FAAN-C Trial- A look at Hospital Discharge Follow up
At the time of hospital discharge, automatic follow-up is often a hospitalist’s default recommendation. That is, families are instructed to automatically attend a follow-up visit with the child’s primary care provider shortly after discharge, even if the child recovers from their illness in the meantime. The alternative strategy is PRN (pro re nata, “as-needed”) follow-up, a patient and family-centered approach that empowers parents to monitor their child’s symptoms after discharge and decide if a follow-up visit is necessary. Post-hospitalization follow-up visits are time consuming and often result in missed work for parents, missed school for children, and expenses like co-pays and transportation costs. These burdens disproportionately affect racial/ethnic minority and lower income families. For this reason, greater understanding of the relative merits of automatic vs PRN follow-up is needed.
The Follow-up Automatically vs As-Needed Comparison (FAAN-C, or “fancy”) trial will compare the effectiveness of automatic vs PRN follow-up, among otherwise healthy children hospitalized for pneumonia, skin and soft tissue infection, UTI, or gastroenteritis. The primary outcome for the trial is all-cause hospital readmission within 14 days of hospital discharge. Secondary outcomes include patient and family-centered outcomes (e.g., child missed school, parent missed work, and parent anxiety) and other healthcare utilization outcomes (e.g., ambulatory healthcare visits and medical testing). FAAN-C is funded by the Patient Centered Outcomes Research Institute.
Ten hospitals are participating in FAAN-C, including the Burnet and Liberty campuses of Cincinnati Children's Hospital Medical Center. Eric Coon at Primary Children’s in Utah leads the study. Questions about the study here in Cincinnati can be directed to Pat Brady (Patrick.brady@cchmc.org), Samir Shah (samir.shah@cchmc.org), or Mary Carol Burkhardt (mary.burkhardt@ccchc.org).