013 [75] | Education | Parents received an illustrated scale and were educated about their child’s asthma severity score along with standard discharge communication. | Parent | Research team and ED clinical providers | Parent compliance with scheduling follow-up care. | + |
Wood et al. 2017 [71] | Education | Parents watched a video (3–5 min) specific to their child’s illness, in addition to standard verbal discharge communication and a written information sheet. | Parent | ED nurses from an evidence-based practice project | Parent comprehension of their child’s illness and treatment. | + |
Zorc et al. 2003 [82] | Enablement | Researchers with the study brought parents to a phone in an attempt to get them to schedule follow-up care with their PCP. | Parent | Research team | Parent follow-up with PCP and improvements in asthma-related health outcomes and medication use. | + |
2 Intervention functions | ||||||
Cushman et al. 1991 [86] | Education + Enablement | Physicians received a cue card with information to counsel parents on helmet use. Parents were provided with pamphlets and a card with the names and addresses of retailers selling helmets to take home to encourage the use and purchase of helmets. Follow-up phone calls were made to check if helmets had been purchased and to provide additional counseling, if needed. | Parent | Physicians | Measuring the purchase and use of bicycle helmets. | No change |
Jones et al. 1989 [84] | Education + Enablement | Parents received one of three interventions. Group 1 received standard care in addition to a follow up telephone call. Group 2 received counseling during the ED visit with no follow-up call. Group 3 received both counseling in the ED and a follow-up call. | Parent | Research nurse and clinical nurse | Compliance with scheduling and attending a follow-up appointment based on a referral recommendation. | + |
Kruesi et al. 1999 [87] | Education + Environmental Restructuring | Parents were informed of their child’s increased risk of suicide. Staff also educated and problem solved with parents to try and reduce suicide risk by limiting access to lethal means. Additionally, a safe disposal site was created for parents to encourage the removal of guns from the house. | Parent | ED staff | Reducing access to lethal means. | + |
O’Neill-Murphy et al. 2001 [88] | Education + Modeling | Parents received a review of written fever information, had a discussion to have their questions answered, and received instructions and a demonstration of proper thermometer use. | Parent | Research team | Parent anxiety and rate of return ED visits for fever. | + |
Pizarro et al. 1979 [39] | Education + Enablement | Following administration of oral rehydration fluid at the hospital, parents were sent home with the oral rehydration solution and were instructed of signs to monitor that would require a return visit to the ED. | Parent | ED nurses and interns | Reducing hospital length of stay. | + |
Philips 2009 [38] | Education + Environmental Restructuring | Parents received asthma education packages, asthma discharge plans, and were provided with a spacer if their child did not have one. | Parent | ED staff | Improving parent’s treatment and home management of asthma. | + |
Sauer et al. 2012 [45] | Education + Environmental Restructuring | Parents received written discharge information and access to a telephone hotline to assist with scheduling follow-up care in orthopedics. | Parent | Physicians | Reducing rates of ED use. | + |
Scarfi et al. 2009 [83] | Education + Environmental Restructuring | Children in the intervention group received a skin allergen to determine allergens that could be linked to an asthma episode. Parents were provided with a copy of the allergen test to encourage follow-up care. | Patient and parent | Clinicians and administrator of the skin allergen test | Attending follow-up appointment. | + |
Yin et al. 2008 [63] | Education + Enablement | Parents received illustrated resources about proper dosing of liquid medication. A research assistant reviewed resources with parents and had parent demonstrate how they would administer a medication dose. | Parent | Research team | Parent knowledge of medication dosing accuracy. | + |
Zorc et al. 2009 [82] | Education + Environmental Restructuring | Parents watched a video and were mailed a letter to schedule follow-up care for their child’s asthma. Parents of children with persistent asthma also received an additional letter to encourage follow-up with a PCP. | Parent | Research team | Parent compliance with scheduling and attending follow-up appointment. | No change |
Komoroski et al. 1996 [93] | Incentivization + Environmental Restructuring | Parents received one of two interventions. The first intervention group had their follow-up appointment booked for them and received a written reminder. The second intervention group received the same intervention as the first group with the addition of a mailed reminder one week prior to the appointment, a reminder phone call the day before the appointment, a work excuse, assistance with transportation to and from the appointment, and receiving child care. | Parent | Research team | Parent compliance with attending follow-up appointment. | + |
3 Intervention functions | ||||||
Ducharme et al. 2011 [61] | Education + Enablement + Environmental Restructuring | Parents received a structured written action plan with information about asthma management, treatment, in addition to an asthma assessment tool and a prescription. A valved spacer and MDIS were also provided for children. Surveys and/or telephone calls were completed to determine parents’ completion of educational classes, follow-up visits with PCP and number of return visits to the ED. | Parent | ED physicians and pharmacists | Adherence to prescribed asthma medications four weeks following ED discharge. | + |
Gorelick et al. 2006 [62] | Education + Enablement + Environmental Restructuring | Parents received one of two interventions. Group one received standardized information in addition to having information faxed to their PCP, and phone calls to offer assistance scheduling the follow-up care with PCP. The second group received the same care as intervention group one, in addition to being assigned a nurse or social worker to provide home visits, and additional education and links to community services. | Parent | Research team and home health care staff | Rates of return ED visits six months following initial ED asthma visit. | No change |
Rotheram-Borus et al. 2000 [91] | Enablement + Training + Modeling | ED staff and health care providers received additional training surrounding mental health. Patients and parents were shown a video (20Â min) in the ED about mental health treatments. Patients and parents also received therapy sessions, including identifying positive coping mechanisms, and outpatient treatments. Outpatient treatments included additional therapy sessions to use problem solving and roleplaying techniques to assist with family issues and future suicidal feelings. | Patient, parent and health care provider | Research team, ED staff and clinicians | Reducing suicidal behavior. | + |
Smith et al. 2006 [90] | Enablement + Training + Incentivization | An asthma coach worked with parents to assist with their asthma concerns. Coaches also provided information about the importance of asthma follow-up care with a PCP and helped parents identify and address barriers to follow-up. Additionally, parents received a monetary incentive for attending follow-up care appointment after ED visit. | Parent | Asthma coach | Attending asthma planning visit with PCP. | No change |
Sockrider et al. 2006 [89] | Education + Enablement + Environmental Restructuring | Asthma coaches utilized a computer-based resource that provided a customized written asthma action plan that was provided to parents and sent to their PCP. Asthma coaches conducted follow-up calls with parents to ensure follow-up with their PCP and to reinforce messages from the asthma plan. A phone line was also provided so parents could call with asthma management questions. | Health care provider and parent | Clinicians, respiratory care practitioners, and a layperson | Parent confidence managing asthma and reducing ED visits. | + |
4 Intervention functions | ||||||
Asarnow et al. 2011 [92] | Education + Environmental Restructuring + Restriction + Training | Family members received education and training about the importance of mental health, outpatient treatment, how to provide support and ways to remove access to potential lethal means in the house. Patients and family members also received therapy sessions, including how to identify potential triggers and how to develop safe and healthier coping mechanisms for potential future suicidal thoughts. | Patient and parent | Clinicians | Rates of follow up outpatient treatment after ED discharge. | + |