Parent-Provider Miscommunications in Hospitalized Children

BACKGROUND: Miscommunications lead to medical errors and suboptimal hospital experience. Parent-provider miscommunications are understudied. OBJECTIVES: (1) Examine characteristics of parent-provider miscommunications about hospitalized children, (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience, and (3) compare parent and attending physician reports of parent-provider miscommunications. METHODS: Prospective cohort study of 471 parents of 0- to 17-year-old medical inpatients in a pediatric hospital between May 1, 2013 and October 1, 2014. At discharge, parents reported parent-provider miscommunication and type (selecting all applicable responses), overall experience, and errors during hospitalization. During discharge billing, the attending physicians ( n = 52) of a subset of patients ( n = 217) also reported miscommunications, enabling comparison of parent and attending physician reports. We used logistic regression to examine characteristics of parent-reported miscommunications; McNemar’s test to examine associations between miscommunications, errors, and top-box (eg, “excellent”) experience; and generalized estimating equations to compare parent- and attending physician-reported miscommunication rates. RESULTS: Parents completed 406 surveys (86.2% response rate). 15.3% of parents ( n = 62) reported miscommunications. Parents of patients with nonpublic insurance (odds ratio: 1.99; 95% confidence interval: 1.03–3.85) and longer lengths of stay (odds ratio: 1.12; 95% confidence interval: 1.02–1.23) more commonly reported miscommunications. Parents reporting miscommunications were 5.3 times more likely to report errors and 78.6% less likely to report top-box overall experience ( P n = 35) of parents and 3.7% ( n = 8) of attending physicians reported miscommunications ( P CONCLUSIONS: Parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.