Kelly Michelle M, Thurber Anne S, Coller Ryan J, Khan Alisa, Dean Shannon M, Smith Windy, Hoonakker Peter L T
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;
Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, Wisconsin.
Hosp Pediatr. 2019 Apr;9(4):273-280. doi: 10.1542/hpeds.2018-0166.
Engaging with parents in care improves pediatric care quality and patient safety; however, parents of hospitalized children often lack the information necessary to effectively participate. To enhance engagement, some hospitals now provide parents with real-time online access to information from their child's inpatient medical record during hospitalization. Whether these "inpatient portals" provide benefits for parents of hospitalized children is unknown. Our objectives were to identify why parents used an inpatient portal application on a tablet computer during their child's hospitalization and identify their perspectives of ways to optimize the technology.
Semistructured in-person interviews were conducted with 14 parents who were given a tablet computer with a commercially available inpatient portal application for use throughout their child's hospitalization. The portal included vital signs, diagnoses, medications, laboratory test results, patients' schedule, messaging, education, and provider pictures and/or roles. Interviews were audio recorded and transcribed and continued until reaching thematic saturation. Three researchers used an inductive approach to identify emergent themes regarding why parents used the portal.
Five themes emerged regarding parent motivations for accessing information within the portal: (1) monitoring progress, (2) feeling empowered and/or relying less on staff, (3) facilitating rounding communication and/or decision-making, (4) ensuring information accuracy and/or providing reassurance, and (5) aiding memory. Parents recommended that the hospital continue to offer the portal and expand it to allow parents to answer admission questions, provide feedback, and access doctors' daily notes.
Providing parents with real-time clinical information during their child's hospitalization using an inpatient portal may enhance their ability to engage in caregiving tasks critical to ensuring inpatient care quality and safety.
让家长参与医疗护理可提高儿科护理质量和患者安全；然而，住院儿童的家长往往缺乏有效参与所需的信息。为了加强家长参与，一些医院现在在住院期间为家长提供从孩子的住院病历中实时在线获取信息的途径。这些“住院患者门户”是否对住院儿童的家长有益尚不清楚。我们的目标是确定家长在孩子住院期间使用平板电脑上的住院患者门户应用程序的原因，并确定他们对优化该技术方法的看法。
对14位家长进行了半结构化的面对面访谈，他们在孩子住院期间都获得了一台装有市售住院患者门户应用程序的平板电脑。该门户包括生命体征、诊断结果、用药情况、实验室检查结果、患者日程安排、信息传递、教育内容以及医护人员照片和/或角色信息。访谈进行了录音和转录，一直持续到达到主题饱和。三位研究人员采用归纳法来确定关于家长使用该门户原因的新出现主题。
出现了五个关于家长访问门户内信息动机的主题：（1）监测进展情况；（2）感到有掌控感和/或减少对医护人员的依赖；（3）促进查房沟通和/或决策制定；（4）确保信息准确性和/或获得安心感；（5）辅助记忆。家长建议医院继续提供该门户，并进行扩展，以便家长能够回答入院问题、提供反馈以及查看医生的每日记录。
在孩子住院期间通过住院患者门户为家长提供实时临床信息，可能会增强他们参与对确保住院护理质量和安全至关重要的护理任务的能力。
