From the Section of Pediatric Emergency Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
Pediatr Emerg Care. 2021 Dec 1;37(12):e1535-e1543. doi: 10.1097/PEC.0000000000002108.
Follow-up and feedback foster improvement. General emergency medicine providers working in community hospitals desire follow-up and feedback on pediatric patients transferred to children's hospitals. We implemented a novel program to provide these data to our colleagues. The objective of this study was to explore stakeholder perspectives of our program.
We provided secure, electronic reports on transfers from 7 general emergency departments (GEDs). Patient follow-up and feedback data were delivered to the GED's pediatric emergency care coordinator. Seven pediatric emergency care coordinators and 2 children's hospital liaisons participated in semistructured interviews. Five researchers coded and analyzed transcribed data using the constant comparative method of grounded theory. Codes were refined and clustered to develop themes.
Perceived values of the program included GED appreciation of closing the loop on transferred patients, providing education, and informing quality improvement. Participants valued the concise and timely nature of the reports and their empathetic delivery. Facilitators of program implementation included established professional relationships between the GED and the children's hospital liaisons and a GED's culture of self-inquiry. Barriers to program implementation included potential medicolegal exposure and the time burden for report generation and processing. Suggested programmatic improvements included focusing on generalizable, evidence-based learning points and analyzing care trends.
Stakeholders of our pediatric posttransfer follow-up and feedback program reported many benefits and provided key suggestions that may promote successful dissemination of similar programs nationwide. Examining data trends in transferred children may focus efforts to improve the care of children across all emergency care settings.
随访和反馈有助于改进。在社区医院工作的普通急诊医师希望对转至儿童医院的儿科患者进行随访和反馈。我们实施了一项新计划来为我们的同事提供这些数据。本研究的目的是探讨利益相关者对我们计划的看法。
我们为 7 个普通急诊部（GED）提供了有关转院的安全、电子报告。患者随访和反馈数据被传递给 GED 的儿科急救护理协调员。7 名儿科急救护理协调员和 2 名儿童医院联络人参加了半结构化访谈。5 名研究人员使用扎根理论的恒定性比较方法对转录数据进行编码和分析。对代码进行了精炼和聚类，以开发主题。
该计划的感知价值包括 GED 对转院患者的闭环、提供教育和告知质量改进的感激之情。参与者重视报告的简洁和及时性以及其富有同理心的传递方式。该计划实施的促进因素包括 GED 与儿童医院联络人之间既定的专业关系以及 GED 的自我探究文化。该计划实施的障碍包括潜在的医疗法律风险暴露以及报告生成和处理的时间负担。建议的计划改进包括关注可推广的、基于证据的学习要点以及分析护理趋势。
我们的儿科转院后随访和反馈计划的利益相关者报告了许多益处，并提供了可能促进全国类似计划成功传播的关键建议。分析转院儿童的护理数据趋势可能会集中精力改善所有急诊护理环境中儿童的护理。
