Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios.

Autor:	Khan A; Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts., Patel SJ; Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii.; Kapi'olani Medical Center for Women and Children, Hawaii Pacific Health, Honolulu, Hawaii., Anderson M; Family Centered Care Department, Lucile Packard Children's Hospital Stanford, Palo Alto, California.; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts., Baird JD; Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, California., Johnson TM; Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts., Liss I; Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts., Graham DA; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.; Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts., Calaman S; Division of Pediatric Critical Care, NYU Langone Health/Hassenfeld Children's Hospital, NYU Grossman School of Medicine; New York City, New York., Fegley AE; Center for Quality Improvement, Society of Hospital Medicine, Philadelphia, Pennsylvania., Goldstein J; Center for Quality Improvement, Society of Hospital Medicine, Philadelphia, Pennsylvania., O'Toole JK; Departments of Pediatrics and Internal Medicine, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio., Rosenbluth G; Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California.; Benioff Children's Hospital, San Francisco, University of California San Francisco School of Medicine, San Francisco, California., Alminde C; Department of Nursing, St Christopher's Hospital for Children, Philadelphia, Pennsylvania., Bass EJ; Department of Information Science in the College of Computing and Informatics, Drexel University, Philadelphia, Pennsylvania., Bismilla Z; Departments of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada., Caruth M; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts., Coghlan-McDonald S; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts.; Benioff Children's Hospital, San Francisco, University of California San Francisco School of Medicine, San Francisco, California., Cray S; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts.; Patient Safety and Quality Improvement Committee, St Christopher's Hospital for Children, Philadelphia, Pennsylvania., Destino LA; Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.; Lucile Packard Children's Hospital Stanford, Palo Alto, California., Dreyer BP; Department of Pediatrics, New York University Grossman School of Medicine, New York, New York., Everhart JL; Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.; Lucile Packard Children's Hospital Stanford, Palo Alto, California., Good BP; Department of Pediatrics, Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah., Guiot AB; Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio., Haskell H; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts.; Mothers Against Medical Error, Columbia, South Carolina., Hepps JH; Department of Pediatrics, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland., Knighton AJ; Healthcare Delivery Institute, Intermountain Health, Murray, Utah., Kocolas I; Department of Pediatrics, Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah., Kuzma NC; Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, Pennsylvania.; Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania., Lewis K; Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, Pennsylvania.; Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania., Litterer KP; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts.; Office of Experience, Boston Children's Hospital, Boston, Massachusetts., Kruvand E; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts.; SSM Health Cardinal Glennon Children's Hospital, St Louis, Missouri., Markle P; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts.; Walter Reed National Military Medical Center, Bethesda, Maryland., Micalizzi DA; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts., Patel A; Department of Pediatrics, University of California San Diego, Rady Children's Hospital, San Diego, California., Rogers JE; Department of Nursing, Boston Children's Hospital, Boston, Massachusetts., Subramony A; Department of Pediatrics, Cohen Children's Medical Center, Hofstra Northwell School of Medicine, New Hyde Park, New York., Vara T; Kapi'olani Medical Center for Women and Children, Hawaii Pacific Health, Honolulu, Hawaii.; Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts., Yin HS; Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, New York., Sectish TC; Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts., Srivastava R; Department of Pediatrics, Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah.; Healthcare Delivery Institute, Intermountain Health, Murray, Utah., Starmer AJ; Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts., West DC; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Spector ND; Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, Pennsylvania.; Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania.; The Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program, Philadelphia, Pennsylvania., Landrigan CP; Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts.; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2024 Jan 01; Vol. 153 (2).
DOI:	10.1542/peds.2023-062666
Abstrakt:	Background and Objectives: Patient and Family Centered I-PASS (PFC I-PASS) emphasizes family and nurse engagement, health literacy, and structured communication on family-centered rounds organized around the I-PASS framework (Illness severity-Patient summary-Action items-Situational awareness-Synthesis by receiver). We assessed adherence, safety, and experience after implementing PFC I-PASS using a novel "Mentor-Trio" implementation approach with multidisciplinary parent-nurse-physician teams coaching sites. Methods: Hybrid Type II effectiveness-implementation study from 2/29/19-3/13/22 with ≥3 months of baseline and 12 months of postimplementation data collection/site across 21 US community and tertiary pediatric teaching hospitals. We conducted rounds observations and surveyed nurses, physicians, and Arabic/Chinese/English/Spanish-speaking patients/parents. Results: We conducted 4557 rounds observations and received 2285 patient/family, 1240 resident, 819 nurse, and 378 attending surveys. Adherence to all I-PASS components, bedside rounding, written rounds summaries, family and nurse engagement, and plain language improved post-implementation (13.0%-60.8% absolute increase by item), all P < .05. Except for written summary, improvements sustained 12 months post-implementation. Resident-reported harms/1000-resident-days were unchanged overall but decreased in larger hospitals (116.9 to 86.3 to 72.3 pre versus early- versus late-implementation, P = .006), hospitals with greater nurse engagement on rounds (110.6 to 73.3 to 65.3, P < .001), and greater adherence to I-PASS structure (95.3 to 73.6 to 72.3, P < .05). Twelve of 12 measures of staff safety climate improved (eg, "excellent"/"very good" safety grade improved from 80.4% to 86.3% to 88.0%), all P < .05. Patient/family experience and teaching were unchanged. Conclusions: Hospitals successfully used Mentor-Trios to implement PFC I-PASS. Family/nurse engagement, safety climate, and harms improved in larger hospitals and hospitals with better nurse engagement and intervention adherence. Patient/family experience and teaching were not affected. (Copyright © 2024 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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