Children's Health

Better communication with parents of hospitalized children may be the best way to improve parental ratings of hospital care

A new survey of over 6,000 parents of children cared for in 38 hospitals reveals that although parents on average rated the hospital care that their child received as very good to excellent, they still had problems with certain hospital processes. All dimensions of hospital care, with the exception of the child's physical comfort, had problem scores above 20 percent, indicating significant room for improvement in most aspects of care.

Overall parental ratings of care were associated most closely with communication about their child's condition and involvement in the care of their child. Thus, improving the quality of communication with the parent of a hospitalized child may have the most positive impact on a hospital's pediatric care rating, concludes lead author, John Patrick T. Co, M.D., M.P.H., of Harvard Medical School.

In a study supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00063), the researchers surveyed 6,030 parents of children treated for a medical condition at 38 hospitals. The Pediatric Inpatient Survey measured seven dimensions of inpatient care quality: partnership, coordination, information to parent, information to child, child's physical comfort, confidence and trust, and continuity and transition of care. The researchers asked parents to give an overall quality of care rating from 1 to 5, with five being excellent, and specific process problem scores (from 0 to 100, with 0 representing no problems).

Parents on average rated their child's care as very good (mean of 4.2). However, they reported problems with 27 percent of the survey's hospital process measures. They had the most problems with poor information to the child (33 percent) and coordination of care (30 percent). Parent communication problems correlated most strongly with overall quality of care ratings. Parents whose children were hospitalized at academic health centers or in more competitive markets reported more problems. Yet, patient and hospital characteristics explained only 6 percent of the variation in problem scores.

See "Are hospital characteristics associated with parental views of pediatric inpatient care quality?" by Dr. Co, Timothy G. Ferris, M.D., M.P.H., Barbara L. Marino, Ph.D., R.N., and others, in the February 2003 Pediatrics 111(2), pp. 308-314.

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