This career development proposal will provide Dr. Michelle Kelly, a Pediatric Hospitalist Physician at the University of Wisconsin School of Medicine and Public Health, with the training and mentorship required for success as an independent, physician-scientist leveraging tools and technologies supporting family engagement to improve the quality and safety of care of hospitalized children. Dr. Kelly has championed efforts to promote family engagement, including redesigning hospital rounds to include families and implementing a bedside portal ? an online application giving families? access to parts of their child?s inpatient medical record. She has attained an MS in Clinical Investigation to develop skills in conducting literature reviews, analyzing quantitative data, and designing clinical and translational studies. Building on this foundation, her proposed K08 career development plan focuses on three knowledge gaps: qualitative methods, human-centered design of interventions to support health communication and literacy, and systematic intervention implementation and evaluation. With the protected time afforded by this award for coursework, participation in national meetings and mentored research, Dr. Kelly will attain the critical skills necessary to develop and disseminate healthcare interventions. In her proposed research plan, she will develop BedsideNotes as a model intervention and implementation bundle. This bundle will consist of expanding the bedside portal to share inpatient doctors? admission and progress notes with families and complementary implementation strategies to optimally support family engagement while mitigating unintended negative consequences. She will develop this bundle using these aims: 1) identify family and clinician perspectives of barriers, facilitators and strategies to share inpatient doctors? notes; 2) develop BedsideNotes design requirements; and 3) implement and evaluate the feasibility and preliminary efficacy of BedsideNotes in a pilot study with families of hospitalized children. This proposed study responds directly to NOT-HS-13-011 and addresses multiple research areas, including health IT design and implementation, and will provide preliminary data describing the use and impact of health IT on family engagement and patient safety outcomes. As faculty at an institution with extensive research infrastructure, Dr. Kelly is in an ideal environment to complete this proposed research and pursue advanced training. Her career development plan includes protected time for coursework and mentorship from a committed team of experts in human factors and systems engineering, patient safety, qualitative methods, health communication/literacy, pediatric ethics, and health IT intervention design, implementation, evaluation and dissemination. At the end of this project, Dr. Kelly will have the preliminary data necessary to support a competitive R01 proposal in which she will test whether this intervention improves family engagement and safety concern reporting. This K08 award will also allow her to achieve her goal of independently leading a program leveraging tools and technologies to improve the safety of care of hospitalized children, an AHRQ priority population.
Hospitalized children suffer harm from medical errors at a rate three times that of adults and depend on clinicians to partner with their families to improve patient safety. Sharing doctors? notes, which detail their diagnoses, treatment and contingency plans, has prompted adult outpatients to identify safety concerns, over half of which resulted in changes of care. Extending this work to hospitals, the objective of this proposed research is to design an intervention, BedsideNotes, to share doctors? inpatient notes with families at the bedside to engage them in the care of their hospitalized child and partner with them to prevent harm.
