# Bridging hospital to home for children with medical complexity and their families: an observational prospective cohort study protocol to assess the effectiveness of an innovative transitional care unit in the Netherlands (BRIDGE study)

## TL;DR

This study evaluates a transitional care unit to help children with complex medical needs and their families transition from hospital to home more effectively.

## Contribution

The study introduces and evaluates a novel transitional care unit designed to improve outcomes for children with medical complexities and their families.

## Key findings

- The study will compare healthcare consumption and outcomes between children transitioning via a TCU and those transitioning directly from hospital to home.
- Bayesian inverse probability weighting will be used to account for confounding factors in the analysis.
- Results will inform the development of a national care pathway for children with medical complexities in the Netherlands.

## Abstract

Children with Medical Complexities (CMC) often require 24/7 expert care, which frequently necessitates prolonged (re)admissions to a university medical centre (UMC), thereby impeding discharge to home. The transition from hospital to home for CMC is a multifaceted process with numerous challenges and obstacles. This protocol describes the evaluation of an innovative transitional care unit (TCU), where families can stay together in a home-like environment between hospital and home. Under the supervision of healthcare professionals, parents are supported in preparing for a sustainable home situation. We hypothesise that an intermediate stay at the Jeroen Pit Huis (JPH) will have a favourable effect on healthcare consumption, patient, parent and family-relevant outcomes in comparison to discharge directly from a hospital ward to home. Therefore, the purpose of this study is to compare the transition via the TCU JPH versus transition from hospital ward to home as provided elsewhere for CMC patients in the Netherlands.

This observational prospective cohort study compares patients who transition directly from hospital to home with those who transition via the TCU. The control group comprises five UMCs in the Netherlands. Data will be collected by extracting information from electronic health records and through online questionnaires. Parents complete questionnaires at three time points: on discharge home, 3 months and 12 months postdischarge. Bayesian inverse probability weighting will be used to control for confounding effects and analyse the results.

Ethical approval was granted by the Amsterdam UMC Medical Ethics Committee (W20_220#20.007). The need for ethical approval was waived by all other participating UMCs. Results will be disseminated through peer-reviewed scientific journals and conference presentations. The insights gained from this study will contribute to the development of a national care pathway to enhance transitional care for CMC and their families in the future.

NCT06599398 (ClinicalTrials.gov) - Bridging Hospital to Home for CMC and Their Families.