Table 2.

Description of intervention studies (n = 44)

Author, publication year	Intervention type	Description of intervention	Intervention target	Who delivered intervention	Description of primary outcome	Direction of effect
1 Intervention function
Baker et al. 2009 [64]	Education	Parents watched a video (11 min) about how to manage child’s fever at home.	Parent	Research team	Reducing return ED visits.	+
Bloch and Bloch 2013 [67]	Education	Parents watched a video (3 min) regarding their child’s illness in addition to standard discharge communication. Parents were provided the opportunity to ask clarifying questions to a clinician prior to leaving the ED.	Parent	Medical student volunteers	Parent comprehension of treatment plan and follow-up information.	+
Boychuk et al. 2006 [70]	Education	Parents watched a video (6 min) outlining asthma and asthma management techniques, in addition to conversations with ED staff about the importance of asthma management and treatment, a review or written or verbal instructions, and a demonstration of how asthma affects the lungs. Health care providers also received asthma education.	Patient, parent, and health care provider	Research team, and physicians	Improving asthma management through written action plans and medications.	+
Brooks et al. 2017 [90]	Education	Parents received written discharge instructions specific to their child’s concussion level and symptoms they experienced.	Parent	Research team	Use of discharge instructions.	+
Chande et al. 1996 [69]	Education	Parents watched a video (10 min) and received an information booklet on pediatric illnesses. A research assistant reviewed the booklet with parents and answered parent questions.	Parent	Research team	Reducing return ED visits.	–
Cheng et al. 2002 [22]	Education	Caregivers received education about asthma and a demonstration of an appropriate MDIS technique during the ED visit.	Parent	Discharge facilitator and ED clinicians	Improving rates of MDIS use.	+
Considine and Brennan 2007 [78]	Education	Nurses in the ED attended two tutorials that reviewed the physiology and treatment of fevers to improve the content of discharge communication provided to parents.	Health care provider	Online tutorial	Information caregivers received about fever as part of their discharge instructions.	+
Delp and Jones 1996 [60]	Education	Parents received cartoon wound care instructions in addition to standard written instructions.	Patient and parent	Physicians	Patient compliance with ED discharge instructions.	+
Hanson et al. 2017 [29]	Education	Patients and parents received cartoon pain management information.	Patient and parent	Research team	Parent recall of information provided in the cartoon.	+
Hart et al. 2015 [72]	Education	Parents received one of two interventions. One intervention group received access to a standard fever education website. The second intervention group received accessed to an interactive fever education website.	Parent	Research team	Parent knowledge of fever.	+ for both interventions
Hussain-Rizvi et al. 2009 [81]	Modeling	Physician demonstrated for the parent how to use of the albuterol MDIS. The parent then provided the treatment while under observation.	Parent	Physicians	Adherence to MDIS use at home following ED discharge.	+
Gaucher et al. 2011 [28]	Education	Parents who notified the triage nurse they were leaving without being seen by a physician received information about their child’s illness and when to seek additional care and return to ED	Parent	Triage nurse	Rates of return ED visits within 48 h of the initial visit.	+
Isaacman et al. 1992 [74]	Education	Parents whose child presented with otitis media received one of two interventions. One intervention group received verbal instructions. The second intervention group received the same verbal instructions in addition to a written copy of discharge communication.	Parent	Residents and medical students	Parent recall of medications and signs to monitor at home.	+ for both interventions
Ismail et al. 2016 [68]	Education	Parents watched a video (3–5 min) about fever or closed head injury in addition to standard verbal discharge communication. Parents were also given the opportunity to ask questions to clinicians prior to leaving ED.	Parent	Clinicians	Parent comprehension of diagnosis and follow-up care.	+
Kaestli et al. 2015 [55]	Education	Parents received written information regarding drug dosing, indication, and frequency of administration.	Parent	Research team	Improving comprehension of prescribed drug usage.	+
LeMay et al. 2010 [73]	Education	Parents received a booklet about pain management and a bookmark printed with pain scale information in addition to standard care.	Parent	Research team	Children’s pain and parents’ perceptions of pain management 24 h following ED visit.	No change
Macy et al. 2011 [65]	Education	Parents watched a video (20 min) about an asthma management.	Parent	Health care providers and research assistants	Parent knowledge of asthma information provided during ED visit.	+
Patel et al. 2009 [76]	Education	Parents received verbal reinforcement of discharge communication from a discharge facilitator in addition to standard written information.	Parent	Discharge facilitator	Parent recall of discharge instructions.	+
