Study Summary

Children with medical complexity can face difficulties after hospital discharge. For example, it is common for problems to arise with medications after returning home. You may also find it hard to know who to call when these problems do arise — the hospital or your primary care provider.

In this study (called GET2HOME), we plan to enroll about 600 families. Half of the families will continue to receive the standard of care that families currently receive, and half the families will receive the intervention.

The intervention includes 3 steps:

  1. A pre-discharge telehealth visit allows families to speak to everyone involved in their care before they leave the hospital. Both the hospital doctors and your outpatient doctors will be there.

  2. A discharge task tracker which allows families in the hospital to know which tasks are done and which still need to be completed before discharge.

  3. A post-discharge telehealth visit, with the hospital doctor and outpatient doctor, that allows you to reconnect a few days after you leave the hospital.

To measure if the intervention works, all families will be contacted about 7 days, 30 days, 60 days, and 90 days after you leave the hospital. We will ask questions on how hospital discharge went and how life is returning to baseline/normal.