Michelle M Kelly1, Catherine Arnott Smith2, Peter L T Hoonakker3, Carrie L Nacht4, Shannon M Dean5, Daniel J Sklansky4, Windy Smith6, Megan A Moreno4, Anne S Thurber4, Ryan J Coller4. 1. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (MM Kelly, CL Nacht, SM Dean, DJ Sklansky, MA Moreno, AS Thurber, and RJ Coller), Madison, Wis; Center for Quality and Productivity Improvement, University of Wisconsin-Madison (MM Kelly and PLT Hoonakker), Madison, Wis. Electronic address: michelle.kelly@wisc.edu. 2. The Information School, University of Wisconsin-Madison (CA Smith), Madison, Wis. 3. Center for Quality and Productivity Improvement, University of Wisconsin-Madison (MM Kelly and PLT Hoonakker), Madison, Wis. 4. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (MM Kelly, CL Nacht, SM Dean, DJ Sklansky, MA Moreno, AS Thurber, and RJ Coller), Madison, Wis. 5. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (MM Kelly, CL Nacht, SM Dean, DJ Sklansky, MA Moreno, AS Thurber, and RJ Coller), Madison, Wis; UW Hospital and Clinics (SM Dean and W Smith), Madison, Wis. 6. UW Hospital and Clinics (SM Dean and W Smith), Madison, Wis.
Abstract
OBJECTIVE: Elicit stakeholder perspectives on the anticipated benefits and challenges of sharing hospital physicians' admission and daily progress notes with parents at the bedside during their child's hospitalization and identify strategies to aid implementation of inpatient note sharing. METHODS: Five semistructured focus groups were conducted with 34 stakeholders (8 parents, 8 nurses, 5 residents, 7 hospitalists, 6 administrators) at a tertiary children's hospital from October to November 2018 to identify anticipated benefits, challenges, and implementation strategies prior to sharing inpatient physicians' notes. A facilitator guide elicited participants' perspectives about the idea of sharing notes with parents during their child's hospitalization. Three researchers used content analysis to analyze qualitative data inductively. RESULTS: Anticipated benefits of sharing inpatient notes included: Reinforcement of information, improved parental knowledge and empowerment, enhanced parent communication and partnership with providers, and increased provider accountability and documentation quality. Expected challenges included: Increased provider workload, heightened parental confusion, distress or anxiety, impaired parent relationship with providers, and compromised note quality and purpose. Suggested implementation strategies included: Setting staff and parent expectations upfront, providing tools to support parent education, and limiting shared note content and family eligibility. CONCLUSIONS: Stakeholders anticipated multiple benefits and drawbacks of sharing notes with parents during their child's hospital stay and made practical suggestions for ways to implement inpatient note sharing to promote these benefits and mitigate challenges. Findings will inform the design and implementation of an intervention to share notes using an inpatient portal and evaluation of its effect on child, parent, and healthcare team outcomes.
OBJECTIVE: Elicit stakeholder perspectives on the anticipated benefits and challenges of sharing hospital physicians' admission and daily progress notes with parents at the bedside during their child's hospitalization and identify strategies to aid implementation of inpatient note sharing. METHODS: Five semistructured focus groups were conducted with 34 stakeholders (8 parents, 8 nurses, 5 residents, 7 hospitalists, 6 administrators) at a tertiary children's hospital from October to November 2018 to identify anticipated benefits, challenges, and implementation strategies prior to sharing inpatient physicians' notes. A facilitator guide elicited participants' perspectives about the idea of sharing notes with parents during their child's hospitalization. Three researchers used content analysis to analyze qualitative data inductively. RESULTS: Anticipated benefits of sharing inpatient notes included: Reinforcement of information, improved parental knowledge and empowerment, enhanced parent communication and partnership with providers, and increased provider accountability and documentation quality. Expected challenges included: Increased provider workload, heightened parental confusion, distress or anxiety, impaired parent relationship with providers, and compromised note quality and purpose. Suggested implementation strategies included: Setting staff and parent expectations upfront, providing tools to support parent education, and limiting shared note content and family eligibility. CONCLUSIONS: Stakeholders anticipated multiple benefits and drawbacks of sharing notes with parents during their child's hospital stay and made practical suggestions for ways to implement inpatient note sharing to promote these benefits and mitigate challenges. Findings will inform the design and implementation of an intervention to share notes using an inpatient portal and evaluation of its effect on child, parent, and healthcare team outcomes.
Authors: Sarah Collins; Patricia Dykes; David W Bates; Brittany Couture; Ronen Rozenblum; Jennifer Prey; Kristin O'Reilly; Patricia Q Bourie; Cindy Dwyer; S Ryan Greysen; Jeffery Smith; Michael Gropper; Anuj K Dalal Journal: J Am Med Inform Assoc Date: 2018-02-01 Impact factor: 4.497
Authors: Jennifer L Wolff; Jonathan D Darer; Andrea Berger; Deserae Clarke; Jamie A Green; Rebecca A Stametz; Tom Delbanco; Jan Walker Journal: J Am Med Inform Assoc Date: 2017-04-01 Impact factor: 4.497
Authors: Fabienne C Bourgeois; Patrick L Taylor; S Jean Emans; Daniel J Nigrin; Kenneth D Mandl Journal: J Am Med Inform Assoc Date: 2008-08-28 Impact factor: 4.497
Authors: Sarah A Collins; Ronen Rozenblum; Wai Yin Leung; Constance Rc Morrison; Diana L Stade; Kelly McNally; Patricia Q Bourie; Anthony Massaro; Seth Bokser; Cindy Dwyer; Ryan S Greysen; Priyanka Agarwal; Kevin Thornton; Anuj K Dalal Journal: J Am Med Inform Assoc Date: 2017-04-01 Impact factor: 4.497