Effects of structured encounter forms on pediatric house staff knowledge, parent satisfaction, and quality of care. A randomized, controlled trial
E. A. Zenni and T. N. Robinson
Department of Pediatrics, Stanford University School of Medicine, Calif, USA.
OBJECTIVE: To evaluate the effects of health supervision structured
encounter forms on pediatric house staff knowledge, parent satisfaction,
and quality of care. DESIGN: Randomized, controlled trial. SETTING:
Pediatric house staff continuity clinic in a university-based children's
hospital. PARTICIPANTS: 53 pediatric house officers and 153 parents.
INTERVENTIONS: House staff were randomized to use structured encounter
forms focused on developmental milestones (group 1) or anticipatory
guidance/preventive care (group 2) during health supervision visits.
OUTCOME MEASURES: Changes in house staff knowledge were assessed with
pretests and posttests. Parent satisfaction was assessed with surveys.
Quality of care, defined as compliance with recommended guidelines for
age-specific health supervision, was assessed by audiotaping visits.
RESULTS: Group 1 demonstrated greater but not significantly different
improvement in knowledge of developmental milestones than group 2, while
group 2 improved more than group 1 in knowledge of anticipatory guidance/
preventive care. Parent satisfaction with developmental screening was
significantly greater for group 1 visits than for group 2 visits (P <
.001). Group 1 demonstrated significantly greater compliance than group 2
with recommended standards of developmental screening (P = .001).
CONCLUSIONS: The use of structured encounter forms for health supervision
in pediatric house staff continuity clinics may increase house staff
knowledge of developmental milestones and anticipatory guidance/preventive
care, increases parent satisfaction with developmental assessment during
health supervision, and improves compliance with recommended guidelines for
developmental assessment.
