54 - Parent and Emergency Medical Services Professional Perspectives on Pediatric Care During Transports to the Emergency Department

Poster Number: 54
Publication Number: 54.407

Mark X. Cicero, Yale School of Medicine, New Haven, CT, United States; Janette Baird, The Warren Alpert Medical School of Brown University, Providence, RI, United States; Kathleen Adelgais, University of Colorado School of Medicine, Aurora, CO, United States; Marc Auerbach, Yale School of Medicine, Milford, CT, United States; Linda L. Brown, The Warren Alpert Medical School of Brown University, Providence, RI, United States

Background:
Family-centered care is associated with improved satisfaction and better outcomes in the hospital setting.

 

Objective:
The primary aim of this study was to assess parent perspectives on pediatric Emergency Medical Services (EMS), a setting where family-centered care is understudied.  A secondary aim was to compare parent’s perspectives and those of the EMS personnel.

Design/Methods: This is a prospective study of parents/guardians and EMS professionals associated with a pediatric EMS transport to one of two tertiary care children's emergency departments (EDs). Parents answered a previously validated 12-item survey of their perspectives after a pediatric patient was transported to the ED by an EMS service. The survey consisted of four domains related to transport experience: safety, communication with family, family participation, cultural awareness. Parents responded to the survey at the time of ED visit, and when available, data were matched with a response from an EMS professional involved with the patient transport (dyads). Responses to the items are reported as median with interquartile range (IQR) of the Likert-type response scale (1 -7), higher scores indicated a more positive response. EMS professionals and parents were asked an additional question about their overall satisfaction with the EMS care (1-5 scale). Analysis was conducted within each group and by dyads.

Results:

From November 2019 until October 2021, 287 EMS personnel and 219 parents or guardians (96.4% parents) completed the survey, with 85 dyads. Median score across the 12 items for EMS responses was 7 (IQR: 7,7; range 1-7) and across all components, except cultural awareness (median = 6.5, IQR: 5,7). Responses from parents also had a median score of 7 (IQR:7,7) across all items except asking about child’s modesty/religious needs (median = 7, IQR: 4,7).  Median EMS professional satisfaction with care and parent satisfaction with care were both 5 (IQR: 5,5). Agreements between dyads showed significant and positive agreement on how EMS cared for child, encouraging caregiver to be present, respectful care for child’s adaptive needs and with overall satisfaction with EMS service (Table 1).

 
Conclusion(s):
EMS personnel and caregivers of pediatric EMS patients showed good concordance regarding satisfaction across family communication, family participation and overall satisfaction domains. Dyad agreement was poorest for safety, cultural awareness and listening to parent concerns. Understanding parental perspectives of gaps in EMS safety, cultural awareness and acknowledging parent concerns may improve quality of pediatric EMS care.

Table 1: Agreement Among EMS Professionals and Parents for Pediatric EMS Care Domains* All survey items on 1-7 Likert type scale; *1-5 scale, higher values indicate greater endorsement. IQR = interquartile range; r = Spearman rank order correlation coefficient