Familial Caregiver and Physician Perceptions of the Family-Physician Interactions During Interfacility Transfers

Rosenthal, Jennifer L.; Li, Su-Ting Terry; Hernandez, Lenore; Alvarez, Michelle E.; Rehm, Roberta S.; Okumura, Megumi J.

doi:10.1542/hpeds.2017-0017

Cited by 15 publications

(14 citation statements)

References 22 publications

(24 reference statements)

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“…Current pediatric emergency transfer consultations involve telephone communication primarily between the physicians. Telemedicine transforms the communication framework by bringing the patient, family, and bedside nurse into the conversation; this may address the issue that families are often uninformed and uninvolved during transfers . We propose encouraging the use of telemedicine for all pediatric emergency transfer consultations by promoting its effectiveness in increasing collaboration and integrating more individuals in the process.…”

Section: Discussionmentioning

confidence: 99%

Acceptability, Usability, and Effectiveness: A Qualitative Study Evaluating a Pediatric Telemedicine Program

Sauers‐Ford

Hamline

Gosdin

et al. 2019

Academic Emergency Medicine

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Background: Pediatric emergency telemedicine consultations have been shown to provide support to community emergency departments treating critically ill pediatric patients. However, despite the recognized value of telemedicine, adoption has been slow. To determine why clinicians frequently do not use telemedicine when it is available for pediatric patients, as well as to learn how to improve telemedicine programs, we conducted a qualitative study using stakeholder interviews.Methods: We conducted a qualitative study using grounded theory methodology, with in-depth interviews of referring and accepting physicians and referring, transport, and transfer center nurses. We analyzed data iteratively and adapted the interview guide based on early interviews. We solicited feedback from the participants on the conceptual model.Results: Sixteen interviews were conducted; all respondents had been involved in a telemedicine consultation at least five times, with some having used telemedicine more than 30 times. Analysis resulted in three themes: 1) recognizing and addressing telemedicine biases are central to gaining buy-in; 2) as technology advances, telemedicine processes need to adapt accordingly; and 3) telemedicine increases collaboration among health care providers and patients/families in the patient care process.Conclusions: To improve patient care through increased use of telemedicine for pediatric emergency consultations, processes need to be modified to address provider biases and end-user concerns. Processes should be adapted to allow users to utilize a variety of technologies (including smartphones) and to enable more users, such as nurses, to participate. Finally, telemedicine can be used to improve the patient and family experience by including them in consultations.

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Section: Discussionmentioning

confidence: 99%

Acceptability, Usability, and Effectiveness: A Qualitative Study Evaluating a Pediatric Telemedicine Program

Sauers‐Ford

Hamline

Gosdin

et al. 2019

Academic Emergency Medicine

Self Cite

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“…Communication between providers and various aspects of the health care system was also identified as a significant barrier in our cohort. In a qualitative study of inter-facility transfers, parents of Children with Special Healthcare Needs felt that communication from physicians could be significantly improved [34]. Key community stakeholders caring for Children with Special Healthcare Needs in Arizona similarly identified communication and family education as vital for improving care coordination [35].…”

Section: Discussionmentioning

confidence: 99%

Caregiver-Reported Outcomes and Barriers to Care among Patients with Cleft Lip and Palate

Bennett

Ranganathan

Patterson

et al. 2018

Plastic &Amp; Reconstructive Surgery

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Background For children with cleft lip and/or palate (CLCP), access to care is vital for optimizing speech, appearance, and psychosocial outcomes. The authors posited that that inadequate access to care negatively impacts outcomes in the CLCP population. Methods Sixty caregivers of children with CLCP were surveyed to assess perceived barriers using the validated Barriers to Care questionnaire (BCQ). The BCQ includes 39 items divided into five subscales, with higher scores indicating fewer barriers. Caregiver reported outcomes (CROs) were assessed using the Cleft Evaluation Profile (CEP), which captures CLCP specific appearance- and speech-related outcomes. Higher scores correspond to less satisfactory outcomes. Desire for revision surgery was assessed as a binary outcome amongst caregivers. Multivariable regression was used to evaluate the relationship between barriers to care, CROs, and desire for revision, adjusting for clinical and demographic covariates. Results 60% of caregivers perceived barriers to care, and caregivers who reported poorer access to care described poorer cleft-related outcomes (r2=0.19, p=0.024). Caregivers with poorer Skills (r2=0.17, p=0.037), Expectations (r2=0.17, p=0.045), and Pragmatics (r2=0.18, p=0.026) subscale scores were associated with lower CEP scores. Barriers were also negatively associated with aesthetic item scores (r2=0.11, p=0.025). Finally, caregivers reporting fewer barriers were 21.2% less likely to express interest in revision surgery. Conclusions Barriers to care were associated with poorer appearance-related outcomes and increased interest in revision among caregivers of patients with CLCP. Enhancing access to care is critical in order to effectively meet goals of care for these families.

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“…An important component of the dialog involving the patient's loved ones is to establish good rapport and an open conversation between the receiving facility and the family who may not be familiar with the staff and/or capabilities of the destination hospital. It also allows both the transferring and receiving facility to better understand family expectations (e.g., goals of care) and to establish an effective platform for any follow-up inquiries [45]. The additional allocation of time and effort that is devoted to informing the patient's loved ones far outweighs the risk of any associated delays [46].…”

Section: Poet-pcmentioning

confidence: 99%

Interhospital Transfers: Managing Competing Priorities while Ensuring Patient Safety

Luster¹,

Yanagawa²,

Bendas³

et al. 2018

Vignettes in Patient Safety - Volume 2

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Interhospital patient transfers (IPTs) are highly complex logistical undertakings, involving a multitude of interdependent procedures, critical steps and a degree of unpredictability. Beginning with interfacility communication and patient acceptance agreement, a cascade of numerous handoffs takes place, ultimately culminating in safe arrival of the patient at the receiving facility. Due to the complexity of the IPT process, significant potential for critical errors and adverse patient safety (PS) outcomes exists. To minimize any associated risks, key PS considerations include checklists, handoffs, vehicle/aircraft safety, distance of travel, crew training, team factors, and many other critical components. Detailed knowledge of factors that may influence the risk of errors or adverse events is critical to optimizing both PS and clinical outcomes.

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Familial Caregiver and Physician Perceptions of the Family-Physician Interactions During Interfacility Transfers

Cited by 15 publications

References 22 publications

Acceptability, Usability, and Effectiveness: A Qualitative Study Evaluating a Pediatric Telemedicine Program

Acceptability, Usability, and Effectiveness: A Qualitative Study Evaluating a Pediatric Telemedicine Program

Caregiver-Reported Outcomes and Barriers to Care among Patients with Cleft Lip and Palate

Interhospital Transfers: Managing Competing Priorities while Ensuring Patient Safety

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