Intervention to Increase Parent-provider Communication During Referrals
| Status: | Active, not recruiting |
|---|---|
| Healthy: | No |
| Age Range: | Any - 17 |
| Updated: | 4/21/2016 |
| Start Date: | March 2013 |
| End Date: | August 2016 |
Parent-Provider Partnerships for Referral Communication
The overall goal of this three-year study is to adapt and test a brief, feasible
intervention using a communication tool and brief parent coaching to increase the capability
of parents of children and youth with special health care needs to exchange and use medical
information in partnership with their child's physicians when their children require
sub-specialty referral. We hypothesize that the use of tools to coordinate referrals between
physicians and parents will facilitate increased communication between primary care
physicians(PCPs) and specialists, and that parents trained in information exchange and care
planning will experience increased self-efficacy in interacting with their child's
physicians.
There are two primary aims of the study. The first aim is to adapt a joint parent-provider
referral communication and care planning intervention (i.e., the 'referral care plan') for
use with ethnically diverse populations in an electronic communication environment, and
optimize its usability in the practice setting. The second aim is to test the referral care
plan in nine pediatric primary care and subspecialty practices in two states, using a
stepped wedge cluster randomized trial, to evaluate its effect on communication, parent
self-efficacy, and patient outcomes.
intervention using a communication tool and brief parent coaching to increase the capability
of parents of children and youth with special health care needs to exchange and use medical
information in partnership with their child's physicians when their children require
sub-specialty referral. We hypothesize that the use of tools to coordinate referrals between
physicians and parents will facilitate increased communication between primary care
physicians(PCPs) and specialists, and that parents trained in information exchange and care
planning will experience increased self-efficacy in interacting with their child's
physicians.
There are two primary aims of the study. The first aim is to adapt a joint parent-provider
referral communication and care planning intervention (i.e., the 'referral care plan') for
use with ethnically diverse populations in an electronic communication environment, and
optimize its usability in the practice setting. The second aim is to test the referral care
plan in nine pediatric primary care and subspecialty practices in two states, using a
stepped wedge cluster randomized trial, to evaluate its effect on communication, parent
self-efficacy, and patient outcomes.
One highly-promoted, evidence-based model for chronic illness service delivery for children
is the Care Model for Child Health in the Medical Home. The Medical Home (MH) model has been
promoted as way to improve quality while making care more efficient. Communication among
members of the health care team is an essential part of the model, with sharing of care
between providers preferred by families, PCPs and specialists. However, communication
between referring and consulting physicians is frequently missing. Failure of communication
can produce uncoordinated care, which may contribute to unmet family needs, duplication or
omission of needed medical services, and medical errors.
Data on effectiveness of specific MH interventions, especially in children, are scarce. A
large intervention in the MH setting was tested using written care plans and use of forms as
tools to promote communication with specialists. Results indicated decreases of 40 to 70% in
parent reports of lost work/school time, ER visits, and hospital admissions. Additional
studies produced decreased hospitalizations and emergency room use in children.
Family-centered care (FCC), a Medical Home core component, has been conceptualized for
measurement purposes as having four components: communication with health care providers,
shared decision making, providing families with needed information, and self-care management
and support. Interventions to improve FCC through parent-to-parent support groups and
community-based support have produced increased parent confidence and problem-solving
ability. Studies of asthma have shown that teaching primary care providers to take a
family-centered approach to medication prescribing as part of an overall education protocol
improves symptoms and decreases follow-up visits, and using a family coordinator to help
physicians and parents interact more effectively is integral to improving asthma outcomes.
Shared decision-making (SDM), an element of FCC and an approach favored by family advocacy
groups to help parents achieve the greatest benefits for their children with special needs,
is addressed by our proposed intervention. Merely providing information to patients and
families is not sufficient; families must be able to express preferences, participate in
dialogue, and make informed decisions as partners with physicians.
The proposed project addresses the health care quality gaps outlined above by improving
primary care-specialty-parent communication, family-centered care, and shared
decision-making within the MH model. It also addresses knowledge gaps by examining the
effectiveness of an important recommended component of the MH and investigating the
relationship between the intervention and both process and outcome measures, in a
"real-world" practice setting. If the aims of the project are achieved, we will have
discovered a practical way to improve care that can be promoted to payers and policymakers.
is the Care Model for Child Health in the Medical Home. The Medical Home (MH) model has been
promoted as way to improve quality while making care more efficient. Communication among
members of the health care team is an essential part of the model, with sharing of care
between providers preferred by families, PCPs and specialists. However, communication
between referring and consulting physicians is frequently missing. Failure of communication
can produce uncoordinated care, which may contribute to unmet family needs, duplication or
omission of needed medical services, and medical errors.
Data on effectiveness of specific MH interventions, especially in children, are scarce. A
large intervention in the MH setting was tested using written care plans and use of forms as
tools to promote communication with specialists. Results indicated decreases of 40 to 70% in
parent reports of lost work/school time, ER visits, and hospital admissions. Additional
studies produced decreased hospitalizations and emergency room use in children.
Family-centered care (FCC), a Medical Home core component, has been conceptualized for
measurement purposes as having four components: communication with health care providers,
shared decision making, providing families with needed information, and self-care management
and support. Interventions to improve FCC through parent-to-parent support groups and
community-based support have produced increased parent confidence and problem-solving
ability. Studies of asthma have shown that teaching primary care providers to take a
family-centered approach to medication prescribing as part of an overall education protocol
improves symptoms and decreases follow-up visits, and using a family coordinator to help
physicians and parents interact more effectively is integral to improving asthma outcomes.
Shared decision-making (SDM), an element of FCC and an approach favored by family advocacy
groups to help parents achieve the greatest benefits for their children with special needs,
is addressed by our proposed intervention. Merely providing information to patients and
families is not sufficient; families must be able to express preferences, participate in
dialogue, and make informed decisions as partners with physicians.
The proposed project addresses the health care quality gaps outlined above by improving
primary care-specialty-parent communication, family-centered care, and shared
decision-making within the MH model. It also addresses knowledge gaps by examining the
effectiveness of an important recommended component of the MH and investigating the
relationship between the intervention and both process and outcome measures, in a
"real-world" practice setting. If the aims of the project are achieved, we will have
discovered a practical way to improve care that can be promoted to payers and policymakers.
Inclusion Criteria:
- Parents of children aged 0-17, AND
- Parents of children with a chronic health condition, AND
- Parents whose children are receiving a NEW referral to a pediatric neurologist,
gastroenterologist, cardiologist, or pulmonologist
Exclusion Criteria:
- Parents of children 18 and older
- Parents of children without a chronic health condition
- Parents of children who are not receiving a referral, or who are receiving a referral
to a different sub-specialty
We found this trial at
2
sites
Click here to add this to my saved trials
940 NE 13th St
Oklahoma City, Oklahoma 73190
Oklahoma City, Oklahoma 73190
(405) 271-6458
University of Oklahoma Health Sciences Center The OU Health Sciences Center is composed of seven...
Click here to add this to my saved trials