Associate Professor UTHSC Memphis, Tennessee, United States
Background: Hospital admissions are known to cause parental emotional distress. This parental distress can present itself as inappropriate verbal or physical behavior. Our children’s hospital implemented a Family Focused Intervention Program (FFIP) in December of 2021 to address parental distress early in admission. The program was developed for two purposes: to provide families a space to identify underlying concerns or stressors, provide them with coping skills, and increase the sense of safety in the workplace by providing staff with a direct line of support and an action plan. Objective: We aimed to pilot a program to support families and staff when complex interactions are first noticed. Design/Methods: This study was a pilot intervention study. Anyone on the clinical team could make an FFIP referral. After a referral, the assessment and response team would perform an assessment, recommend the resources needed, and make an action plan. FFIP referrals were discussed in daily safety briefs. Also, all FFIP referrals were reviewed by a multi-disciplinary group that met monthly. This group reviewed the trigger for referral, the illness severity score, the behavioral score, what support was provided, and whether follow-up was needed or if the case could be closed out. Results: Over the two years, we had 96 referrals. The NICU had the most referrals at 40% (38). The age range of the patients was four days to 17 years old. African Americans made up 57% (55), and Caucasians made up 35% (34) of the population. Parental verbal behavior (40%) and emotional state (40%) were the most common triggers for a referral. The clinical psychologist continued to follow 66% (64) provided coping techniques, and helped with team communication, and the patient advocate 20% (19) of the referrals for follow-up and continued support for the family.
Conclusion(s): We present a novel approach to help address social determinants of health at our children’s hospital. We have built an infrastructure to address family stressors and staff safety by engaging with staff and parents early on in admission when specific triggers are present. The NICU had the most referrals, correlating with illness severity, unanticipated hospital admission, and the stressors of the postpartum period. We also highlight the importance of compassionately picking up on triggers early that could lead to inappropriate behavior later in long hospital admissions. In the future, we plan to analyze how these interventions affect our number of patient advocate, clinical psychologist, and security referrals.
