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Team Communication and Expectations Following Pediatric Cardiac Surgery: A Multi-Disciplinary Survey

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Abstract

Patients and families desire an accurate understanding of the expected recovery following congenital cardiac surgery. Variation in knowledge and expectations within the care team may be under-recognized and impact communication and care delivery. Our objective was to assess knowledge of common postoperative milestones and perceived efficacy of communication with patients and families and within the care team. An 18-question survey measuring knowledge of expected milestones for recovery after four index operations and team communication in the postoperative period was distributed electronically to multidisciplinary care team members at 16 academic pediatric heart centers. Answers were compared to local median data for each respondent’s heart center to assess accuracy and stratified by heart center role and years of experience. We obtained 874 responses with broad representation of disciplines. More than half of all respondent predictions (55.3%) did not match their local median data. Percent matching did not vary by care team role but improved with increasing experience (35.8% < 2 years vs. 46.4% > 10 years, p = 0.2133). Of all respondents, 62.7% expressed confidence discussing the anticipated postoperative course, 78.6% denoted confidence discussing postoperative complications, and 55.3% conveyed that not all members of their care team share a common expectation for typical postoperative recovery. Most respondents (94.6%) stated that increased knowledge of local data would positively impact communication. Confidence in communication exceeded accuracy in predicting the timing of postoperative milestones. Important variation in knowledge and expectations for postoperative recovery in pediatric cardiac surgery exists and may impact communication and clinical effectiveness.

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Abbreviations

LOS:

Length of stay

PC4:

Pediatric Cardiac Critical Care Consortium

CNU:

Cardiac Networks United

TBC:

Target-Based Care

VSD:

Ventricular Septal Defect

TOF:

Tetralogy of Fallot

BDG:

Bidirectional Glenn

ASO:

Arterial Switch Operation

ICU:

Intensive Care Unit

PCICU:

Pediatric Cardiac Intensive Care Unit

References

  1. Franck L, Mcquillan A, Wray J, Grocott M, Goldman A (2010) Parent stress levels during children’s hospital recovery after congenital heart surgery. Pediatr Cardiol 31(7):961–968

    Article  PubMed  Google Scholar 

  2. LeRoy S, Elixson E, O’Brien P, Tong E, Turpin S et al (2003) Recommendations for preparing children and adolescents for invasive cardiac procedures: a statement from the American Heart Association Pediatric nursing subcommittee of the council on cardiovascular nursing in collaboration with the council on cardiovascular diseases of the young. Circulation 108(10):2550–2564

    PubMed  Google Scholar 

  3. Shudy M, de Almeida M, Ly S, Landon C, Groft S et al (2006) Impact of pediatric critical illness and injury on families: a systematic literature review. Pediatrics 118(Suppl 3):5203–5219

    Google Scholar 

  4. Lion K, Wright D, Spencer S, Zhou C, Del Beccaro M, Mangione-Smith R (2016) Standardized clinical pathways for hospitalized children and outcomes. Pediatrics. 2016;137(4).

  5. Rove K, Edney J, Brockel M (2018) Enhanced recovery after surgery in children: promising, evidence-based multidisciplinary care. Pediatr Anesth 28(6):482–492

    Article  Google Scholar 

  6. Shin A, Rao I, Bassett H, Chadwick W, Kim J, Kipps A et al (2021) Target-based care: an intervention to reduce variation in postoperative length of stay. J Pediatr 228:208–212

    Article  PubMed  Google Scholar 

  7. Harris P, Taylor R, Thielke R, Payne J, Gonzalez N et al (2009) Research electronic data capture (REDCap) A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 42(2):377–81

    Article  PubMed  Google Scholar 

  8. Harris P, Taylor R, Minor B, Elliott V, Fernandez M et al (2019) The REDCap consortium: building an international community of software partners. J Biomed Inform. https://doi.org/10.1016/j.jbi.2019.103208

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D (2016) Squire 2.0 (Standards for quality improvement reporting excellence): revised publication guidelines from a detailed consensus process. BMJ Qual Saf. 25(12):986–992

    Article  PubMed  Google Scholar 

  10. Eysenbach G (2004) Improving the quality of web surveys: the checklist for reporting results of internet e-surveys (Cherries). J Med Internet Res 6(3):e34

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jacobs M, Jacobs J, Thibault D, Hill K, Anderson B et al (2021) Updating an empirically based tool for analyzing congenital heart surgery mortality. World J Pediatr Congenit Heart Surg 12(2):246–281

    Article  PubMed  Google Scholar 

  12. Hummel K, White B, Algaze C, Marrone T, Sinnott J, Wawrzynski S et al (2021) Bedside benchmarks: transparent data to reduce variation in postoperative care. NEJM Catalyst. https://doi.org/10.1056/CAT.21.0032

    Article  Google Scholar 

  13. Nassar A, Caruso P (2015) ICU physicians are unable to accurately predict length of stay at admission: a prospective study. Int J Qual Health Care 28(1):99–103

    Article  PubMed  Google Scholar 

  14. Gusmão Vicente F, Polito Lomar F, Mélot C, Vincent J (2004) Can the experienced ICU physician predict ICU length of stay and outcome better than less experienced colleagues? Intensive Care Med 30(4):655–659

    Article  PubMed  Google Scholar 

  15. Pagel C, Bull C, Utley M, Wray J, Barron D, Stoica S et al (2019) Exploring communication between parents and clinical teams following children’s heart surgery: a survey in the UK. BMJ Paediatrics Open 3(1):e000391

    Article  PubMed  PubMed Central  Google Scholar 

  16. Blumenthal-Barby J, Krieger H (2015) Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy. Med Decis Making 35:539–557

    Article  CAS  PubMed  Google Scholar 

  17. Saposnik G, Redelmeier D, Ruff C, Tobler P (2016) Cognitive biases associated with medical decisions: a systematic review. BMC Med Inform Decis Mak 16:138

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

The authors have no financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, CA, USA

    Julie Bushnell & Amy N. McCammond

  2. University of Cincinnati School of Medicine, Cincinnati Children’s Hospital and James M. Anderson Center for Health Systems Excellence, Cincinnati, OH, USA

    Chloe Connelly

  3. Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA

    Claudia A. Algaze, Monica Mafla, Laura Presnell & Andrew Y. Shin

  4. Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA

    David K. Bailly

  5. Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA

    Andrew Koth

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  1. Julie Bushnell
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  2. Chloe Connelly
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  3. Claudia A. Algaze
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  4. David K. Bailly
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  6. Monica Mafla
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  7. Laura Presnell
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  8. Andrew Y. Shin
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  9. Amy N. McCammond
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Contributions

A.M., J.B., C.A., L.P, and M.M. primarily wrote the manuscript text. C.C performed the statistical analysis and preparation of all figures. All authors participating significantly in review and editing of the manuscript.

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Correspondence to Amy N. McCammond.

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Bushnell, J., Connelly, C., Algaze, C.A. et al. Team Communication and Expectations Following Pediatric Cardiac Surgery: A Multi-Disciplinary Survey. Pediatr Cardiol 44, 908–914 (2023). https://doi.org/10.1007/s00246-022-03059-9

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  • DOI: https://doi.org/10.1007/s00246-022-03059-9

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