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Alex Finlinson Katie Brown Tracy Golden Sarah Grant Emily Hoopes (Parent Consultant)

Development of a Survey Instrument to Assess Family Participation in Follow-up Care in Pediatric Antimicrobial Home Infusion Therapy. Alex Finlinson Katie Brown Tracy Golden Sarah Grant Emily Hoopes (Parent Consultant). Pediatric Antimicrobial Home Infusion Therapy (HIT).

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Alex Finlinson Katie Brown Tracy Golden Sarah Grant Emily Hoopes (Parent Consultant)

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  1. Development of a Survey Instrument to Assess Family Participation in Follow-up Care in Pediatric Antimicrobial Home Infusion Therapy Alex Finlinson Katie Brown Tracy Golden Sarah Grant Emily Hoopes (Parent Consultant)

  2. Pediatric Antimicrobial Home Infusion Therapy (HIT) • The administration of IV antibiotic/antimicrobial in the home is to treat an acute infection. • The administration of the antibiotic/antimicrobial is for a time-limited period and is not an ongoing infusion that may be part of the child's regular, daily care. • The person giving the IV treatment is the child's parent or other family member, not a medical professional providing a paid service

  3. Statement of Problem • Missed follow-up visits for HIT may be cost inefficient and may contribute to a lower quality of care and poorer outcomes for families, including re-hospitalization.

  4. Key Literature • HIT follow-up appointments will likely reduce the rate of re-hospitalization (Nguyen 2010; Gilchrist, Franklin & Patel, 2008). • Scheduling, clinic attributes, and transportation contribute to missed follow-up appointments (Daggey et al., 2010; Chariatte, Berchtold, Akré, Michaud & Suris, 2008 ). • Individual characteristics contribute to missed follow-up appointments (Daggey et al.; Chariatte et al.). • Families of children on HIT may have similar risk factors, but may have unique factors as well.

  5. Objectives • Year I: Develop and beta test a survey instrument to gain insight into the perspective of parents regarding HIT and assess possible underlying causes for missed follow-up visits in pediatric, antimicrobial HIT (2011-2012). • Year II: Deliver the survey to a random sample of parents participating in HIT and use results to make recommendations for process change (2012-2013).

  6. Methods • Procedures – survey development and testing • Participants - volunteer families with child participants of HIT • Analysis – synthesis of feedback to refine the survey

  7. Results/Data Analysis • Parent Feedback • Qualtrics Survey • Correlational Analysis: • Demographics • Satisfaction with HIT • Barriers to Follow-up • Family’s experience with HIT

  8. Limitations • Small number of parents who provided feedback for beta testing • Lack of a pilot of the survey to collect and analyze a sample of data • Only provided in English which will limit participation by minority groups such as Spanish speakers

  9. Emily Feedback • A web-based survey attempts to address obstacles of distance, time & availability for respondents. • Limitations of a web-based study: • May exclude respondents without web access at home (lower income, working parents). • Patients most likely to respond may also be more likely to attend follow-up appointments. • Respondents must be self-motivated to seek out study. • Many chronic patients are over-surveyed & question the value of this type of study. • Not possible to beta test across diagnoses (acute vs. chronic).

  10. Sarah Feedback • Post PDC discussion with mentors • Include time for discussion immediately after each PDC • Positive and critical feedback in a timely manner to better understand the layers of complexity and subtlety in working with families –focusing on the interaction more than the content

  11. Katie Feedback Nutrition Therapy for children with special health care needs Interdisciplinary teams in the school setting Physical activity for persons with disabilities

  12. Tracy Feedback • Identify the change/additions to the program that you are suggesting: clinic discussion group • Identify how it could/should be implemented • Discussion time during a seminar • Individual assignment with reaction to clinic visit • Identify why you think this would make you a more effective leader • Time to process what is/isn’t effective in clinic settings that we could bring into our own work settings as models

  13. Alex Feedback • Encourage and build strong mentor and trainee relationships • Create expectations or guidelines of communication • Enhances experience, communication skills, goal setting, and networking

  14. Special Thanks • To Emily Hoopes, volunteer families, and our project mentor Terry Pavia

  15. References • Nguyen HH. Hospitalist to home: outpatient parenteral antimicrobial therapy at an academic center. Clin Infect Dis.51 Suppl 2:S220-223. • Gilchrist M, Franklin BD, Patel JP. An outpatient parenteral antibiotic therapy (OPAT) map to identify risks associated with an OPAT service. J Antimicrob Chemother. 2008;62:177-183. • Daggy J, Lawley M, Willis D, Thayer D, Suelzer C, DeLaurentis PC, Turkcan A, Chakraborty S, Sands L. Using no-show modeling to improve clinic performance. Health Informatics Journal. 2010;16: 246. • Chariatte V, Berchtold A, Akré C, Michaud PA, Suris JC. Missed appointments in an outpatient clinic for adolescents, an approach to predict the risk of missing. Journal of Adolescent Health. 43 2008; 38–45.

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