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Paediatric family activation rapid response (FARR) in acute care: a qualitative study for developing a multilingual
Takawira C Marufu1,2, Nicola Taylor1, Shannon Cresham Fox1
1Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Insights
Parents can now escalate concerns about their child's health using a new app. This digital tool supports family-integrated care and improves communication for families with diverse linguistic backgrounds.
Area of Science:
- Digital health interventions
- Paediatric patient safety
- Family-integrated care
Background:
- Delayed recognition of clinical deterioration in children can lead to adverse patient outcomes.
- Parents and carers often identify changes in a child's condition before healthcare professionals.
- Current communication methods for escalating concerns are limited, particularly for those with communication challenges.
Purpose of the Study:
- To develop a digital, multilingual intervention enabling families to escalate concerns directly to rapid response teams in acute pediatric care.
Main Methods:
- A qualitative, co-design app development study was conducted at a single center.
- Systematic literature review informed interviews and co-design focus groups for prototype development.
- Participant recruitment prioritized underserved communities to ensure multilingual functionality and validity.
Main Results:
- Thirty parents/carers and healthcare professionals participated in the study.
- Key themes identified included relational, technological, and individual/environmental considerations.
- A prototype for a family-activated rapid response (FARR) app was developed based on study findings.
Conclusions:
- The prototype app offers a technological platform for coordinated paediatric FARR.
- It addresses cultural nuances and communication preferences, empowering parents to escalate concerns effectively.
- This approach enhances the quality of care by improving communication and timely intervention.
Background:
Delayed recognition of clinical deterioration can result in harm to patients. Parents/carers can often recognise changes in the child's condition before healthcare professionals (HCPs). To mitigate the risk of failure to rescue and promote early intervention, family-activated rapid response (FARR) systems are part of family-integrated care. Mechanisms for parents/carers to escalate concerns regarding their child's clinical status remain limited to direct verbal communication, which may impede those with communication/linguistic challenges.
Aim:
To develop a digital multilingual intervention by which families/carers can escalate their concerns directly to the rapid response team while in acute paediatric care.
Methods:
A single-centre qualitative, co-design app development study was conducted. Evidence synthesis from a systematic review of the international literature informed interviews on intervention prototype development using co-design focus groups. Participant recruitment targeted underserved communities for multilingual functionality validity. Data were analysed using qualitative content analysis.
Results:
Thirty parents/carers (n=16) and HCPs (n=14) participated in the study. Three themes were generated from the data analysis: (1) relational considerations; communication, professional and parental attributes, and collaborative working; (2) technology considerations; app content, usage and outcomes; and (3) individual and environmental considerations; parental and professional elements, and workload. A FARR app prototype was developed based on the data.
Conclusion:
The prototype app provides a platform to develop a coordinated and consistent technological approach to paediatric FARR that acknowledges cultural nuances and preferences, ensuring that parents can communicate in a manner that aligns with their cultural background and communication abilities, thereby enhancing the quality of care delivered.
