Using Nurse led Integrated Team Electronic Discharges (IT-EDs approach) for children with medical complexity: UNITED study

This study aims to include an evidence-based approach with a small 'open label' pilot randomized controlled study (RCT) to establish evidence for IT-EDS (integrated team electronic discharge summary) made by nursing and medical input together in a collaborative environment. The pharmacy team will be able to input medications into the electronic discharge summary and nurses will also liaise with the allied health staff to input the allied health aspects in the discharge summaries. 1) An educational module (IT-EDS module) to teach the nurses on how to make discharge summary will be created. 2) Clinical nurses (CN) / Nurse navigators (NN) in the intervention arm will receive training on the IT-EDS module so that they will be able to contribute to making and keeping the discharge summary document up to date Intervention NN/CN will play an integral role in the discharge process and will be involved in following aspects of clinical care in the patients in intervention arm. a. Clinical nurse will have EDS access and be trained in IT-EDS module b. They will be Involved in making and updating medical discharge summaries; liaising with the medical staff as required. c. Nurses will also Populate Allied health input in IT-EDS d. Pharmacist will update the medications in IT-EDS e. IT-EDS will be validated and signed by the medical team before distribution f. The medical and nursing staff will use the same "Multidisciplinary-IT-EDS document" for discharge education of parents prior to discharge. g. Both nursing and the medical teams will aim to counsel the patients/ carers together before discharge. h. NN/CN will also aim to liaise with GPs post discharge for discharge communication. IT-EDS training: will be provided using the IT-EDS module 2 weeks prior to the start of the trial. The module will enable self-directed training with a competency quiz at the end. Each nurse will be involved in making 5 discharge summaries and receive critical feedback from a general paediatrician involved in hospital wide discharge summaries improvement group. IT-EDS module will include a step by step approach to making discharge summaries and include education to make effective and safe discharge summaries using the Hospital wide online Electronic Discharge Summary platform that is currently used to make the discharge summaries at the Queensland Children's Hospital. Overall duration of intervention is estimated to be around 6 months.