Parent and Emergency Physician Comfort with a System of On-Line Emergency-Focused Medical Summaries for Infants with Significant Cardiac Disease
- 129 Downloads
Surveys were developed and administered to assess parental comfort with emergency care for children with special health care needs (CSHCN) with cardiac disease and the impact of a web-based database of emergency-focused clinical summaries (emergency information forms-EIF) called Midwest Emergency Medical Services for Children Information System (MEMSCIS) on parental attitudes regarding emergency care of their CSHCN. We hypothesized that MEMSCIS would improve the parent and provider outlook regarding emergencies of young children with heart disease in a randomized controlled trial. Children under age 2 were enrolled in MEMSCIS by study nurses associated with pediatric cardiac centers in a metropolitan area. Parents were surveyed at enrollment and 1 year on a 5-Point Likert Scale. Validity and reliability of the survey were evaluated. Study nurses formulated the emergency-focused summaries with cardiologists. One-hundred-seventy parent subjects, 94 study and 76 control, were surveyed at baseline and 1 year. Parents felt that hospital personnel were well-prepared for emergencies of their children and this improved from baseline 4.07 ± 1.03 to 1 year 4.24 ± 1.04 in study parents who had an EIF for their child and participated in the program (p = 0.0114) but not control parents. Parents perceived an improved comfort level by pre-hospital (p = 0.0256) and hospital (p = 0.0031) emergency personnel related to the MEMSCIS program. The MEMSCIS Program with its emergency-focused web-based clinical summary improved comfort levels for study parents. We speculate that the program facilitated normalization for parents even if the EIF was not used in an emergency during the study. The MEMSCIS program helps to prepare the family and the emergency system for care of CSHCN outside of the medical home.
KeywordsChildren with special health care needs Emergency information form Emergency preparedness Congenital heart disease
- 4.American Academy of Pediatrics, Committee on Pediatric Emergency Medicine, Wiebe, R. A., Barlow, B. A., Foltin, G. L., Heath, B. W., Hodge, D., McCloskey, K. A., Pyles, L. A., Mulligan-Smith, D., Yeh, T. S. Emergency preparedness for children with special health care needs. Pediatrics Epages October 99.Google Scholar
- 6.US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (2000). Five-year plan: Emergency medical services for children, 2001–2005. Washington, DC: Emergency Medical Services for Children Resource Center.Google Scholar
- 9.NEMSIS EMS Data Definition. http://www.nemsis.org (Accessed 26 Nov 2007).
- 10.American Academy of Pediatrics Committee on Pediatric Emergency Medicine. (1999). Emergency preparedness for children with special health care needs. Pediatrics 104(4). URL: http://www.pediatrics.org/cgi/contents/full/104/4/53e.
- 11.Pyles, L. A., Einzig, S., Neal, W. A., & Moller, J. H. (1999). Congenital heart disease regional variability from a multicenter. Consortium Circular, 100, I–I736.Google Scholar
- 13.Consumer Assessment of Healthcare Providers and Systems. CAHPS Item Set for Children with Chronic Conditions. https://www.cahps.ahrq.gov/content/products/CCC/PROD_CCC_Intro.asp?p=1021&s=218 (Accessed 4 Sept 2007).
- 15.SPSS frequently asked questions. http://www.ats.ucla.edu/STAT/SPSS/faq/alpha.html. Accessed 23 Dec 2007.
- 16.National Center for Education in Maternal and Child Health. (1994). Emergency medical services for children: Abstracts of active projects FY 1994. Arlington, VA: National Center for Education in Maternal and Child Health. NM 21-21, WI 111-113, OH 28-29, Tri-State Appalachian, pp. 41–42.Google Scholar
- 17.Preparing the West Virginia EMS System for the Child of the Year 2000, US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (1997). Emergency medical services for children: Abstracts of active projects FY 1997 (pp. 80–82). Torrance, CA: National Emergency Medical Services for Children Resource Alliance.Google Scholar
- 18.A Model for the Coordination of EMS for Children with Special Health Care Needs, US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (1997). Emergency medical services for children: Abstracts of active projects FY 1997. Torrance, CA: National Emergency Medical Services for Children Resource Alliance (Rhode Island pp. 145–146).Google Scholar
- 20.EMSC Resource Center website www.ems-c.org, current grant section. Accessed 14 Apr 2007.
- 21.Urquhart, G. A., Williams, W., Tobias, J., & Welch, F. J. (2007). Immunization information systems use during a public health emergency in the United States. Journal of Public Health Management Practice, 13(5), 481–485.Google Scholar
- 22.AAFP’s Center for Health Information Technology. www.centerforhit.org (Accessed 14 Apr 2007).
- 23.Wisconsin Child Alert; personal communication.Google Scholar