Petersen et al. 1999 [77]	Education	Parents received personalized written asthma information about signs of asthma attack, medication doses, and following up with a PCP within 72 h of the ED visit.	Parent	Respiratory care providers and clinicians	Compliance with attending follow-up appointment and length of time before appointment was made.	No change
Porter et al. 2006 [80]	Environmental Restructuring	Parents used an interactive asthma kiosk to document asthma symptoms and care needs. Information generated from the kiosk was shared with ED clinicians through a reminder summary on chart.	Parent and health care provider	Research team and clinicians	Parent satisfaction with care and providers’ adoption of guideline-endorsed process measures.	No change
Stevens et al. 2012 [66]	Education	Parents watched a video (6 min) that provided information about common myths and misunderstandings surrounding home management of pain.	Parent	Research team	Parent use of pain management information provided at the ED following discharge.	+
Thomas et al. 2017 [47]	Education	Parents received verbal reinforcement of written discharge instructions.	Parent	Research team	Parent understanding of discharge instructions.	+
To et al. 2010 [79]	Environmental Restructuring	Health care providers received an evidence-based asthma guideline reminder card.	Health care provider	Research team	Changes to asthma medication, asthma education, and discharge planning provided to families in the ED.	+/ No change/ No change
Waisman et al. 2005 [50]	Education	Parents received a written information sheet regarding their child’s illness.	Parent	Physicians	Parent understanding of discharge instructions.	+
Williams et al. 2013 [75]	Education	Parents received an illustrated scale and were educated about their child’s asthma severity score along with standard discharge communication.	Parent	Research team and ED clinical providers	Parent compliance with scheduling follow-up care.	+
Wood et al. 2017 [71]	Education	Parents watched a video (3–5 min) specific to their child’s illness, in addition to standard verbal discharge communication and a written information sheet.	Parent	ED nurses from an evidence-based practice project	Parent comprehension of their child’s illness and treatment.	+
Zorc et al. 2003 [82]	Enablement	Researchers with the study brought parents to a phone in an attempt to get them to schedule follow-up care with their PCP.	Parent	Research team	Parent follow-up with PCP and improvements in asthma-related health outcomes and medication use.	+
2 Intervention functions
Cushman et al. 1991 [86]	Education + Enablement	Physicians received a cue card with information to counsel parents on helmet use. Parents were provided with pamphlets and a card with the names and addresses of retailers selling helmets to take home to encourage the use and purchase of helmets. Follow-up phone calls were made to check if helmets had been purchased and to provide additional counseling, if needed.	Parent	Physicians	Measuring the purchase and use of bicycle helmets.	No change
Jones et al. 1989 [84]	Education + Enablement	Parents received one of three interventions. Group 1 received standard care in addition to a follow up telephone call. Group 2 received counseling during the ED visit with no follow-up call. Group 3 received both counseling in the ED and a follow-up call.	Parent	Research nurse and clinical nurse	Compliance with scheduling and attending a follow-up appointment based on a referral recommendation.	+
Kruesi et al. 1999 [87]	Education + Environmental Restructuring	Parents were informed of their child’s increased risk of suicide. Staff also educated and problem solved with parents to try and reduce suicide risk by limiting access to lethal means. Additionally, a safe disposal site was created for parents to encourage the removal of guns from the house.	Parent	ED staff	Reducing access to lethal means.	+
O’Neill-Murphy et al. 2001 [88]	Education + Modeling	Parents received a review of written fever information, had a discussion to have their questions answered, and received instructions and a demonstration of proper thermometer use.	Parent	Research team	Parent anxiety and rate of return ED visits for fever.	+
Pizarro et al. 1979 [39]	Education + Enablement	Following administration of oral rehydration fluid at the hospital, parents were sent home with the oral rehydration solution and were instructed of signs to monitor that would require a return visit to the ED.	Parent	ED nurses and interns	Reducing hospital length of stay.	+
Philips 2009 [38]	Education + Environmental Restructuring	Parents received asthma education packages, asthma discharge plans, and were provided with a spacer if their child did not have one.	Parent	ED staff	Improving parent’s treatment and home management of asthma.	+
Sauer et al. 2012 [45]	Education + Environmental Restructuring	Parents received written discharge information and access to a telephone hotline to assist with scheduling follow-up care in orthopedics.	Parent	Physicians	Reducing rates of ED use.	+
