title: Parent and Provider Experience and Shared Understanding After a Family-Centered Nighttime Communication Intervention.
abstract: To assess parent and provider experience and shared understanding after a family-centered, multidisciplinary nighttime communication intervention (nurse-physician brief, family huddle, family update sheet).
  
  
  
  We performed a prospective intervention study at a children's hospital from May 2013 to October 2013 (preintervention period) and May 2014 to October 2014 (postintervention period). Participants included 464 parents, 176 nurses, and 52 resident physicians of 582 hospitalized 0- to 17-year-old patients. Pre- versus postintervention, we compared parent/provider top-box scores (eg, "excellent") for experience with communication across several domains; and level of agreement (shared understanding) between parent, nurse, and resident reports of patients' reason for admission, overnight medical plan, and overall medical plan, as rated independently by blinded clinician reviewers (agreement = 74.7%, kappa = .60).
  
  
  
  Top-box parent experience improved for 1 of 4 domains: Experience and Communication With Nighttime Doctors (23.6% to 31.5%). Top-box provider experience improved for all 3 domains, including Communication and Shared Understanding With Families (resident rated, 16.5% to 35.1%; nurse rated, 32.2% to 37.9%) and Experience, Communication, and Shared Understanding With Other Providers (resident rated, 20.3% to 35.0%; nurse rated, 14.7% to 21.5%). Independently rated shared understanding remained unchanged for most domains but improved for parent-nurse composite shared understanding (summed agreement for reason for admission, overall plan, and overnight plan; 36.2% to 48.2%) and nurse-resident shared understanding regarding reason for admission (67.1% to 71.2%) and regarding overall medical plan (45.0% to 58.6%). All P <.05.
  
  
  
  A family-centered, multidisciplinary nighttime communication intervention was associated with improvements in some, but not all, domains of parent/provider experience and shared understanding, particularly provider experience and nurse-family shared understanding. The intervention was promising but requires further refinement.
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address: alisa.khan@childrens.harvard.edu.
authors.forename: Alisa
authors.initials: A
authors.lastname: Khan
authors.affiliation: Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Baird
authors.affiliation: Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Jayne E
authors.initials: JE
authors.lastname: Rogers
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Stephannie L
authors.initials: SL
authors.lastname: Furtak
authors.affiliation: Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Williams
authors.affiliation: Family Advisory Council, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Brenda
authors.initials: B
authors.lastname: Allair
authors.affiliation: Center for Families, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Litterer
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Meesha
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Alla
authors.initials: A
authors.lastname: Smith
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schuster
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Sleep Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Landrigan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009726:Nurses; D010290:Parents; D010820:Physicians; D011368:Professional-Family Relations; D011446:Prospective Studies
keywords: communication; family-centered care; hospital experience; shared understanding