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Development of an App to Facilitate Communication and Shared Decision-making With Parents of Febrile Infants ≤ 60

Paul L Aronson1,2, Mary C Politi3, Paula Schaeffer1

  • 1From the, Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|July 11, 2020
PubMed

Insights

A new app, e-Care, enhances communication and shared decision-making for parents of febrile infants in the emergency department. This tool supports discussions about lumbar puncture (LP) for infants aged 29-60 days, proving highly usable.

Area of Science:

  • Pediatric Emergency Medicine
  • Health Informatics
  • Patient Communication

Background:

  • Febrile infants evaluated in emergency departments (EDs) require clear communication with parents regarding diagnostic testing.
  • Shared decision-making (SDM) is crucial for parental engagement in infant care, particularly for invasive procedures like lumbar puncture (LP).

Purpose of the Study:

  • To develop and test a tool, e-Care, aimed at improving communication and supporting SDM for parents of febrile infants (≤60 days) in the ED.
  • To specifically aid SDM regarding LP for infants aged 29 to 60 days.

Main Methods:

  • A multiphase approach including parent/clinician interviews, storyboard design, and prototype development (e-Care app).
  • Usability testing of the e-Care app using qualitative assessment and the System Usability Scale (SUS).

Main Results:

  • Interviews indicated a preference for a web-based tool that augments verbal communication and provides information on infection testing rationale.
  • The e-Care app, available in English and Spanish, includes sections on test rationale and risks/benefits for LP, with versions for infants ≤28 days and 29-60 days.
  • Usability testing yielded a mean SUS score of 90.3, indicating "excellent" usability, with parents and clinicians finding the app understandable and helpful.

Conclusions:

  • The e-Care app is a usable and understandable tool for enhancing communication and SDM with parents of febrile infants in the ED.
  • This digital tool can empower parents in making informed decisions about their child's healthcare, particularly concerning lumbar puncture.
Abstract

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