This Article  • Full text  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (40)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Quality of Care, Other  • Pain  • Alert me on articles by topic

The Parents' Perspective

Charles J. Homer, MD, MPH; Barbara Marino, RN, PhD; Paul D. Cleary, PhD; Hillel R. Alpert, MPM; Barbara Smith, MBA; Constance M. Crowley Ganser, MS, RNC; Robert M. Brustowicz, MD; Donald A. Goldmann, MD

Arch Pediatr Adolesc Med. 1999;153:1123-1129.

Objectives  To develop a measure of parental perceptions of pediatric inpatient quality of care, to identify processes of care that influence these perceptions, and to describe these perceptions of care.

Design  An interdisciplinary team modified an existing measure of inpatient care for adults using focus groups and expert review. The resulting survey was administered by telephone.

Setting  Tertiary care pediatric hospital.

Patients  Trained telephone interviewers obtained reports from parents of children discharged from the hospital during specified months. This report is based on the answers to 122 questions provided by 3622 (77%) of 4724 parents who responded when surveyed from 1991 through 1995.

Main Outcome Measures  Parents provided reports about specific clinical experiences, overall ratings of care, and patient demographic and illness characteristics 2 weeks after patient discharge from the hospital. The analysis classified reports about pediatric care as either problems or not problems. Problems in different areas of care were averaged to create scores for the dimensions.

Results  Parents most often noted problems related to hospital discharge planning (18%) and pain management (18%) and less often reported problems concerning communication about surgery (10%) or transmission of information to children (6%). Problems in communication between clinicians and parents correlated most strongly with overall quality ratings by parents (r = 0.59). Parents' specific reports of problems with care accounted for 42% of the variation in their overall assessments of the inpatient care experience.

Conclusions  Parental assessment of inpatient pediatric care rests heavily on the quality of communication between the clinician and parent. Specific processes of care strongly influence overall assessments. Such reports could be used to focus the quality-improvement activities of hospitals and increase the accountability of providers of care to children and families.

From the Departments of Medicine (Drs Homer and Goldmann), Nursing (Dr Marino), Anesthesia (Dr Brustowicz), and Quality Improvement (Drs Homer, Marino, and Goldmann, Mr Alpert, Ms Smith, and Ms Ganser), Children's Hospital, and the Departments of Pediatrics (Drs Homer and Goldmann) and Health Care Policy (Dr Cleary), Harvard Medical School, Boston, Mass.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Communicating With Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information
Levetown and and the Committee on Bioethics
Pediatrics 2008;121:e1441-e1460.
ABSTRACT | FULL TEXT  

Do Adolescent Inpatient Wards Make a Difference? Findings From a National Young Patient Survey
Viner
Pediatrics 2007;120:749-755.
ABSTRACT | FULL TEXT  

Quality of Health Care for Children: Role of Health and Chronic Illness in Inpatient Care Experiences
Mack et al.
Arch Pediatr Adolesc Med 2007;161:828-834.
ABSTRACT | FULL TEXT  

Pediatric Brain Tumor Patients: Their Parents' Perceptions of the Hospital Experience
Jackson et al.
Journal of Pediatric Oncology Nursing 2007;24:95-105.
ABSTRACT  

Parental Experiences: Care of Children With High and Intermediate Imperforate Anus.
Ojmyr-Joelsson et al.
Clin Nurs Res 2006;15:290-305.
ABSTRACT  

What Postoperative Outcomes Matter to Pediatric Patients?
Cucchiaro et al.
Anesth. Analg. 2006;102:1376-1382.
ABSTRACT | FULL TEXT  

Pediatric Hospitalists: Report of a Leadership Conference
Lye et al.
Pediatrics 2006;117:1122-1130.
ABSTRACT | FULL TEXT  

Improving the Quality of End-of-Life Care in the Pediatric Intensive Care Unit: Parents' Priorities and Recommendations
Meyer et al.
Pediatrics 2006;117:649-657.
ABSTRACT | FULL TEXT  

Impact of Patient-Centered Decision Support on Quality of Asthma Care in the Emergency Department
Porter et al.
Pediatrics 2006;117:e33-e42.
ABSTRACT | FULL TEXT  

Parent and Physician Perspectives on Quality of Care at the End of Life in Children With Cancer
Mack et al.
JCO 2005;23:9155-9161.
ABSTRACT | FULL TEXT  

A Simple Approach to Improving Patient Satisfaction
Maisels and Kring
CLIN PEDIATR 2005;44:797-800.
ABSTRACT  

Parents' Priorities and Satisfaction With Acute Pediatric Care
Ammentorp et al.
Arch Pediatr Adolesc Med 2005;159:127-131.
ABSTRACT | FULL TEXT  

Listening to Families: First Steps Toward Improved Hospital Care
Britto et al.
Arch Pediatr Adolesc Med 2005;159:187-188.
FULL TEXT  

Parents' Assessment of Quality of Care and Grief Following a Child's Death
Seecharan et al.
Arch Pediatr Adolesc Med 2004;158:515-520.
ABSTRACT | FULL TEXT  

Generalist-Subspecialist Communication for Children With Chronic Conditions: A Regional Physician Survey
Stille et al.
Pediatrics 2003;112:1314-1320.
ABSTRACT | FULL TEXT  

Are Hospital Characteristics Associated With Parental Views of Pediatric Inpatient Care Quality?
Co et al.
Pediatrics 2003;111:308-314.
ABSTRACT | FULL TEXT  

Impact of a Health Maintenance Organization Hospitalist System in Academic Pediatrics
Landrigan et al.
Pediatrics 2002;110:720-728.
ABSTRACT | FULL TEXT  

Parents' Perceptions of Primary Care: Measuring Parents' Experiences of Pediatric Primary Care Quality
Seid et al.
Pediatrics 2001;108:264-270.
ABSTRACT | FULL TEXT  

Family Nursing: Theory-Anemic, Nursing Theory-Deprived
Baumann
Nurs Sci Q 2000;13:285-290.