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Reducing conflict and tension across a children's hospital: pre-post service evaluation after multimodal

Rachel Amos1, Katy Wood1, Samuel Bunn1

  • 1Great North Children's Hospital, Newcastle upon Tyne, UK.

Archives of Disease in Childhood
|December 9, 2025
PubMed

Insights

Multimodal interventions in a UK children's hospital reduced reported tensions between healthcare staff and families. Safeguarding concerns significantly decreased, improving the hospital environment for patients and staff.

Area of Science:

  • Healthcare Management
  • Patient Safety
  • Clinical Ethics

Background:

  • Hospital environments can experience significant conflict and tension between healthcare professionals, patients, and families.
  • Addressing these tensions is crucial for patient safety, staff well-being, and overall quality of care.

Purpose of the Study:

  • To evaluate the impact of multimodal interventions on healthcare professional-reported conflict and tension within a UK children's hospital.
  • To measure changes in the prevalence and nature of tensions before and after intervention implementation.

Main Methods:

  • A prospective, pre-post, single-centre study was conducted in a 10-ward UK children's hospital.
  • Five interventions were implemented between 2020 and 2023, focusing on conflict resolution, ethics, palliative care, safeguarding, and escalation support.
  • On-ward surveys of nursing and medical teams were conducted in 2019 (pre-intervention) and 2024 (post-intervention).

Main Results:

  • The prevalence of children with reported tensions decreased from 42% (65/153) to 30% (42/138) post-intervention (p=0.03).
  • A statistically significant reduction was observed in unresolved safeguarding concerns (18% to 3%, p<0.0001).
  • Tensions were reduced in children with multiple comorbidities (55% to 38%, p=0.028).

Conclusions:

  • Multimodal, hospital-wide interventions are associated with a reduction in overall healthcare-related tensions.
  • Further research is warranted to confirm reproducibility and explore patient and family perspectives on these interventions.
Abstract

Keywords:
child healthchild health serviceschild welfarehealth services research

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