Elsevier

Academic Pediatrics

Volume 16, Issue 5, July 2016, Pages 460-467
Academic Pediatrics

Hospital Medicine
The Patient Passport Program: An Intervention to Improve Patient–Provider Communication for Hospitalized Minority Children and Their Families

https://doi.org/10.1016/j.acap.2015.12.008Get rights and content

Abstract

Objective

Effective patient–provider communication is essential to improve health care delivery and satisfaction and to minimize disparities in care for minorities. The objective of our study was to evaluate the impact of a patient–provider communication program, the Patient Passport Program, to improve communication and satisfaction for hospitalized minority children.

Methods

This was a qualitative evaluation of a communication project for families with hospitalized children. Families were assigned to either the Patient Passport Program or to usual care. The Passport Program consisted of a personalized Passport book and additional medical rounds with medical providers. Semistructured interviews at the time of patient discharge were conducted with all participants to measure communication quality and patient/family satisfaction. Inductive qualitative methods were used to identify common themes.

Results

Of the 40 children enrolled in the Passport Program, 60% were boys; the mean age was 9.7 years (range, 0.16–19 years). The most common themes in the qualitative analysis of the interviews were: 1) organization of medical care; 2) emotional expressions about the hospitalization experience; and 3) overall understanding of the process of care. Spanish- and English-speaking families had similar patient satisfaction experiences, but the Passport families reported improved quality of communication with the medical care team.

Conclusions

The Patient Passport Program enhanced the quality of communication among minority families of hospitalized children with some common themes around the medical care expressed in the Passport book.

Section snippets

Patient Passport Program

This was a qualitative evaluation of a patient–provider communication project to enhance communication between minority (nonwhite) families and their medical providers in the inpatient setting. The Passport Program included a customized paper-based Passport book and an additional set of family-centered medical rounds during the hospital day with medical providers for the patient/family. The personalized patient Passport summarized patient-specific demographic and clinical data as a source of

Passport Program Participants

In phase 1 (Spanish-speaking families), 10 Passport Program and 10 usual-care families were enrolled. In phase 2 (minority English-speaking families), 10 Passport Program and 10 usual-care families were enrolled. Overall, when combining both phases of this project, for the Passport Program, 60% of the patients were boys, and the mean age of the hospitalized child was 9.7 years (range, 0.16–19 years), while 50% of usual-care patients were boys, and mean age was 5.9 years (range, 0.08–17 years).

Discussion

The Passport Program was designed as a patient–provider communication program to address the specific needs of communication-vulnerable populations, specifically Spanish-speaking as well as English-speaking minority families, by enhancing communication to improve patient-centered and culturally competent care. This need for improved communication was recognized to be particularly important around knowing the medical care team and understanding the patient's care plan and test results. Improved

Acknowledgments

Presented in part at the American Public Health Association annual meeting, San Francisco, Calif, October 27–31, 2012. This work was supported by the Blue Cross Blue Shield Foundation of Massachusetts by a Pathways to Cultural Competence grant. Blue Cross Blue Shield Foundation had no role in the study design, data analysis, or manuscript preparation.

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      Family-centered rounds provided an opportunity for patient, provider, and nurse communication and family engagement (Walker-Vischer et al., 2015; Zurca et al., 2017). One innovative project was the Patient Passport Program (Lee et al., 2016). Parents whose children were hospitalized on medical/surgical units received a passport book to record questions and comments and use as a reference during interpreter assisted, physician-nurse rounds.

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    Conflict of Interest: The authors declare that they have no conflict of interest.

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