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A parental communication assessment initiative in the paediatric cardiovascular ICU

Published online by Cambridge University Press:  29 April 2024

Katherine Hansen Open the ORCID record for Katherine Hansen [Opens in a new window] ,
Erin Jenkins ,
Aihua Zhu ,
Shawna Collins ,
Kimberly Williams ,
Ariadna Garcia ,
Yingjie Weng ,
Beth Kaufman ,
Loren D. Sacks  and
Harvey Cohen
...Show all authors
Katherine Hansen*
Affiliation:
Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
Erin Jenkins
Affiliation:
Division of Cardiology, Lucile Packard Children’s Hospital, Palo Alto, CA, USA
Aihua Zhu
Affiliation:
Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
Shawna Collins
Affiliation:
Division of Cardiology, Lucile Packard Children’s Hospital, Palo Alto, CA, USA
Kimberly Williams
Affiliation:
Division of Cardiology, Lucile Packard Children’s Hospital, Palo Alto, CA, USA
Ariadna Garcia
Affiliation:
Quantitative Sciences Unit, Department of Medicine, Stanford University, Palo Alto, CA, USA
Yingjie Weng
Affiliation:
Quantitative Sciences Unit, Department of Medicine, Stanford University, Palo Alto, CA, USA
Beth Kaufman
Affiliation:
Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
Loren D. Sacks
Affiliation:
Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
Harvey Cohen
Affiliation:
Palliative Care Program, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
Andrew Y. Shin
Affiliation:
Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
Meghna D. Patel
Affiliation:
Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
*
Corresponding author: K. Hansen; Email: katherine.hansen@utsouthwestern.edu
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Abstract

Objective:

Challenges to communication between families and care providers of paediatric patients in intensive care units (ICU) include variability of communication preferences, mismatched goals of care, and difficulties carrying forward family preferences from provider to provider. Our objectives were to develop and test an assessment tool that queries parents of children requiring cardiac intensive care about their communication preferences and to determine if this tool facilitates patient-centred care and improves families’ ICU experience.

Design:

In this quality improvement initiative, a novel tool was developed, the Parental Communication Assessment (PCA), which asked parents with children hospitalised in the cardiac ICU about their communication preferences. Participants were prospectively randomised to the intervention group, which received the PCA, or to standard care. All participants completed a follow-up survey evaluating satisfaction with communication.

Main Results:

One hundred thirteen participants enrolled and 56 were randomised to the intervention group. Participants who received the PCA preferred detail-oriented communication over big picture. Most parents understood the daily discussions on rounds (64%) and felt comfortable expressing concerns (68%). Eighty-six percent reported the PCA was worthwhile. Parents were generally satisfied with communication. However, an important proportion felt unprepared for difficult decisions or setbacks, inadequately included or supported in decision-making, and that they lacked control over their child’s care. There were no significant differences between the intervention and control groups in their communication satisfaction results.

Conclusions:

Parents with children hospitalised in the paediatric ICU demonstrated diverse communication preferences. Most participants felt overall satisfied with communication, but individualising communication with patients’ families according to their preferences may improve their experience.

Keywords

Paediatric ICUpatient-centred caregoals of carepatient satisfactionpatient preference
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 9
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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