Scarfi et al. 2009 [83]	Education + Environmental Restructuring	Children in the intervention group received a skin allergen to determine allergens that could be linked to an asthma episode. Parents were provided with a copy of the allergen test to encourage follow-up care.	Patient and parent	Clinicians and administrator of the skin allergen test	Attending follow-up appointment.	+
Yin et al. 2008 [63]	Education + Enablement	Parents received illustrated resources about proper dosing of liquid medication. A research assistant reviewed resources with parents and had parent demonstrate how they would administer a medication dose.	Parent	Research team	Parent knowledge of medication dosing accuracy.	+
Zorc et al. 2009 [82]	Education + Environmental Restructuring	Parents watched a video and were mailed a letter to schedule follow-up care for their child’s asthma. Parents of children with persistent asthma also received an additional letter to encourage follow-up with a PCP.	Parent	Research team	Parent compliance with scheduling and attending follow-up appointment.	No change
Komoroski et al. 1996 [93]	Incentivization + Environmental Restructuring	Parents received one of two interventions. The first intervention group had their follow-up appointment booked for them and received a written reminder. The second intervention group received the same intervention as the first group with the addition of a mailed reminder one week prior to the appointment, a reminder phone call the day before the appointment, a work excuse, assistance with transportation to and from the appointment, and receiving child care.	Parent	Research team	Parent compliance with attending follow-up appointment.	+
3 Intervention functions
Ducharme et al. 2011 [61]	Education + Enablement + Environmental Restructuring	Parents received a structured written action plan with information about asthma management, treatment, in addition to an asthma assessment tool and a prescription. A valved spacer and MDIS were also provided for children. Surveys and/or telephone calls were completed to determine parents’ completion of educational classes, follow-up visits with PCP and number of return visits to the ED.	Parent	ED physicians and pharmacists	Adherence to prescribed asthma medications four weeks following ED discharge.	+
Gorelick et al. 2006 [62]	Education + Enablement + Environmental Restructuring	Parents received one of two interventions. Group one received standardized information in addition to having information faxed to their PCP, and phone calls to offer assistance scheduling the follow-up care with PCP. The second group received the same care as intervention group one, in addition to being assigned a nurse or social worker to provide home visits, and additional education and links to community services.	Parent	Research team and home health care staff	Rates of return ED visits six months following initial ED asthma visit.	No change
Rotheram-Borus et al. 2000 [91]	Enablement + Training + Modeling	ED staff and health care providers received additional training surrounding mental health. Patients and parents were shown a video (20 min) in the ED about mental health treatments. Patients and parents also received therapy sessions, including identifying positive coping mechanisms, and outpatient treatments. Outpatient treatments included additional therapy sessions to use problem solving and roleplaying techniques to assist with family issues and future suicidal feelings.	Patient, parent and health care provider	Research team, ED staff and clinicians	Reducing suicidal behavior.	+
Smith et al. 2006 [90]	Enablement + Training + Incentivization	An asthma coach worked with parents to assist with their asthma concerns. Coaches also provided information about the importance of asthma follow-up care with a PCP and helped parents identify and address barriers to follow-up. Additionally, parents received a monetary incentive for attending follow-up care appointment after ED visit.	Parent	Asthma coach	Attending asthma planning visit with PCP.	No change
Sockrider et al. 2006 [89]	Education + Enablement + Environmental Restructuring	Asthma coaches utilized a computer-based resource that provided a customized written asthma action plan that was provided to parents and sent to their PCP. Asthma coaches conducted follow-up calls with parents to ensure follow-up with their PCP and to reinforce messages from the asthma plan. A phone line was also provided so parents could call with asthma management questions.	Health care provider and parent	Clinicians, respiratory care practitioners, and a layperson	Parent confidence managing asthma and reducing ED visits.	+
4 Intervention functions
Asarnow et al. 2011 [92]	Education + Environmental Restructuring + Restriction + Training	Family members received education and training about the importance of mental health, outpatient treatment, how to provide support and ways to remove access to potential lethal means in the house. Patients and family members also received therapy sessions, including how to identify potential triggers and how to develop safe and healthier coping mechanisms for potential future suicidal thoughts.	Patient and parent	Clinicians	Rates of follow up outpatient treatment after ED discharge.	+

ED emergency department, MDIS metered-dose inhaler spacers, PCP primary care provider