Supplement to Hospital to Home Outcomes

Supplement to Hospital to Home Outcomes (H2O): A Study to Improve the Fluidity of Transitions Between Hospital and Home

Post-discharge nurse phone call

Previous work has identified barriers to successful transitions that are most meaningful to patients and families. Investigators used these learnings to iteratively adapt an existing nurse home visit program to address these barriers, and have been studying the effectiveness of the redesigned nurse home visit in a randomized control trial (NCT02081846).

Inclusion Criteria:

• Patient is under 18 years of age
• Patient is admitted to Cincinnati Children's Hospital Medical Center to hospital medicine, ,community pediatrics, or adolescent medicine.

Exclusion Criteria:

• Patient to be discharged someplace other than home (e.g., residential facility, psychiatric facility)
• Patient's home residence is outside the home nursing service area
• Patient is eligible for "traditional" home nursing services
• Caregiver is non-English speaking