Fellows journal Club
Fellow: Chionye Ossai, MD | Cleveland Clinic Children’s
Article: Kelly MM, Thurber AS, Coller RJ, et al. Parent Perceptions of Real-time Access to Their Hospitalized Child's Medical Records Using an Inpatient Portal: A Qualitative Study. Hosp Pediatr. 2019; 9(4):273-280
Summary: The objective of this qualitative study was to identify why parents used a portal during hospitalization and generate suggestions for improvement. The authors conducted semi-structured in-person interviews with 14 parents whose children were hospitalized in a general medical-surgical unit in a tertiary care children’s hospital. They excluded parents who were non-English speaking and whose children were 12 years and older. Parents were selected by convenience sampling method. They transcribed audio recordings and performed data analysis using a standard inductive, qualitative content analysis approach. Parents reported using the portal an average of 2 times/day. The authors identified the following themes regarding parents’ desire for accessing information: need to monitor the child’s progress, feeling of empowerment, promoting communication, improving recall and confirming that information was accurate.
Key Strengths: This article was the first to study parents’ perspectives on inpatient portal use during their child’s hospitalization. The authors ensured accurate and systematic data analysis, utilizing three researchers trained in qualitative data methods to independently review the data. The themes they identified could assist health care organizations and vendors in optimizing inpatient portals and providing functionality that will be effectively utilized by parents.
Limitations: The study included a small sample size of parents who spoke English and whose children were older than 12 thereby limiting its generalizability. The study did not account for parents’ prior experiences with portals or computer technology. Selecting parents via convenience sampling may predispose to selection bias by interviewing parents who are already more likely to be engaged in their children’s care.
Major Takeaway: Thirteen out of fourteen parents interviewed recommended that the hospital continue to offer inpatient portal access to parents. Parents were willing to use the portal to complete admission and discharge surveys, view vitals and laboratory results and even report safety events. Parents’ suggestions were focused on improving portal functionalities such as greater advocacy for portal use by staff and having access to physician notes.
Impact on Practice: One of the benefits of Family-Centered Rounds (FCR) is improving patient/parent-provider communication. However, parents and caregivers of pediatric patients usually lack the necessary information to be able to engage in a meaningful conversation to aid shared-decision making. Inpatient portals can provide real-time information to parents and may be able to bridge the communication gap and promote patient safety. Research surrounding inpatient portals is in its infancy in the pediatric population. There is a need to further study its utility for hospitalized children and its impact on specific outcomes.
Article: Kelly MM, Thurber AS, Coller RJ, et al. Parent Perceptions of Real-time Access to Their Hospitalized Child's Medical Records Using an Inpatient Portal: A Qualitative Study. Hosp Pediatr. 2019; 9(4):273-280
Summary: The objective of this qualitative study was to identify why parents used a portal during hospitalization and generate suggestions for improvement. The authors conducted semi-structured in-person interviews with 14 parents whose children were hospitalized in a general medical-surgical unit in a tertiary care children’s hospital. They excluded parents who were non-English speaking and whose children were 12 years and older. Parents were selected by convenience sampling method. They transcribed audio recordings and performed data analysis using a standard inductive, qualitative content analysis approach. Parents reported using the portal an average of 2 times/day. The authors identified the following themes regarding parents’ desire for accessing information: need to monitor the child’s progress, feeling of empowerment, promoting communication, improving recall and confirming that information was accurate.
Key Strengths: This article was the first to study parents’ perspectives on inpatient portal use during their child’s hospitalization. The authors ensured accurate and systematic data analysis, utilizing three researchers trained in qualitative data methods to independently review the data. The themes they identified could assist health care organizations and vendors in optimizing inpatient portals and providing functionality that will be effectively utilized by parents.
Limitations: The study included a small sample size of parents who spoke English and whose children were older than 12 thereby limiting its generalizability. The study did not account for parents’ prior experiences with portals or computer technology. Selecting parents via convenience sampling may predispose to selection bias by interviewing parents who are already more likely to be engaged in their children’s care.
Major Takeaway: Thirteen out of fourteen parents interviewed recommended that the hospital continue to offer inpatient portal access to parents. Parents were willing to use the portal to complete admission and discharge surveys, view vitals and laboratory results and even report safety events. Parents’ suggestions were focused on improving portal functionalities such as greater advocacy for portal use by staff and having access to physician notes.
