582 Bridging the Gap Between Inpatient and Outpatient Burn Care Compliance: Incentive Programs for Pediatric Burn Patients

Abstract

Abstract Introduction As healthcare advances, treatment options are expanding to allow patients to be cared for in outpatient settings. To ensure quality of treatment is maintained, efforts must be made to translate resources offered during inpatient stays to the outpatient population. This is especially important for pediatric burn patients and their families whose treatment plan is contingent on maintaining critical aspects of care provided during the course of an admission. Optimal outcomes are dependent on patients complying with physical/occupational therapy activities, meeting increased nutritional standards, and performing daily dressing changes. Methods Incentive programs have traditionally been effective during hospital stays by rewarding children upon completion of difficult tasks, which encourages participation and provides a sense of control. In order to meet the needs of our patient population, a burn specific incentive program named “Burn Bucks” was developed with the intent to establish early patient engagement and goal setting. This program allows for a successful transition from inpatient to the home setting. Patients identify their most difficult healthcare goals and a dollar amount is assigned to that goal. Throughout their stay, staff give “bucks” for the completion of goals. As patients progress, goals are updated. Patients may use Burn Bucks earned to shop in the “Burn Bucks Store.” In preparation for discharge, home care goals are set for patients. Upon return to clinic, patients may shop in the Burn Bucks Store at the end of each appointment. Results Patients who participated in the Burn Bucks program returned as outpatients less fearful of the treatment room and more motivated to take an active role in their therapies. Preliminary data shows those who use burn bucks in the home setting are more likely to meet or surpass treatment goals. Additionally, parents and staff report increased participation as well as an improved overall demeanor by children who participate in the Burn Bucks program. Conclusions The Burn Bucks program has proven to be a successful tool to engage patients and families in their treatment plan. Early introduction during inpatient stays encourages participants to continue using Burn Bucks in the home setting. We continue to find ways to adapt the structure of the program to support various age groups and abilities, enhance coping, and individualize incentives to achieve optimal outcomes. Applicability of Research to Practice The success this program has brought to our patient population has prompted other teams within our hospital to adopt the Burn Bucks program to accommodate a variety of treatment plans. The ability for this particular incentive program to adapt to various treatment goals contributes to its consistent success. The principles of this program can be easily implemented in burn centers of any size.