Department of Pediatrics, School of Medicine and Public Health.
Center for Quality and Productivity Improvement, and.
Hosp Pediatr. 2021 May;11(5):503-508. doi: 10.1542/hpeds.2020-005447. Epub 2021 Apr 1.
Physicians increasingly share ambulatory visit notes with patients to meet new federal requirements, and evidence suggests patient experiences improve without overburdening physicians. Whether sharing inpatient notes with parents of hospitalized children yields similar outcomes is unknown. In this pilot study, we evaluated parent and physician perceptions of sharing notes with parents during hospitalization.
Parents of children aged <12 years admitted to a hospitalist service at a tertiary children's hospital in April 2019 were offered real-time access to their child's admission and daily progress notes on a bedside inpatient portal (MyChart Bedside). Upon discharge, ambulatory OpenNotes survey items assessed parent and physician (attendings and interns) perceptions of note sharing.
In all, 25 parents and their children's discharging attending and intern physicians participated. Parents agreed that the information in notes was useful and helped them remember their child's care plan (100%), prepare for rounds (96%), and feel in control (91%). Although many physicians (34%) expressed concern that notes would confuse parents, no parent reported that notes were confusing. Some physicians perceived that they spent more time writing and/or editing notes (28%) or that their job was more difficult (15%). Satisfaction with sharing was highest among parents (100%), followed by attendings (81%) and interns (35%).
Parents all valued having access to physicians' notes during their child's hospital stay; however, some physicians remained concerned about the potential negative consequences of sharing. Comparative effectiveness studies are needed to evaluate the effect of note sharing on outcomes for hospitalized children, families, and staff.
医生越来越多地与患者共享门诊记录，以满足新的联邦要求，有证据表明，这不会给医生增加负担，还能改善患者体验。但目前尚不清楚与住院患儿的父母共享住院记录是否会产生类似的结果。在这项试点研究中，我们评估了父母和医生对住院期间与父母共享记录的看法。
2019 年 4 月，一家三级儿童医院的住院医师服务部门为年龄<12 岁的患儿的父母提供了实时访问其孩子入院和每日进展记录的床边住院门户（MyChart 床边）。出院时，门诊 OpenNotes 调查项目评估了父母和医生（主治医生和住院医生）对共享记录的看法。
共有 25 名父母及其孩子的主治医生和住院医生参加了调查。父母均认为记录中的信息有用，有助于他们记住孩子的护理计划（100%）、为查房做准备（96%）并感到掌控局面（91%）。尽管许多医生（34%）担心记录会让父母感到困惑，但没有父母表示记录令人困惑。一些医生认为他们花更多时间写和/或编辑记录（28%）或他们的工作更困难（15%）。父母对共享记录的满意度最高（100%），其次是主治医生（81%）和住院医生（35%）。
所有父母都认为在孩子住院期间可以访问医生的记录；然而，一些医生仍然担心共享记录可能带来的负面影响。需要进行比较有效性研究，以评估共享记录对住院儿童、家庭和医护人员的影响。
