Closing the loop in pediatric emergency care: A narrative review of best practice for providing discharge instructions to caregivers in the emergency department

Over 87% of children who visit Canadian emergency departments are discharged back to their home. Following discharge, many caregivers are unable to list their child's diagnosis, recount the name and purpose of medications they received, outline the recommended post emergency department care or know when to return to seek medical advice. The current lack of standards and variation in practice regarding discharge instruction in emergency departments pose a quality and safety risk for children and caregivers.The aim of this synthesis is to better understand how and why discharge instructions work in the context of pediatric emergency care. We will conduct a narrative review to describe the types of interventions and strategies that are recommended in the literature for the delivery of discharge instruction and examine the policies that currently guide development of discharge instructions in Canadian emergency departments. This work will result in the development of national recommendations for best practice regarding discharge instructions in Canadian emergency departments.