Natasha Parekh
Name
EmpowerED: A Multidisciplinary Parent and Carer Toolkit to Support Parental Home Meal Supervision Following Hospitalisation for Adolescents with Anorexia Nervosa
Description

Adolescents with anorexia nervosa (AN) experience high rates of early hospital readmission, with reported rates of up to 40% within 28 days of discharge. The period between hospital discharge and engagement with community-based treatment is associated with increased risk of readmission. Parents and carers frequently report feeling underprepared to supervise meals, manage distress, and support recovery during this transition. To address this gap, a multidisciplinary team at Monash Children’s Hospital developed the Parent and Carer Toolkit (PACT) through the Safer Care Victoria(SCV) and Institute for Healthcare Improvement Health(IHI) Innovators Programme. PACT was designed to strengthen parent and carer capability during this at-risk period. Methods: Guided by the IHI Improvement 90-Day Innovation Model and Model for Improvement methodology, PACT was developed through literature review, stakeholder consultation, and iterative co-design. Content and format were informed by a multidisciplinary team comprising doctors, dietitians, mental health clinicians, teachers, quality improvement specialists, and feedback from families. A structured paper-based toolkit was developed containing dietetic information, meal supervision guidance, distress management strategies, discharge planning resources, reflective activities, and practical tools for home use. Multiple Plan-Do-Study-Act cycles were undertaken to refine content, usability, and visual design. Evaluation included parent questionnaires at one week and one-month post-discharge, qualitative feedback on toolkit usage, and monitoring of readmission rates. Results: The toolkit was piloted with five families over a three-month period. Feedback informed iterative refinements, including simplified meal supervision guides, development of a “What to Expect After Discharge” resource, and enhancements to visual design. Qualitative feedback found that one week following discharge, 89% of respondents reported using the toolkit, with many accessing it daily. All respondents used the meal supervision guidance and reported confidence in meal supervision, while 87.5% referred to the dietetic information and 75% shared the resource with their community treatment team. At one month, 82% of respondents continued to use the toolkit, most commonly accessing meal supervision strategies, dietary information, and the “What to Expect After Discharge” guide. Early readmission rates decreased from 23.3% to 13.6%, representing an estimated reduction of 125 bed days annually. Conclusion: PACT highlights how multidisciplinary collaboration is used to develop an educational resource that strengthens parent and carer capability during the transition from hospital to community care. Preliminary findings suggest sustained engagement with educational content, improved confidence in meal supervision, and reduced readmissions. Further research and co-design with families is recommended to refine and scale the intervention for broader implementation.