Getting on the same page: Leveraging an inpatient portal to engage families of hospitalized children

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PROJECT SUMMARY/ABSTRACT While sharing honest, unbiased health information with parents is endorsed by the American Academy of Pediatrics as critical to improving patient safety, hospitalizations present unique challenges for parents to engage with clinicians. To improve information transparency, the American Family Children’s Hospital was the first pediatric center to implement an inpatient portal (MyChart Bedside, Epic) – a bedside tablet app that gives parents’ real-time access to clinical information from their child’s inpatient health record. Preliminary findings suggest that parents want the portal expanded to include access to their child’s inpatient doctors’ daily notes, detailing their child’s diagnoses, treatment, and discharge plans. Studies suggest adult outpatients reading their doctors’ office visit notes had improved understanding of care and identified safety concerns that resulted in changes in care. Whether sharing notes would provide similar benefits for parents during their child’s hospitalization is unknown. The long-term goal of this research is to leverage an inpatient portal to engage parents as a way to improve the quality and safety of care of hospitalized children. The objective of this proposed study is to pilot test BedsideNotes – a new capability within the inpatient portal to share doctors’ admission and daily notes with parents during their child’s hospitalization. To guide the evaluation of this innovative health IT capability, investigators will use a recognized sociotechnical systems framework, the Systems Engineering Initiative for Patient Safety 2.0. This objective will be accomplished with these aims: 1) Measure the use, usefulness, and acceptance of BedsideNotes, and 2) Identify parent and clinician (physician, nurse) experiences with BedsideNotes. In this self-contained pilot study, the approach will be to share doctors’ notes with 40 parents of children <12-years old admitted to a hospitalist service at the American Family Children’s Hospital. Mixed methods (EHR audit reports, surveys, interviews) will assess use and experiences with sharing notes. These expected deliverables will be used to test the impact of BedsideNotes in a future study. The assembled research team brings complementary expertise in pediatric health services research, human factors and systems engineering, and consumer-facing informatics. This expertise and the team’s experience successfully collaborating to evaluate the initial implementation of the inpatient portal at this hospital form a strong foundation for this research. As faculty at an institution with extensive research infrastructure, this team is in an ideal environment to complete this project. This proposal is innovative because it will be the first to evaluate sharing doctors’ notes with parents of hospitalized children, an AHRQ priority population. By expanding a commercially-available inpatient portal and incorporating feedback from a national advisory group, findings will have a likelihood for having a sustained positive impact on the delivery of patient- and family-centered care. This study is significant because findings will advance scientific knowledge regarding the potential to harness health IT to engage parents as partners to improve inpatient care quality and safety.