Singh Amit, Rhee Kyung E, Brennan Jesse J, Kuelbs Cynthia, El-Kareh Robert, Fisher Erin S
Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California;
Division of Academic General Pediatrics, Developmental Pediatrics, and Community Health, and.
Hosp Pediatr. 2016 Mar;6(3):157-65. doi: 10.1542/hpeds.2015-0164. Epub 2016 Jan 1.
Increase parent/caregiver ability to correctly identify the attending in charge and define terminology of treatment team members (TTMs). We hypothesized that correct TTM identification would increase with use of an electronic communication tool. Secondary aims included assessing subjects' satisfaction with and trust of TTM and interest in computer activities during hospitalization.
Two similar groups of parents/legal guardians/primary caregivers of children admitted to the Pediatric Hospital Medicine teaching service with an unplanned first admission were surveyed before (Phase 1) and after (Phase 2) implementation of a novel electronic medical record (EMR)-based tool with names, photos, and definitions of TTMs. Physicians were also surveyed only during Phase 1. Surveys assessed TTM identification, satisfaction, trust, and computer use.
More subjects in Phase 2 correctly identified attending physicians by name (71% vs. 28%, P < .001) and correctly defined terms intern, resident, and attending (P ≤ .03) compared with Phase 1. Almost all subjects (>79%) and TTMs (>87%) reported that subjects' ability to identify TTMs moderately or strongly impacted satisfaction and trust. The majority of subjects expressed interest in using computers to understand TTMs in each phase.
Subjects' ability to correctly identify attending physicians and define TTMs was significantly greater for those who used our tool. In our study, subjects reported that TTM identification impacted aspects of the TTM relationship, yet few could correctly identify TTMs before tool use. This pilot study showed early success in engaging subjects with the EMR in the hospital and suggests that families would engage in computer-based activities in this setting.
提高家长/照顾者正确识别主治医生以及明确治疗团队成员（TTM）术语的能力。我们假设使用电子通信工具能提高对TTM的正确识别率。次要目标包括评估受试者对TTM的满意度和信任度，以及住院期间对计算机活动的兴趣。
对两组情况相似的家长/法定监护人/主要照顾者进行调查，这些儿童因计划外首次入院进入儿科医院医学教学服务部门。在实施一种基于新型电子病历（EMR）的工具（包含TTM的姓名、照片和定义）之前（第1阶段）和之后（第2阶段）进行调查。医生仅在第1阶段接受调查。调查评估了对TTM的识别、满意度、信任度和计算机使用情况。
与第1阶段相比，第2阶段更多受试者能正确说出主治医生的姓名（71%对28%，P <.001），并能正确定义实习医生、住院医生和主治医生等术语（P≤.03）。几乎所有受试者（>79%）和TTM（>87%）报告称，受试者识别TTM的能力对满意度和信任度有中度或强烈影响。大多数受试者在每个阶段都表示有兴趣使用计算机来了解TTM。
使用我们工具的受试者正确识别主治医生和定义TTM的能力明显更强。在我们的研究中，受试者报告称识别TTM会影响TTM关系的各个方面，但在使用工具之前，很少有人能正确识别TTM。这项初步研究表明在医院让受试者参与使用电子病历方面取得了早期成功，并表明在这种环境下家庭会参与基于计算机的活动。
