Smart Discharges

CICH 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.

Smart Discharges in Children

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. We are currently conducting a pragmatic clinical effectiveness study of the Smart Discharges Program in children aged 6 months to 5 years, across 4 hospitals in Uganda. We expect to have the final results by the end of 2020.

Expanding Smart Discharges to Young Infants

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 the first phase of this project, working with 6 partner health facilities in Uganda, and plan to test the feasibility and effectiveness of our approach in young infants shortly.

Smart Discharges for Mom and Baby

In 2019, the CICH expanded the Smart Discharges Program to include mother-newborn dyads giving birth at healthcare facilities. 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. 

Learn More

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 or contact the project coordinator, Jessica Trawin, at jessica.trawin@cw.bc.ca

Smart Discharges is being supported by Mining4Life, Grand Challenges Canada, and the Thrasher Research Fund.


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