Pediatric Chief Resident Childrens Hospital of Philadelphia Philadelphia, Pennsylvania, United States
Background: Pediatric patients who are lower income and those from minoritized racial and ethnic backgrounds are at increased risk of poor health outcomes. Differences in families’ experiences of care during pediatric hospitalizations may contribute to these inequities. Previous studies have found that Black and Latinx parents of pediatric patients report experiencing less partnership and being treated with less respect than white caregivers on inpatient rounds. However, no prior studies have quantified differences in inpatient rounding time and structure based on demographic characteristics. Objective: To examine the association between patient demographic characteristics (race, ethnicity, language and SES), and inpatient rounding structure, including (1) time spent on family-centered rounds and (2) questions asked by patients and family members during rounds. We hypothesize that inpatient general pediatrics teams may spend less time rounding with low-income and minoritized families, and that these families may have fewer opportunities to ask questions during rounds. Design/Methods: This observational study will focus on family-centered rounds on two General Pediatrics inpatient teams at an academic quaternary care children’s hospital. We are conducting daily observations of rounds to track time spent rounding with each patient and questions asked by parents and caregivers on rounds. We will abstract patient demographic information (sex, age, race, ethnicity, language, zip code and payer), and clinical information (discharge diagnosis, number of chronic conditions, subspecialty consults, and healthcare utilization in the previous year), from the Electronic Health Record. We will use multivariable linear regression to examine the relationship between patient demographic characteristics and inpatient rounding time and structure, after adjusting for patient clinical characteristics. We will use this information to inform future quality improvement initiatives aimed at promoting more equitable care for low-income and minoritized families in the inpatient setting.
