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The purpose of this project was to implement a protocol facilitating discharge from the emergency department (ED) after successful radiologic ileocolic intussusception reduction in a pediatric referral center.METHODS: A multidisciplinary team identified drivers for successful quality improvement including educational brochures, a standardized radiologic report, an observation period in the ER with oral hydration challenges, and follow-up phone calls the day after discharge. Patient outcomes were tracked, and quarterly feedback was provided.RESULTS: Of 80 patients identified over a 24-month period, 34 (42.5%) did not qualify for discharge home due to need for surgical intervention (n = 9), specific radiologic findings (n = 11), need for additional intravenous hydration (n = 4), or other reasons (n = 7). Of 46 patients who qualified for discharge, 30 (65.2%) were successfully sent home from the ED. One patient returned with recurrent symptoms that required repeat enema reduction. Sixteen patients were observed and discharged within 23 hours. Adherence with discharge from the ED improved over time. Discharge from the ED was associated with cost savings and improved net margins at the hospital level for each encounter. CONCLUSIONS:A sustainable multidisciplinary quality improvement project to discharge intussusception patients from the ED after air-contrast enema reduction was successfully integrated in a high-volume referral center through education, standardized radiologic reporting, and protocoled follow-up.Intussusception remains one of the most common causes of intestinal obstruction in young children and infants. Treatment of intussusception has evolved over time from a predominantly operative disease to one managed nonoperatively most of the time with high success with radiologically guided enema reduction. 1 Traditional practice after successful enema reduction of intussusception includes surgical admission for observation to ensure toleration of enteral diet advancement and to monitor for recurrence of intussusception, which occurs in ,10% of patients. 2 Absolute indications for admission in the setting of intussusception include perforation, failed enema reduction, and successful enema reduction with identification of a lead point that would merit semiurgent resection to prevent recurrent obstruction. Relative indications for admission after successful enema reduction of intussusception are poorly defined but include a prolonged prodrome of symptoms, presence of bloody stools, and dehydration. Several institutions

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