Patient, Caregiver, and Clinician Participation in Prioritization of Research Questions in Pediatric Hospital Medicine

Abstract

Key Points Question What are the highest-priority unanswered research questions in pediatric hospital medicine from the perspective of young people, parents/caregivers, and health care professionals? Findings This study, which included 2 surveys and a final consensus meeting using nominal group technique, gathered the perspectives of youths, parents/caregivers, and clinicians. The top 10 questions identified focused on the care of special inpatient populations (eg, children with medical complexity), communication, shared decision-making, support strategies, mental health supports, reducing time in the hospital, and supporting Indigenous families. Meaning The findings of this study suggest that the most important research questions in pediatric hospital medicine focus on processes and models of care, communication, and hospitalization outcomes.

Family, nurse, and physician beliefs on family‐centered rounds: A 21‐site study

“…Promoted at the organizational and team level, sensemaking may help narrow the belief gaps demonstrated by team members to incorporate nurse and family input during FCR; however basic workflow needs must first and foremost be understood. A future area of study is to systematically assess how resident physicians (as crucial members of FCR, who may have less input into how FCR will be conducted compared to attending physicians) would prioritize elements of FCR if given an opportunity to build a model of FCR “from scratch.” 32 …”

Improving Outcomes for Hospitalized Children—Include the Voice of the Patient and Caregiver When Prioritizing for Implementation

“…However, we have neglected an important constituency in the prioritization of PHM: the voice of the patient and parent/caregiver. The study of Gill et al provides the patient and caregiver voice to prioritization for questions around hospitalized children. The Canadian Pediatric Inpatient Research Network (PIRN) used a modified Delphi approach with nominal group techniques to broadly survey participants across Canada.…”

“…So, what might pediatric hospitalists do when the evidence base is clear but a gap remains between their current care delivery and optimal care delivery? Inclusion of the patient and parent/caregiver for prioritization in the study by Gill et al fills a key, but until now, missing piece. Inclusion of these voices for prioritization should amplify the synergy for when health care systems, clinicians, and researchers also agree there is an opportunity to partner on solutions.…”

“…The following is an example of how this might work using just such a partnership from design through rigorous implementation, and ultimately improve medical/health outcomes for hospitalized children. A PHM group could take the list provided in the Gill et al study and perhaps be drawn to priority 2 (What methods of communication are most effective between patients, caregivers, and health care providers on a general pediatric inpatient unit [GPIU]?) and priority 10 (What are the most effective communication methods [eg, handover, rounds] between health care providers on a GPIU?).…”

“…Another way of amplifying the results for priority 3 (What are best practices and support strategies for Indigenous parents, families, and children and youth on the GPIU? ) would be for the hospitalist group to want to focus on disadvantaged groups. The clinical teams would use their quality improvement methods and identify what might need to be changed to improve the processes for these disadvantaged groups, in particular, recognizing that different interventions may be needed.…”