One of the key measures of healthcare quality is the patient experience, especially when the patient is a child. Adult caregivers are not shy to express their opinions about their child’s experience as an inpatient, and these opinions can make or break the reputation of the hospitals. Are there some aspects of the patient experience that are more apt to influence whether a child and family have a positive or negative experience receiving inpatient care? Feng et al (10.1542/peds.2019-1264) explored this question by analyzing 17,727 Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) surveys obtained from 69 hospitals in 34 states from 2012-2014. The HCAHPS looks at multiple dimensions of care such as provider communication with patients, privacy, discharge planning, cleanliness, quiet, and child comfort to name but a few. Two key domains were related to the willingness to recommend a hospital—child comfort (i.e. how child-friendly the environment of care was) and nurse-parent communication. Discharge planning, doctor-parent communication, and being kept informed were also associated with willingness to recommend but not as strongly as child comfort and nurse-parent communication. Of note, the degree of privacy and quietness were not at all associated with willingness to recommend.
What can we do to improve care based on these findings? We asked Dr. Tubbs-Cooley from the Ohio State University, Dr. Mallory Perry from Children’s Hospital of Philadelphia, and Dr. Keim-Malpass from the University of Virginia to provide an accompanying commentary (10.1542/peds.2019-3760). They suggest a number of steps we can take to maximize the child-friendly environment and emphasize the important role that communication plays in not just our patients but in our own wellness. After all, it is these human interactions of caring and concern that brought many of us into health care in the first place. Hopefully you’ll find this article and commentary to be a wonderful reminder of what called us to the profession of pediatrics and keeps us there every day.
