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BedsideNotes: Sharing Physicians' Notes With Parents During Hospitalization
Benjamin M Zellmer1, Carrie L Nacht1, Ryan J Coller1
1Department of Pediatrics, School of Medicine and Public Health.
Insights
Parents found sharing inpatient notes beneficial for understanding their child's care plan. While physicians had concerns, no parents reported confusion, indicating a positive impact of shared medical record access for hospitalized children.
Area of Science:
- Pediatric hospital medicine
- Patient engagement
- Health informatics
Background:
- Physicians increasingly share outpatient (ambulatory) visit notes with patients.
- Evidence suggests this improves patient experience without increasing physician burden.
- The impact of sharing inpatient notes with parents of hospitalized children is not well understood.
Purpose of the Study:
- To evaluate parent and physician perceptions of sharing inpatient pediatric medical record notes with parents during hospitalization.
Main Methods:
- A pilot study involving parents of children under 12 admitted to a tertiary children's hospital.
- Parents were offered real-time access to admission and progress notes via a bedside portal (MyChart Bedside).
- Perceptions were assessed using OpenNotes survey items upon discharge for parents and physicians (attendings and interns).
Main Results:
- 25 parent-physician dyads participated.
- Parents found notes useful for care plans (100%), preparing for rounds (96%), and feeling in control (91%).
- No parents reported confusion, despite physician concerns (34%); physician-reported increased workload was noted by some (28%).
- Parent satisfaction was high (100%), followed by attendings (81%) and interns (35%).
Conclusions:
- Parents highly valued access to inpatient notes during their child's hospital stay.
- Physicians expressed some concerns regarding potential negative consequences of note sharing.
- Further comparative effectiveness research is needed to assess the impact on children, families, and healthcare staff.
Objectives:
Physicians increasingly share ambulatory visit notes with patients to meet new federal requirements, and evidence suggests patient experiences improve without overburdening physicians. Whether sharing inpatient notes with parents of hospitalized children yields similar outcomes is unknown. In this pilot study, we evaluated parent and physician perceptions of sharing notes with parents during hospitalization.
Methods:
Parents of children aged <12 years admitted to a hospitalist service at a tertiary children's hospital in April 2019 were offered real-time access to their child's admission and daily progress notes on a bedside inpatient portal (MyChart Bedside). Upon discharge, ambulatory OpenNotes survey items assessed parent and physician (attendings and interns) perceptions of note sharing.
Results:
In all, 25 parents and their children's discharging attending and intern physicians participated. Parents agreed that the information in notes was useful and helped them remember their child's care plan (100%), prepare for rounds (96%), and feel in control (91%). Although many physicians (34%) expressed concern that notes would confuse parents, no parent reported that notes were confusing. Some physicians perceived that they spent more time writing and/or editing notes (28%) or that their job was more difficult (15%). Satisfaction with sharing was highest among parents (100%), followed by attendings (81%) and interns (35%).
Conclusions:
Parents all valued having access to physicians' notes during their child's hospital stay; however, some physicians remained concerned about the potential negative consequences of sharing. Comparative effectiveness studies are needed to evaluate the effect of note sharing on outcomes for hospitalized children, families, and staff.
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