Impact on Practice: One of the benefits of Family-Centered Rounds (FCR) is improving patient/parent-provider communication. However, parents and caregivers of pediatric patients usually lack the necessary information to be able to engage in a meaningful conversation to aid shared-decision making. Inpatient portals can provide real-time information to parents and may be able to bridge the communication gap and promote patient safety. Research surrounding inpatient portals is in its infancy in the pediatric population. There is a need to further study its utility for hospitalized children and its impact on specific outcomes.
Fellow: Chionye Ossai, MD | Cleveland Clinic Children’s
Fellow Accomplishments/Current Work: My research interest is in the area of Clinical Informatics. I plan to study the role of informatics tools such as patient portals and mobile apps in improving provider/patient engagement and experience. In addition to my fellowship, I am completing a Master’s program in Clinical Informatics. My current research project is looking at the association of parental portal use and breastfeeding rates among infants. Prior to this, I used big data from a large data warehouse to describe the incidence and demographics of pediatric appendicitis.
Fellow Abstract Submissions, Publications and Presentations:
- Im J, Adeyanju O, Tchou M, Hogan A, O’Hara K, Farrell M, Ossai C, Rudnick M, Patel A. Apps for Busy Pediatric Hospitalists – Tools to Facilitate Teaching and Learning in the Digital Age. Workshop presentation at PHM 2018, Atlanta, GA
- Ossai C, Pu L, Kaelber D. Using Aggregated Data from 1.4 Million Pediatric Patients to Describe the Epidemiology and Demographic Characteristics of Appendicitis. Accepted for poster presentation at AAP 2019 National Conference and Exhibition (SOHM)
Fun fact about yourself: I am in a professional Bachata dance group. We travel across the country for performances.
Fellow Accomplishments/Current Work: My research interest is in the area of Clinical Informatics. I plan to study the role of informatics tools such as patient portals and mobile apps in improving provider/patient engagement and experience. In addition to my fellowship, I am completing a Master’s program in Clinical Informatics. My current research project is looking at the association of parental portal use and breastfeeding rates among infants. Prior to this, I used big data from a large data warehouse to describe the incidence and demographics of pediatric appendicitis.
Fellow Abstract Submissions, Publications and Presentations:
- Im J, Adeyanju O, Tchou M, Hogan A, O’Hara K, Farrell M, Ossai C, Rudnick M, Patel A. Apps for Busy Pediatric Hospitalists – Tools to Facilitate Teaching and Learning in the Digital Age. Workshop presentation at PHM 2018, Atlanta, GA
- Ossai C, Pu L, Kaelber D. Using Aggregated Data from 1.4 Million Pediatric Patients to Describe the Epidemiology and Demographic Characteristics of Appendicitis. Accepted for poster presentation at AAP 2019 National Conference and Exhibition (SOHM)
Fun fact about yourself: I am in a professional Bachata dance group. We travel across the country for performances.
Previous Articles:
- Hannah Neubauer - HHFNC vs. low flow
- Amanda Messer - UTIs and renal scarring
- Christiane Lenzen - procalcitonin and CAP
- Melanie Rudnick - dexamethasone and parapneumonic effusions
- Jane Im - empiric antibiotic therapy in infants
- Ashley Jenkins - AKI with vancomycin and piperacillin/tazobactam therapy
- Fatuma Barqadle - US for LPs
- Marni Shear - Hypotonic IV fluids and bronchiolitis
- Ivy Tam - Ipratropium and IV magnesium in asthmatics
- Daniela Burger - HSV in Infants
- Lindsay Weiss - macrolides in pneumonia
- Tiranun Rungvivatjarus - High Flow Nasal Cannula
- Karisa Grizzle - Empiric Antibiotics in Osteomyelitis
- Mike Fenster - Bacterial meningitis in positive UA
- Courtney Charvat - CSF bioplex assay
- Audrey Uong - Complex Care Discharges
- Adam Cohen - Early Master Clinician Traits
- Alice Lee - Variation in Orbital Cellulitis Care
- Joy Solano - Family centered interventions to improve education
- Sunita Hemani - Discharging after q3 albuterol in asthma
- Jennifer Chen - Discharge Instruction Literacy
- John Morrison - Readmission Models for Complex Care
- Hanna Siddiqui - Fever, PEWS, and deterioration
- Kate Kyler - Reducing Safety Events in Suicidal Patients via QI
- Sonya Tang Girwood - Antibiotics in RSV Related Respiratory Failure
- Maria Santos - Positive UA and Meningitis