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Healthcare provider-child-parent communication in the preoperative surgical setting
Zeev N Kain1, Jill E MacLaren, Carrie Hammell
1Department of Anesthesiology and Perioperative Care, Pediatrics & Psychiatry, University of California, Irvine, CA, USA. zkain@uci.edu
Insights
Healthcare providers spend minimal time interacting with children and families in the preoperative area on surgery day. This limited interaction time may impact the effectiveness of same-day surgical preparation for pediatric outpatients.
Area of Science:
- Pediatric Surgery
- Healthcare Communication
- Perioperative Care
Background:
- Outpatient surgery for children often lacks preoperative preparation programs.
- Children and families are typically first exposed to the hospital on the day of the procedure.
- Preoperative preparation on the day of surgery is advocated.
Purpose of the Study:
- To quantify the time healthcare providers spend interacting with children and families in the preoperative holding area.
- To analyze the nature of interactions (medical vs. nonmedical talk) between providers and families.
- To assess the proportion of time families spend interacting with providers during their preoperative stay.
Main Methods:
- Video recording of all interactions in the preoperative holding area at Yale New Haven Children's Hospital.
- Systematic coding of videotapes to characterize and quantify healthcare professional behaviors.
- Analysis of interaction time and communication content between providers, children, and families.
Main Results:
- Healthcare providers spent a median of 2.75-4.81 minutes interacting with children and parents.
- Families spent a median of 46.5 minutes in the preoperative area.
- Most provider-family interaction time was dedicated to medical talk (42.5-48.2%), with limited nonmedical talk (6.2-6.9%).
Conclusions:
- Families interact with healthcare providers for a small fraction of their preoperative time.
- Increased production pressure in perioperative settings may contribute to limited interaction.
- Findings have implications for the feasibility and effectiveness of same-day preoperative preparation for pediatric outpatients.
Objectives:
Although preoperative preparation programs were once common, most children currently undergoing outpatient surgery are first exposed to the hospital on the day of the procedure. It is advocated that these outpatient children undergo the preparation just prior to surgery.
Aim:
To assess the amount of time that healthcare providers spend with children and families on the day of surgery in the preoperative area.
Materials And Methods:
The study used video infrastructure in the preoperative holding area of Yale New Haven Children's Hospital to record all interactions between children, families, and healthcare providers. Videotapes were coded to characterize and quantify behaviors of healthcare professionals.
Results:
On the day of surgery, healthcare providers spent medians of 2.75-4.81 min interacting with children and parents in the preoperative area. Families spent a median of 46.5 min in the preoperative area. Healthcare professionals spent the most time in medical talk (averages of 42.5-48.2% of time spent with family) and little time was spent in nonmedical talk (range of 6.2-6.9% of time spent with family). Anesthesiologists and surgeons spent 28% and 18% of the interview in talk to children; admitting nurses spent more of the interview talking to children (43%).
Conclusions:
Families interact with healthcare providers for only a small proportion of the time they spent in the preoperative area. This is likely to be a result of increased production pressure in the perioperative settings and has implications for providing preparation for surgery on the morning of the procedure.
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