Family participation during intensive care unit rounds: attitudes and experiences of parents and healthcare providers in a tertiary pediatric intensive care unit. (Petrillo)

Stickney CA, Ziniel SI, Brett MS, Truog RD. Family participation during intensive care unit rounds: attitudes and experiences of parents and healthcare providers in a tertiary pediatric intensive care unit. J Pediatr. 2013 Nov 8.

OBJECTIVE: To compare the experiences and attitudes of healthcare providers and parents regarding parental participation in morning rounds, in particular to evaluate for differences in perception of parental comprehension of rounds content and parental comfort with attendance, and to identify subgroups of parents who are more likely to report comfort with attending rounds.

STUDY DESIGN: Cross-sectional survey of 100 parents and 131 healthcare providers in a tertiary care pediatric medical/surgical intensive care unit. Descriptive statistics were used to analyze survey responses; univariate and multivariate analyses were performed to compare parent and healthcare provider responses.

RESULTS: Of parents, 92% reported a desire to attend rounds, and 54% of healthcare providers reported a preference for parental presence. There were significant discrepancies in perception of understanding between the 2 groups, with healthcare providers much less likely to perceive that parents understood both the format (30% vs 73%, P < .001) and content (21% vs 84%, P < .001) of rounds compared with parents. Analysis of parent surveys did not reveal characteristics correlated with increased comfort or desire to attend rounds.

CONCLUSIONS: A majority of parents wish to participate in morning rounds, whereas healthcare provider opinions are mixed. Important discrepancies exist between parent and healthcare provider perceptions of parental comfort and comprehension on rounds, which may be important in facilitating parental presence.

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Change in Adoption of Electronic Health Records by US Children’s Hospitals. (Vats)

Pediatrics. 2013, 131: e1563-1575. Apr 15. PMID: 23589808

OBJECTIVES: To assess electronic health record (EHR) adoption and meaningful use among US children’s hospitals through 2011 and compare these outcomes with adult hospitals and among subgroups of children’s hospitals. We hypothesized that children’s hospitals would show progress since our initial evaluation of health information technology (HIT) implementation in 2008.

METHODS: We identified children’s hospitals using the membership directory of the Children’s Hospital Association and analyzed their responses from 2008 to 2011 to the American Hospital Association’s annual HIT survey. EHR adoption rates were determined by using previously specified definitions of the essential functionalities comprising an EHR. Achievement of meaningful use was evaluated based on hospitals’ ability to fulfill 12 core meaningful use criteria. We compared these outcomes in 2011 between children’s and adult hospitals and among subgroups of children’s hospitals. 

RESULTS: Of 162 children’s hospitals, 126 (78%) responded to the survey in 2011. The proportion of children’s hospitals with an EHR increased from 21% (in 2008) to 59% (in 2011). In 2011, 29% of children’s hospitals met the 12 core criteria in our meaningful use proxy measure. EHR adoption rates and meaningful use were significantly higher for children’s hospitals than for adult hospitals as a whole but similar for children’s and adult major teaching hospitals. Among children’s hospitals, major teaching hospitals were significantly more likely to have an EHR.

CONCLUSIONS: Children’s hospitals have achieved substantial gains in HIT implementation although minor teaching and nonteaching institutions are not keeping pace.

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