title: Patient, family, and provider complex care situations in pediatric acute medical care: Creation of the Red Flags Situation Assessment Tool.
abstract: OBJECTIVE
  To develop and test a questionnaire to identify situations among patients, families, and providers that lead to complex pediatric medical care in a tertiary hospital setting.
  
  
  METHODS
  A mixed methods approach was used. Qualitative content analysis of hospital documents was conducted to develop questionnaire items. Psychometric analyses were used to measure reliability, and factor analysis was used to reduce instrument length.
  
  
  RESULTS
  A 54-item questionnaire with 11 categories was distributed to 205 nurses and medical staff. Psychometric analysis of responses identified a final refined tool with 31 items comprised of six factors.
  
  
  CONCLUSIONS
  The Red Flags Situation Assessment Tool can be used to identify complex care situations and address them earlier in a hospital course to avoid challenges to providing patient- and family-centered care.
authors.affiliation: Behavioral Health Systems, Philadelphia, PA, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Steinmiller
authors.affiliation: The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ely
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D003422:Critical Care / Q000458:organization & administration*; D005163:Factor Analysis, Statistical; D022143:Family Nursing / Q000458:organization & administration*; D005260:Female; D006282:Health Personnel / Q000458:organization & administration; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D016347:Medical Records Systems, Computerized; D010287:Parent-Child Relations; D010347:Patient Care Planning; D010348:Patient Care Team / Q000458:organization & administration*; D010372:Pediatrics / Q000458:organization & administration*; D011594:Psychometrics; D036301:Qualitative Research; D011787:Quality of Health Care; D018570:Risk Assessment; D011795:Surveys and Questionnaires
keywords: Complex care; patient- and family-centered care; “difficult” patient and/or family