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. 2017 Sep;7(9):505-515.
doi: 10.1542/hpeds.2016-0190. Epub 2017 Aug 2.

Parent-Provider Miscommunications in Hospitalized Children

Alisa Khan  1   2 , Stephannie L Furtak  3 , Patrice Melvin  4 , Jayne E Rogers  5 , Mark A Schuster  3   2 , Christopher P Landrigan  3   2   6
Affiliations

Parent-Provider Miscommunications in Hospitalized Children

Alisa Khan et al. Hosp Pediatr. 2017 Sep.

Abstract

Background: Miscommunications lead to medical errors and suboptimal hospital experience. Parent-provider miscommunications are understudied.

Objectives: (1) Examine characteristics of parent-provider miscommunications about hospitalized children, (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience, and (3) compare parent and attending physician reports of parent-provider miscommunications.

Methods: Prospective cohort study of 471 parents of 0- to 17-year-old medical inpatients in a pediatric hospital between May 1, 2013 and October 1, 2014. At discharge, parents reported parent-provider miscommunication and type (selecting all applicable responses), overall experience, and errors during hospitalization. During discharge billing, the attending physicians (n = 52) of a subset of patients (n = 217) also reported miscommunications, enabling comparison of parent and attending physician reports. We used logistic regression to examine characteristics of parent-reported miscommunications; McNemar's test to examine associations between miscommunications, errors, and top-box (eg, "excellent") experience; and generalized estimating equations to compare parent- and attending physician-reported miscommunication rates.

Results: Parents completed 406 surveys (86.2% response rate). 15.3% of parents (n = 62) reported miscommunications. Parents of patients with nonpublic insurance (odds ratio: 1.99; 95% confidence interval: 1.03-3.85) and longer lengths of stay (odds ratio: 1.12; 95% confidence interval: 1.02-1.23) more commonly reported miscommunications. Parents reporting miscommunications were 5.3 times more likely to report errors and 78.6% less likely to report top-box overall experience (P < .001 for both). Among patients with both parent and attending physician surveys, 16.1% (n = 35) of parents and 3.7% (n = 8) of attending physicians reported miscommunications (P < .001). Both parents and attending physicians attributed miscommunications most often to family receipt of conflicting information.

Conclusions: Parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Landrigan has consulted with and holds equity in the I-PASS Institute, which seeks to train institutions in best handoff practices and aid in their implementation. Dr Landrigan has also served as a paid consultant to Virgin Pulse to help develop a Sleep and Health Program. He is supported in part by the Children’s Hospital Association for his work as an Executive Council member of the Pediatric Research in Inpatient Settings (PRIS) network. In addition, Dr Landrigan has received monetary awards, honoraria, and travel reimbursement from multiple academic and professional organizations for teaching and consulting on sleep deprivation, physician performance, handoffs, and safety, and has served as an expert witness in cases regarding patient safety and sleep deprivation; the other authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Cohort diagram. General pediatric and short-stay attending physicians reported communication problems as part of a series of quality questions completed at the time of discharge billing. aSubspecialty attending physicians were not asked these questions and thus did not contribute data for the paired parent-attending physician analysis. bPatients with attending physician survey data (linked to billing codes) missing. For example, because of incorrect billing code or coverage by private attending physician.
FIGURE 2
FIGURE 2
Parent- and attending physician-reported miscommunications by type. Proportions and types of miscommunications reported by parents (n = 35) and by attending physicians (n = 8) among a subset of patients (n = 217) with paired parent and attending physician data are represented.
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References

    1. The Joint Commission Online. Sentinel event statistics released for 2014. Available at: www.jointcommission.org/assets/1/23/jconline_April_29_15.pdf. Accessed January 3, 2017.
    1. Starmer AJ, Spector ND, Srivastava R, et al. I-PASS Study Group Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371(19):1803–1812. - PubMed
    1. Horwitz LI, Moin T, Krumholz HM, Wang L, Bradley EH. Consequences of inadequate sign-out for patient care. Arch Intern Med. 2008;168(16):1755–1760. - PubMed
    1. Arora V, Johnson J, Lovinger D, Humphrey HJ, Meltzer DO. Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis. Qual Saf Health Care. 2005;14(6):401–407. - PMC - PubMed
    1. Venkatesh AK, Curley D, Chang Y, Liu SW. Communication of vital signs at emergency department handoff: opportunities for improvement. Ann Emerg Med. 2015;66(2):125–130. - PubMed

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