The influence of family accommodation on pediatric hospital experience in Canada.

BACKGROUND: The goals of our study were to describe the types of family accommodation for parents of hospitalized children and to examine their influence on the pediatric hospital experience. METHODS: This multi-site cohort survey included 10 hospitals in Ontario Province, Canada. Participants were parents of inpatient children (n = 1240). Main outcome measures included ratings of three parent-reported measures of hospital experience: overall hospital experience; willingness to recommend the hospital to family or friends; and how much the accommodation type helped parent stay involved in their child's hospital care. RESULTS: Parents most often stayed in the child's room (74.7%), their own home (12.3%), hotel (4.0%) or a Ronald McDonald House (3.0%). Accommodation varied based on hospital, parent and child factors. Length of stay and the child's health status were significant predictors for overall hospital experience and recommending the hospital to family or friends, but accommodation type was not. Families who stayed at a Ronald McDonald House reported greater involvement in their child's care compared with other accommodation types (odds ratio: 1.54-20.73 for contrasted accommodation types). CONCLUSION: Use of different overnight accommodations for families of hospitalized pediatric patients in Canada is similar to a previous report of U.S. family hospital accommodations. In contrast to the previous U.S. findings, Canadian hospital experience scores were lower and accommodation type was not a significant predictor of overall hospital experience or willingness to recommend the hospital. In Canada, as in the U.S., families who stayed at a Ronald McDonald House reported that this accommodation type significantly improved their ability to be involved in their child's care.

Successes and Challenges in Patient Care Transition Programming: One Hospital's Journey.

The 2013 addition of the Care Transition Measures to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey; enactment of the Patient Protection and Affordable Care Act (2010); and a greater focus on population health have brought a heightened awareness and need for action with patient transitions. Data are emerging from the additional Care Transition Measures and benchmarks have been developed. This article briefly describes the context of care transition. We describe the journey of Indiana University Health North Hospital to overcome patient care transition obstacles, ultimately achieving designation as a top performer. We will discuss our efforts to personalize patient outcomes and transition through activation and improve transitions for vulnerable populations, specifically in the bariatric and orthopedic patient populations. The article concludes with discussion of overcoming obstacles and future directions with continued focus on collaboration and improvement.

The Child and Family Hospital Experience: Is It Influenced by Family Accommodation?

Patient and family experiences are important indicators of quality of care and little is known about how family accommodation affects hospital experience. We added questions about accommodation to standardized inpatient pediatric and neonatal intensive care unit family experience surveys at 10 U.S. hospitals to determine the accommodation types used by families, compare characteristics across accommodation types and explore accommodation-type influences on overall hospital experience outcomes. Parents of inpatient children (n = 5,105; 93.4%) most often stayed in the child's room (76.8%). Parents of neonatal intensive care unit infants (n = 362; 6.6%) most often stayed overnight in their own home or with relatives/friends (47.2%). Accommodation varied based on hospital, parent, and child factors. Accommodation type was a significant predictor for most hospital experience outcomes, with families who stayed at a Ronald McDonald House reporting more positive overall hospital experiences (odds ratios: ranging from 1.83 to 4.86 for contrasted accommodation types and three experience outcomes).