Physician and Nurse Nighttime Communication and Parents' Hospital Experience.
OBJECTIVE
Night teams of hospital providers have become more common in the wake of resident physician duty hour changes. We sought to examine relationships between nighttime communication and parents' inpatient experience.


METHODS
We conducted a prospective cohort study of parents (n = 471) of pediatric inpatients (0-17 years) from May 2013 to October 2014. Parents rated their overall experience, understanding of the medical plan, quality of nighttime doctors' and nurses' communication with them, and quality of nighttime communication between doctors and nurses. We tested the reliability of each of these 5 constructs (Cronbach's α for each >.8). Using logistic regression models, we examined rates and predictors of top-rated hospital experience.


RESULTS
Parents completed 398 surveys (84.5% response rate). A total of 42.5% of parents reported a top overall experience construct score. On multivariable analysis, top-rated overall experience scores were associated with higher scores for communication and experience with nighttime doctors (odds ratio [OR] 1.86; 95% confidence interval [CI], 1.12-3.08), for communication and experience with nighttime nurses (OR 6.47; 95% CI, 2.88-14.54), and for nighttime doctor-nurse interaction (OR 2.66; 95% CI, 1.26-5.64) (P < .05 for each). Parents provided the highest percentage of top ratings for the individual item pertaining to whether nurses listened to their concerns (70.5% strongly agreed) and the lowest such ratings for regular communication with nighttime doctors (31.4% excellent).


CONCLUSIONS
Parent communication with nighttime providers and parents' perceptions of communication and teamwork between these providers may be important drivers of parent experience. As hospitals seek to improve the patient-centeredness of care, improving nighttime communication and teamwork will be valuable to explore.
Division of General Pediatrics, Department of Medicine, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and alisa.khan@childrens.harvard.edu.
Alisa
A
Khan
Department of Nursing.
Jayne E
JE
Rogers
Center for Patient Safety and Quality Research, Boston Children's Hospital, Boston, Massachusetts.
Patrice
P
Melvin
Division of General Pediatrics, Department of Medicine.
Stephannie L
SL
Furtak
Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts;
G Mayowa
GM
Faboyede
Division of General Pediatrics, Department of Medicine, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and.
Mark A
MA
Schuster
Division of General Pediatrics, Department of Medicine, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Christopher P
CP
Landrigan
D000328:Adult; D002648:Child; D003142:Communication; D003266:Continuity of Patient Care; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010290:Parents; D010348:Patient Care Team; D019555:Physician-Nurse Relations; D011446:Prospective Studies