Critical illness in a child is a challenging experience for all involved.  Patients are generally admitted to a specialized pediatric intensive care unit (PICU) for their care.  Prior to discharge patients are commonly transferred to an acute care ward where care can be coordinated and the transition to outpatient care can be initiated.  However sometimes patients are discharged directly to home from the PICU (DDH – direct discharge home) and bypass the acute care ward. This can be for a variety of reasons.