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Caregiver Perspectives on Provider Continuity During Prolonged PICU Hospitalizations: A Single-Center Qualitative
Patricia Peña Jiménez1, Wendy Leatherman Phipps2, Elizabeth Jacob-Files3
1Department of Pediatrics, Critical Care Medicine, Driscoll Children's Hospital, Corpus Christi, TX.
Summary
Families value familiar providers who show empathy and understand their child
Area of Science:
- Pediatric critical care medicine
- Healthcare delivery systems
- Family-centered care
Background:
- Continuity of care is crucial for children with prolonged Pediatric Intensive Care Unit (PICU) hospitalizations.
- The impact of a dedicated continuity attending (CA) physician on familial caregivers' experiences is not well understood.
Purpose of the Study:
- To explore and describe family perspectives on continuity of care during prolonged PICU stays.
- To compare experiences of caregivers with and without a PICU CA.
Main Methods:
- Qualitative semi-structured interviews with 39 familial caregivers of critically ill children (≥14 days PICU stay).
- Participants were stratified into groups with (n=18) and without (n=21) a PICU CA.
- Interviews were analyzed using a realist thematic approach within the continuity of care model.
Main Results:
- Caregivers identified six themes: provider empathy builds trust, knowledge of baseline health reduces stress, information loss during transitions causes frustration, known providers improve communication, valuing family expertise enhances care, and provider responsibility for long-term plans decreases stress.
- Relational, informational, and management continuity were key factors influencing family experiences.
Conclusions:
- As medical complexity and length of stay increase, caregivers' needs shift towards navigating transitions and long-term planning.
- Interventions enhancing provider continuity, encompassing relational, informational, and management aspects, are essential for optimizing outcomes and family experiences.
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